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

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.

Features of electrophysiological activity in a neonate with severe post-hypoxic brain damage (post-hypoxic cerebral depression)

The article briefly presents the literature data and a description of the clinical dynamic observation of a patient with severe hypoxic brain damage (from the neonatal period to 4 months of life), in the conditions of the neonatal intensive care unit. The article describes the clinical picture, features of paroxysmal states and antiepileptic therapy, dynamics of neuroimaging data, electroencephalographic phenomena recorded in a patient with cerebral depression and structural cerebral injuries. The significance of electroencephalographic examination in the intensive care unit as an informative method for assessing cerebral activity in young children with central nervous system depression syndrome is shown. Disorganization of background activity, indicating structural cerebral damage, long-term persistence of slow-wave activity, detection of epileptic changes in the form of generalized flashes of pointed waves in the theta range, alpha-coma pattern, subsequently replaced by suppression of the background pattern in the patient, are typical electrophysiological disorders recorded in severe hypoxic encephalopathy. In conditions of limited opportunities for visual diagnosis of a patient with impaired consciousness, EEG remains the only method of obtaining information about the functional state of the brain, the data obtained during the study are an important prognostic criterion.