Treatment of COVID-19-induced Refractory Status Epilepticus by Tocilizumab
Overview
Affiliations
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.
Gui R, Li Z, Wang J, Zu Y, Zhang B, Zhao J Heliyon. 2024; 10(22):e40356.
PMID: 39624308 PMC: 11609442. DOI: 10.1016/j.heliyon.2024.e40356.
DePaula-Silva A Viruses. 2024; 16(1).
PMID: 38257819 PMC: 10819099. DOI: 10.3390/v16010119.
Neuroinflammation and status epilepticus: a narrative review unraveling a complex interplay.
Foiadelli T, Santangelo A, Costagliola G, Costa E, Scacciati M, Riva A Front Pediatr. 2023; 11:1251914.
PMID: 38078329 PMC: 10703175. DOI: 10.3389/fped.2023.1251914.
SARS-CoV-2 Variants, Current Vaccines and Therapeutic Implications for COVID-19.
Liang H, Wu Y, Yau V, Yin H, Lowe S, Bentley R Vaccines (Basel). 2022; 10(9).
PMID: 36146616 PMC: 9504858. DOI: 10.3390/vaccines10091538.
Frequency of new seizures after SARS-CoV-2 infections may depend on the length of follow-up.
Finsterer J Seizure. 2022; 104:43-44.
PMID: 35965222 PMC: 9359591. DOI: 10.1016/j.seizure.2022.08.001.