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Treatment of COVID-19-induced Refractory Status Epilepticus by Tocilizumab

Overview
Journal Eur J Neurol
Publisher Wiley
Specialty Neurology
Date 2022 Jun 9
PMID 35678591
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Abstract

Background And Purpose: COVID-19 is a novel infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in which neurological complications have been increasingly recognized. Acute symptomatic epileptic seizures and status epilepticus are frequently reported neurological complications associated with this infection. The nervous system damage caused by SARS-CoV-2 may be mediated by the immune system. Interleukin 6 (IL-6), an important component of the cytokine storm, is directly correlated with the severity of symptoms. Tocilizumab is an inhibitor of IL-6 receptors, which blocks IL-6-mediated signal transduction and is used in the treatment of COVID-19 and status epilepticus.

Case Report: A patient with the Unverricht-Lundborg disease is presented who had developed refractory recurrent status epilepticus during COVID-19 infection, which was finally controlled by treatment with tocilizumab.

Discussion: Tocilizumab, an IL-6 inhibitor, may be considered as a treatment option in patients with status epilepticus and refractory seizures.

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References
1.
Carroll E, Neumann H, Aguero-Rosenfeld M, Lighter J, Czeisler B, Melmed K . Post-COVID-19 inflammatory syndrome manifesting as refractory status epilepticus. Epilepsia. 2020; 61(10):e135-e139. PMC: 7537028. DOI: 10.1111/epi.16683. View

2.
Kashyap H, Gupta V, Gupta A, Gupta T, Sharma S, Valjiyani S . Post-COVID Syndrome (MIS-C) with Refractory Status Epilepticus. Indian J Pediatr. 2021; 88(7):721. PMC: 8057941. DOI: 10.1007/s12098-021-03731-7. View

3.
Anwar M . Immunotherapies and COVID-19 related Neurological manifestations: A Comprehensive Review Article. J Immunoassay Immunochem. 2021; 41(6):960-975. DOI: 10.1080/15321819.2020.1865400. View

4.
Dono F, Nucera B, Lanzone J, Evangelista G, Rinaldi F, Speranza R . Status epilepticus and COVID-19: A systematic review. Epilepsy Behav. 2021; 118:107887. PMC: 7968345. DOI: 10.1016/j.yebeh.2021.107887. View

5.
Emami A, Fadakar N, Akbari A, Lotfi M, Farazdaghi M, Javanmardi F . Seizure in patients with COVID-19. Neurol Sci. 2020; 41(11):3057-3061. PMC: 7501768. DOI: 10.1007/s10072-020-04731-9. View