Post-Covid epilepsy: Symptoms, causes, treatment of epilepsy in Covid survivors
Covid-19 can affect our body in various ways and some of its long-term effects are noticed months after the infection.
Symptoms like dry cough, fever, fatigue, cough and cold, myalgia may be tip of the iceberg in many individuals as studies are now emerging how the deadly virus can attack our liver, kidney, brain, nervous system and change our lives forever.
Covid is not only one of the factors behind increasing incidence of heart attack in young people, it is also causing unexpected complications like stroke and epilepsy in a few. Covid can also cause neurological complications like delirium, confusion, headache, and loss of sense of smell and taste.
Covid can gain entry to our nervous system directly through nerve pathways or indirectly through the ACE2 receptor. The neurological symptoms of a Covid-19 infection in the brain are mainly due to either the entry of pro-inflammatory cytokines into the nervous system or the production of these cytokines by microglia and astrocytes, according to a National Library of Medicine article. Pro-inflammatory cytokines can cause blood-brain barrier disruption, increase in glutamate and aspartate and reduce GABA levels, impairs the function of ion channels, and finally, high levels of cytokines can cause epilepsy, as per NIH.
All about Covid-induced epilepsy
“Covid infection rarely causes epilepsy and where a few cases have been reported it’s mostly in cases where the brain has been affected as well. In certain cases of Covid-related complications, which have been seen in neurological complications like strokes and haemorrhages, and cerebral venous sinus thrombosis, there are structural changes reported in the brain. And they may present and predispose a person to develop Covid-related epilepsy. People who already have epilepsy in the background, and especially in people in which the epilepsy was not very well controlled before the Covid infection in these patients, epilepsy seems to worsen after Covid infection. But it is also mostly due to erratic drug response or drug interactions or missing doses of Covid medicine and related to sleep deprivation or because of the stress factor. All these factors may lead to seizures,” says Dr Ishu Goyal, Associate Consultant, Neurology at Sir HN Reliance Foundation Hospital.
Symptoms of post-Covid epilepsy
Dr Goyal says symptoms of epilepsy post Covid are more or less the same. In this epilepsy also patients may have seizures, which the patient already had in the background with maybe tonic-clonic seizures, jerky movements of the body or abnormal lip movements or fiddling movements of the hand or sometimes blank stares also which are called absent seizures. So, these seizures are not different from what is seen in a non-Covid epilepsy.
Treatment of post-Covid epilepsy
“The treatment of post Covid epilepsy is also more or less the same. It includes intake of various anti convergent drugs which are pretty safe, even when taken during the Covid infection. So, the treatment almost remains the same. The thing to be noted is that even during the Covid infection and post Covid infection, proper rest, proper sleep, a disciplined life and proper intake of medication without any missed doses should be emphasised upon and seizures are most likely to be controlled,” says Dr Goyal.
The expert says it’s important to continue the epilepsy medicine even during the Covid infection as a predisposed body with an underlying infection can put one at risk of seizures.