Medication-resistant acute focal motor seizures in a child with COVID-19 affecting the CNS

Area of Science:

• Neurology
• Infectious Diseases
• Pediatrics

Background:

• Pediatric focal aware motor seizures can have diverse etiologies.
• The neurological manifestations of SARS-CoV-2 infection in children are still being understood.
• Cerebral lesions have been observed in some pediatric COVID-19 cases.

Purpose of the Study:

• To report a case of acute repetitive focal aware motor seizures in a preschool girl.
• To investigate the potential link between SARS-CoV-2 infection and new-onset seizures.
• To explore the efficacy of intravenous immunoglobulin in managing COVID-19-associated seizures.

Main Methods:

• Clinical presentation and neurological examination.
• Brain Magnetic Resonance Imaging (MRI) to identify structural abnormalities.
• Cerebrospinal fluid (CSF) Polymerase Chain Reaction (PCR) for SARS-CoV-2 detection.
• Pharmacological treatment with anti-seizure medications and intravenous immunoglobulin.

Main Results:

• A preschool girl presented with acute, repetitive focal aware motor seizures.
• Brain MRI revealed a lesion in the left posterior cortex.
• CSF PCR confirmed the presence of SARS-CoV-2.
• Seizures were refractory to four anti-seizure medications but ceased following intravenous immunoglobulin administration.

Conclusions:

• SARS-CoV-2 infection may trigger focal aware motor seizures in children.
• A cortical inflammatory process secondary to COVID-19 is a potential mechanism.
• Intravenous immunoglobulin demonstrated significant efficacy in resolving seizures in this case, warranting further investigation.