Table 1. Clinical profile and demographic data of the 24 studies including 33 cases.
Author | Country | Age and sex | Respiratory/ systemic symptom onset | Symptoms | Onset | Method of COVID-19 diagnosis | CSF profile | Brain imaging (CT/MRI) | EEG | Cytokines profile |
---|---|---|---|---|---|---|---|---|---|---|
Duong et al.11 | USA | 41 years, female | NR | Seizure | NR | RT-PCR | Lymphocytic pleocytosis, increased RBC | Normal brain CT with contrast | Generalized slowing with no epileptic discharge | NR |
Bernard-Valnet et al.12 | Switzerland | 64 years, female | 5 days | Tonic-clonic seizures, disorientation, psychosis | Acute (not specified) | RT-PCR | Lymphocytic pleocytosis, increased protein | Normal brain MRI | Nonconvulsive focal status epilepticus | NR |
67 years, female | 17 days | Headache, confused | Few hours before admission | RT-PCR | Lymphocytic pleocytosis, increased protein | Normal brain MRI | NR | NR | ||
Ye et al.13 | China | Male (age NR) | 4 days | Altered consciousness, confusion | Acute (not specified) | RT-PCR | Normal | Normal brain CT | NR | NR |
McAbee et al.14 | USA | 11 years, male | 2 days | Status epilepticus | Acute (not specified) | RT-PCR | Neutrophilic pleocytosis, increased protein and RBC | Normal brain CT | Frontal intermittent delta activity | NR |
Andriuta et al.15 | France | Middle-aged female | 7 days | Gait disturbance, hypopallesthesia, bladder and bowel incontinence | Progressively developed on day 16 of admission | RT-PCR | NR | Brain MRI: medial mesencephalic hyperintensity | Normal | NR |
Middle-aged male | NR | Altered consciousness, flaccid tetraparesis | NR | RT-PCR | NR | Brain MRI: bilateral diffuse white-matter hyperintensities | NR | NR | ||
Chaumont et al.16 | France | 69 years, male | 7 days | Confusion, headache | 1 day before admission | RT-PCR/CT | Lymphocytic pleocytosis, increased protein | Normal brain MRI | Bilateral slowing | NR |
Sohal and Mansur17 | USA | 72 years, male | NR | Weakness, lightheadedness, seizure | Day 3 of admission | RT-PCR | NR | Brain CT: chronic microvascular changes | Six left temporal seizures | NR |
Pilotto et al.18 | Italy | 60 years, male | 2 days | Altered consciousness | 5 days before admission | RT-PCR | Lymphocytic pleocytosis, increased protein | Normal brain CT | Generalized slowing with reduced reactivity to acoustic stimuli | Increased IL-6, IL-8, TNF-α, and β2-microglobulin |
Al-Olama et al.19 | UAE | 36 years, male | 2 days | Drowsy, headache | 4 days after respiratory symptom | RT-PCR | NR | Brain CT: right frontal intracerebral hematoma with subarachnoid hemorrhage in ipsilateral sylvian fissure and frontal and temporal lobes suggestive of viral encephalitis | NR | NR |
Moriguchi et al.20 | Japan | 24 years, male | 1 day | Generalized seizure, unconsciousness | 9 days after respiratory symptom | CT/RT-PCR CSF | Increased opening pressure, mononuclear pleocytosis | Right lateral ventriculitis and encephalitis in right mesial lobe and hippocampus | NR | NR |
Vandervorst et al.21 | Belgium | 29 years, male | 7 days | Generalized weakness, disorientation | 10 days after respiratory symptom | RT-PCR | Normal | Hyperintensity in the left medial temporal lobe with mild gyral expansion | General excess beta rhythm with left temporal delta activity | NR |
Wong et al.22 | UK | 40 years, male | 10 days | Unsteady gait | Day 3 of admission | RT-PCR | Normal | Suggestive of inflammatory rhombencephalitis/ myelitis | NR | NR |
Zandifar and Zandifar23 | Iran | 49 years, male | 2 days | Tonic–clonic seizure, altered consciousness | Acute (not specified) | Clinical, imaging, and exclusion of other possibilities | Pleocytosis, increased protein | Diffuse brain edema | NR | NR |
39 years, male | 5 days | Tonic seizure, altered consciousness, disorientation | Day 3 of admission | RT-PCR | NR | NR | NR | NR | ||
Farhadian et al.24 | USA | 78 years, female | 2 days | Uncontrolled limb movements | 3 days before admission | RT-PCR | Brain MRI: atrophy and patchy periventricular and subcortical white matter hyperintensities | Mild generalized slowing | Increased IL-6, IL-8, and IFN-γ-induced protein 10 | |
Chalil et al.25 | Canada | 48 years, female | 14 days | Altered consciousness | Day 15 of admission | RT-PCR+CT | Neutrophilic pleocytosis | Brain CT: extensive bilateral parietal and occipital intraparenchymal hemorrhage and interventricualr extension with hydrocephalus | NR | NR |
Afshar et al.26 | Iran | 39 years, female | 9 days | Altered consciousness, tonic–clonic seizure | 1 day after respiratory symptom | Clinical, imaging, and serology | Normal | Brain MRI: hyperintensities in bilateral thalami, medial temporal lobe, and pons | NR | NR |
Bodro et al.27 | Spain | 25 years, male | 1 day | Confusion and agitation | 12 hours after respiratory symptom | RT-PCR | Lymphocytic pleocytosis, increased protein | Normal brain CT and MRI | NR | NR |
49 years, male | 7 days | Disorientation | Few hours after admission | RT-PCR | Lymphocytic pleocytosis, increased protein | Normal brain CT and MRI | NR | NR | ||
Abdi et al.28 | Iran | 58 years, male | No complaint | Altered consciousness | 1 month, progressive over 2 days | RT-PCR | Increased glucose | Brain MRI: diffuse confluent white-matter hyperintensities | NR | NR |
Delamarre et al.29 | France | 51 years, male | 10 days | Altered consciousness | 11 days after respiratory symptom | RT-PCR | Albumin-cytological dissociation | Brain MRI: bilateral hyperintensities in bilateral thalami | Low-voltage symmetrical delta activity | |
Huang et al.30 | USA | 40 years, female | NR | Syncope and altered mental status | NR | RT-PCR | Normal | NR | NR | NR |
Khoo et al.31 | UK | 65 years, female | Respiratory symptoms at 2 weeks before admission | Involuntary movements, diplopia, cognitive decline | 7 days before admission | RT-PCR | Normal | Normal brain MRI | Normal | NR |
Zambreanu et al.32 | UK | 66 years, female | NR | Altered consciousness, confusion | Few hours before admission | RT-PCR | Increased protein | Hyperintensities in mesial temporal lobes and medial thalami | NR | NR |
Panariello et al.33 | Italy | 23 years, male | NR | Psychosis | 3 days | RT-PCR | Normal | Normal | 6 Hz theta activity | Increased IL-6 |
Dogan et al.34 | Turkey | 49 years, male | NR | Altered consciousness | NR | RT-PCR | Increased protein | Suggestive of encephalitis | NR | Increased IL-6 |
59 years, male | NR | Altered consciousness | NR | RT-PCR | Increased protein | Suggestive of encephalitis | NR | Increased IL-6 | ||
59 years, male | NR | Altered consciousness | NR | RT-PCR | Increased protein | Normal | NR | Normal | ||
51 years, female | NR | Altered consciousness | NR | RT-PCR | Increased protein | Normal | NR | Normal | ||
55 years, male | NR | Altered consciousness | NR | RT-PCR | Increased protein | Normal | NR | Normal | ||
22 years, male | NR | Altered consciousness | NR | RT-PCR | Increased protein | Suggestive of encephalitis | NR | Increased IL-6 |
COVID-19, coronavirus disease 2019; CSF, cerebrospinal fluid; CT, computed tomography; EEG, electroencephalography; IFN-γ, interferon gamma; NR, not reported; RBC, red blood cells; RT-PCR, reverse-transcription PCR.