Electroencephalographic abnormalities in COVID-19-related encephalopathies: A systematic review

Jie Pan MD, PhD, Shazma Khan BSA, Smathorn Thakolwiboon MD, Dargelis Chi MD


Background: Acute encephalopathy is a common neurological manifestation in coronavirus disease 2019 (COVID-19) patients and presents with confusion, delirium, or poor responsiveness. Non-convulsive status epilepticus (NCSE) is an important differential diagnosis in this situation. The electroencephalography (EEG) patterns in COVID-19 patients remain largely unknown.

Method: A literature search was conducted on MEDLINE, EMBASE, and Cochrane database. Eligibility criteria included case series and case reports of COVID-19 patients with neurological complication who underwent EEG. Two authors screened all resulting studies and extracted the data independently.

Results: Four retrospective case control studies and eleven case reports were identified. Background diffuse slow activity were seen in most of the COVID-19 patients. Other EEG patterns reported included status epilepticus, focal slow activity, rhythmic periodic discharges, and interictal epileptiform discharges. Imaging and CSF studies were available in only a few patients.

Conclusions: Acute encephalopathy is common in the context of COVID-19. There is no specific EEG pattern found in these patients.

Keywords: COVID-19, coronavirus, SAR-CoV-2, electroencephalogram, EEG

Article citation: Pan J, Khan S, Thakolwiboon S, Chi D. Electroencephalographic abnormalities in COVID-19-related encephalopathies: A systematic review. The Southwest Respiratory and Critical Care Chronicles 2020;8(35):36–41
From: Department of Neurology (JP, ST, DC) and the School of Medicine (SK), Texas Tech University Health Sciences Center, Lubbock, Texas
Submitted: 7/10/2020
Accepted: 7/13/2020
Reviewer: Kenneth Nugent MD
Conflicts of interest: none
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.