4.7 Article

Treatment of COVID-19-induced refractory status epilepticus by tocilizumab

Journal

EUROPEAN JOURNAL OF NEUROLOGY
Volume 29, Issue 9, Pages 2861-2863

Publisher

WILEY
DOI: 10.1111/ene.15440

Keywords

COVID-19 infection; status epilepticus; tocilizumab; Unverricht-Lundborg disease

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COVID-19 infection can lead to neurological complications, including epileptic seizures and status epilepticus. IL-6 plays an important role in the severity of symptoms, and tocilizumab, as an IL-6 inhibitor, can be used for the treatment of these complications.
Background and purpose COVID-19 is a novel infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in which neurological complications have been increasingly recognized. Acute symptomatic epileptic seizures and status epilepticus are frequently reported neurological complications associated with this infection. The nervous system damage caused by SARS-CoV-2 may be mediated by the immune system. Interleukin 6 (IL-6), an important component of the cytokine storm, is directly correlated with the severity of symptoms. Tocilizumab is an inhibitor of IL-6 receptors, which blocks IL-6-mediated signal transduction and is used in the treatment of COVID-19 and status epilepticus. Case report A patient with the Unverricht-Lundborg disease is presented who had developed refractory recurrent status epilepticus during COVID-19 infection, which was finally controlled by treatment with tocilizumab. Discussion Tocilizumab, an IL-6 inhibitor, may be considered as a treatment option in patients with status epilepticus and refractory seizures.

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