Skip to main content
Advertisement
  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Genetics
    • Neuroimmunology & Neuroinflammation
    • Education
  • Online Sections
    • Neurology Video Journal Club
    • Inclusion, Diversity, Equity, Anti-racism, & Social Justice (IDEAS)
    • Innovations in Care Delivery
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Null Hypothesis
    • Patient Pages
    • Translations
    • Topics A-Z
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center

Advanced Search

Main menu

  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Genetics
    • Neuroimmunology & Neuroinflammation
    • Education
  • Online Sections
    • Neurology Video Journal Club
    • Inclusion, Diversity, Equity, Anti-racism, & Social Justice (IDEAS)
    • Innovations in Care Delivery
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Null Hypothesis
    • Patient Pages
    • Translations
    • Topics A-Z
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Practice Current
  • Practice Buzz

User menu

  • Subscribe
  • My Alerts
  • Log in

Search

  • Advanced search
Neurology Clinical Practice
Home
A peer-reviewed clinical neurology journal for the practicing neurologist
  • Subscribe
  • My Alerts
  • Log in
Site Logo
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Practice Current
  • Practice Buzz

Share

February 2022; 12 (1) Research

EEG Abnormalities and Their Radiographic Correlates in a COVID-19 Inpatient Cohort

View ORCID ProfileSean T. Hwang, Ahmad A. Ballout, Anup N. Sonti, Amitha Kapyur, Claudia Kirsch, Neeraj Singh, Noah Markowitz, Tung Ming Leung, Derek J. Chong, Richard Temes, Steven V. Pacia, Ruben I. Kuzniecky, Souhel Najjar
First published October 7, 2021, DOI: https://doi.org/10.1212/CPJ.0000000000001136
Sean T. Hwang
Department of Neurology (STH, AAB, NS, DJC, SVP, RIK, SN), Zucker School of Medicine; Zucker School of Medicine (ANS, AK); Department of Neuroradiology (CK), Zucker School of Medicine, Hempstead; Feinstein Institutes for Medical Research (NM, TML), Manhasset; and Department of Neurosurgery (RT), Zucker School of Medicine, Hempstead, NY.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Sean T. Hwang
Ahmad A. Ballout
Department of Neurology (STH, AAB, NS, DJC, SVP, RIK, SN), Zucker School of Medicine; Zucker School of Medicine (ANS, AK); Department of Neuroradiology (CK), Zucker School of Medicine, Hempstead; Feinstein Institutes for Medical Research (NM, TML), Manhasset; and Department of Neurosurgery (RT), Zucker School of Medicine, Hempstead, NY.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Anup N. Sonti
Department of Neurology (STH, AAB, NS, DJC, SVP, RIK, SN), Zucker School of Medicine; Zucker School of Medicine (ANS, AK); Department of Neuroradiology (CK), Zucker School of Medicine, Hempstead; Feinstein Institutes for Medical Research (NM, TML), Manhasset; and Department of Neurosurgery (RT), Zucker School of Medicine, Hempstead, NY.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Amitha Kapyur
Department of Neurology (STH, AAB, NS, DJC, SVP, RIK, SN), Zucker School of Medicine; Zucker School of Medicine (ANS, AK); Department of Neuroradiology (CK), Zucker School of Medicine, Hempstead; Feinstein Institutes for Medical Research (NM, TML), Manhasset; and Department of Neurosurgery (RT), Zucker School of Medicine, Hempstead, NY.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Claudia Kirsch
Department of Neurology (STH, AAB, NS, DJC, SVP, RIK, SN), Zucker School of Medicine; Zucker School of Medicine (ANS, AK); Department of Neuroradiology (CK), Zucker School of Medicine, Hempstead; Feinstein Institutes for Medical Research (NM, TML), Manhasset; and Department of Neurosurgery (RT), Zucker School of Medicine, Hempstead, NY.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Neeraj Singh
Department of Neurology (STH, AAB, NS, DJC, SVP, RIK, SN), Zucker School of Medicine; Zucker School of Medicine (ANS, AK); Department of Neuroradiology (CK), Zucker School of Medicine, Hempstead; Feinstein Institutes for Medical Research (NM, TML), Manhasset; and Department of Neurosurgery (RT), Zucker School of Medicine, Hempstead, NY.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Noah Markowitz
Department of Neurology (STH, AAB, NS, DJC, SVP, RIK, SN), Zucker School of Medicine; Zucker School of Medicine (ANS, AK); Department of Neuroradiology (CK), Zucker School of Medicine, Hempstead; Feinstein Institutes for Medical Research (NM, TML), Manhasset; and Department of Neurosurgery (RT), Zucker School of Medicine, Hempstead, NY.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Tung Ming Leung
Department of Neurology (STH, AAB, NS, DJC, SVP, RIK, SN), Zucker School of Medicine; Zucker School of Medicine (ANS, AK); Department of Neuroradiology (CK), Zucker School of Medicine, Hempstead; Feinstein Institutes for Medical Research (NM, TML), Manhasset; and Department of Neurosurgery (RT), Zucker School of Medicine, Hempstead, NY.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Derek J. Chong
Department of Neurology (STH, AAB, NS, DJC, SVP, RIK, SN), Zucker School of Medicine; Zucker School of Medicine (ANS, AK); Department of Neuroradiology (CK), Zucker School of Medicine, Hempstead; Feinstein Institutes for Medical Research (NM, TML), Manhasset; and Department of Neurosurgery (RT), Zucker School of Medicine, Hempstead, NY.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Richard Temes
Department of Neurology (STH, AAB, NS, DJC, SVP, RIK, SN), Zucker School of Medicine; Zucker School of Medicine (ANS, AK); Department of Neuroradiology (CK), Zucker School of Medicine, Hempstead; Feinstein Institutes for Medical Research (NM, TML), Manhasset; and Department of Neurosurgery (RT), Zucker School of Medicine, Hempstead, NY.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Steven V. Pacia
Department of Neurology (STH, AAB, NS, DJC, SVP, RIK, SN), Zucker School of Medicine; Zucker School of Medicine (ANS, AK); Department of Neuroradiology (CK), Zucker School of Medicine, Hempstead; Feinstein Institutes for Medical Research (NM, TML), Manhasset; and Department of Neurosurgery (RT), Zucker School of Medicine, Hempstead, NY.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Ruben I. Kuzniecky
Department of Neurology (STH, AAB, NS, DJC, SVP, RIK, SN), Zucker School of Medicine; Zucker School of Medicine (ANS, AK); Department of Neuroradiology (CK), Zucker School of Medicine, Hempstead; Feinstein Institutes for Medical Research (NM, TML), Manhasset; and Department of Neurosurgery (RT), Zucker School of Medicine, Hempstead, NY.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Souhel Najjar
Department of Neurology (STH, AAB, NS, DJC, SVP, RIK, SN), Zucker School of Medicine; Zucker School of Medicine (ANS, AK); Department of Neuroradiology (CK), Zucker School of Medicine, Hempstead; Feinstein Institutes for Medical Research (NM, TML), Manhasset; and Department of Neurosurgery (RT), Zucker School of Medicine, Hempstead, NY.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Full PDF
Citation
EEG Abnormalities and Their Radiographic Correlates in a COVID-19 Inpatient Cohort
Sean T. Hwang, Ahmad A. Ballout, Anup N. Sonti, Amitha Kapyur, Claudia Kirsch, Neeraj Singh, Noah Markowitz, Tung Ming Leung, Derek J. Chong, Richard Temes, Steven V. Pacia, Ruben I. Kuzniecky, Souhel Najjar
Neurol Clin Pract Feb 2022, 12 (1) 52-59; DOI: 10.1212/CPJ.0000000000001136

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Permissions

Make Comment

See Comments

Downloads
438

Share

  • Article
  • Figures & Data
  • Info & Disclosures
Loading

Abstract

Background and Objectives To identify the prevalence of EEG abnormalities in patients with coronavirus disease 2019 (COVID-19) with neurologic changes, their associated neuroimaging abnormalities, and rates of mortality.

Methods A retrospective case series of 192 adult COVID-19-positive inpatients with EEG performed between March and June 2020 at 4 hospitals: 161 undergoing continuous, 24 routine, and 7 reduced montage EEG. Study indication, epilepsy history, intubation status, administration of sedatives or antiseizure medications (ASMs), metabolic abnormalities, neuroimaging pathology associated with epileptiform abnormalities, and in-hospital mortality were analyzed.

Results EEG indications included encephalopathy (54.7%), seizure (18.2%), coma (17.2%), focal deficit (5.2%), and abnormal movements (4.6%). Epileptiform abnormalities occurred in 39.6% of patients: focal intermittent epileptiform discharges in 25.0%, lateralized periodic discharges in 6.3%, and generalized periodic discharges in 19.3%. Seizures were recorded in 8 patients, 3 with status epilepticus. ASM administration, epilepsy history, and older age were associated with epileptiform abnormalities. Only 26.3% of patients presented with any epileptiform abnormality, 37.5% with electrographic seizures, and 25.7% patients with clinical seizures had known epilepsy. Background findings included generalized slowing (88.5%), focal slowing (15.6%), burst suppression (3.6%), attenuation (3.1%), and normal EEG (3.1%). Neuroimaging pathology was identified in 67.1% of patients with epileptiform abnormalities, over two-thirds acute. In-hospital mortality was 39.5% for patients with epileptiform abnormalities and 36.2% for those without. Risk factors for mortality were coma and ventilator support at time of EEG.

Discussion This article highlights the range of EEG abnormalities frequently associated with acute neuroimaging abnormalities in COVID-19. Mortality rates were high, particularly for patients in coma requiring mechanical ventilation. These findings may guide the prognosis and management of patients with COVID-19 and neurologic changes.

Footnotes

  • Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.

  • COVID-19 Resources: NPub.org/COVID19

  • Received December 16, 2020.
  • Accepted August 18, 2021.
  • © 2021 American Academy of Neurology
View Full Text

The Nerve!: Rapid online correspondence

  • Author Response: EEG Abnormalities and Their Radiographic Correlates in a COVID-19 Inpatient Cohort
    • Sean T. Hwang, Neurologist, Zucker School of Medicine at Hofstra/Northwell
    • Derek J. Chong, Neurologist, Zucker School of Medicine at Hofstra/Northwell
    • Claudia F. Kirsch, Neuroradiologist, Zucker School of Medicine at Hofstra/Northwell
    • Neeraj Singh, Neurologist, Zucker School of Medicine at Hofstra/Northwell
    Submitted April 29, 2022
  • Reader Response: EEG Abnormalities and Their Radiographic Correlates in a COVID-19 Inpatient Cohort
    • Nitin K. Sethi, Associate Professor of Neurology, New York-Presbyterian Hospital, Weill Cornell Medical Center, New York, NY 10065
    Submitted December 26, 2021
Comment

REQUIREMENTS

If you are uploading a letter concerning an article:
You must have updated your disclosures within six months: http://submit.neurology.org

Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.

If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.

Submission specifications:

  • Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
  • Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
  • Submit only on articles published within 6 months of issue date.
  • Do not be redundant. Read any comments already posted on the article prior to submission.
  • Submitted comments are subject to editing and editor review prior to posting.

More guidelines and information on Disputes & Debates

Compose Comment

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
NOTE: The first author must also be the corresponding author of the comment.
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Publishing Agreement
NOTE: All authors, besides the first/corresponding author, must complete a separate Publishing Agreement Form and provide via email to the editorial office before comments can be posted.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

You May Also be Interested in

Back to top
  • Article
    • Abstract
    • Methods
    • Results
    • Discussion
    • Acknowledgment
    • Study Funding
    • Disclosure
    • Appendix Authors
    • Footnotes
    • References
  • Figures & Data
  • Info & Disclosures
Advertisement

Related Articles

  • No related articles found.

Alert Me

  • Alert me when eletters are published
Neurology: Clinical Practice: 12 (4)

Articles

  • Ahead of Print
  • Current Issue
  • Past Issues
  • Popular Articles

About

  • About the Journals
  • Ethics Policies
  • Editors & Editorial Board
  • Contact Us
  • Advertise

Submit

  • Author Center
  • Submit a Manuscript
  • Information for Reviewers
  • AAN Guidelines
  • Permissions

Subscribers

  • Subscribe
  • Activate a Subscription
  • Sign up for eAlerts
  • RSS Feed
Site Logo
  • Visit neurology Template on Facebook
  • Follow neurology Template on Twitter
  • Visit Neurology on YouTube
  • Neurology
  • Neurology: Clinical Practice
  • Neurology: Genetics
  • Neurology: Neuroimmunology & Neuroinflammation
  • Neurology: Education
  • AAN.com
  • AANnews
  • Continuum
  • Brain & Life
  • Neurology Today

Wolters Kluwer Logo

Neurology: Clinical Practice |  Print ISSN: 2163-0402
Online ISSN: 2163-0933

© 2022 American Academy of Neurology

  • Privacy Policy
  • Feedback
  • Advertise