Electroencephalography and somatosensory evoked potentials in Covid-19 patients. Experience in recording and using telemedicine technologies to analyze results

Abstract

A new coronavirus COVID-19 has led to the development of a global pandemic. It is characterized by a high risk of developing pneumonia and multiple organ failure along with its capability to influence the central nervous system. The main methods of instrumental assessment of the functional state of the brain are electroencephalography (EEG) and somatosensory evoked potentials (SEPs), which have been routinely used with patients in critical care units. We recorded the EEGs and short-latency SEPs of 31 COVID-19 patients, all were treated at the N. V. Sklifosovsky Research Institute of Emergency Care in 2020. The combined data was used to analyse the following outcome. We detected abnormal EEGs in 23 COVID-19 patients (74 %). Seven (30.4 %) patients showed EEGs consisting of diffuse non-specific slowing, 4 patients had lateralized hemispheric slowing (17.4 %) and one patient (4,3 %) had frontal intermittent delta activity (FIRDA). Three (13 %) patients in comas had “burst-suppression» pattern, three (13 %) had isoelectric EEGs and two (8,7 %) had areactive alpha rhythm, regarded as an electrographic manifestation of alpha coma. Two patients had evidence of epileptiform discharges (9 %), triphasic waves were presented in one patient (4.3 %). EEG and SEPs with the median nerve stimulation in COVID-19 patients do not reveal specific changes, nevertheless they are informative instrumental methods for assessing the functional state of the brain to identify biomarkers of epileptic seizures and to prognosticate survival and recovery in comatose patients.