Understanding and managing the impact of the COVID-19 pandemic and lockdown on patients with epilepsy

ABSTRACT

Introduction

The coronavirus disease 2019 (COVID-19) pandemic represented a relevant issue for people with epilepsy (PwE). Medical care and social restrictions exposed PwE to a high risk of seizure worsening. Medical institutions answered to the pandemic assuring only emergency care and implementing a remote assistance that highlighted the technological obsolescence of the medical care paradigms for PwE.

Area covered

We reviewed the literature on the COVID-19-related factors influencing the epilepsy course, from the evidence of seizure risk in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infected PwE to anti-Sars-Cov-2 drugs interactions with antiseizure medications and the perceived changes of seizures in PwE.

Expert opinion

COVID-19 pandemic was a problematic experience for PwE. We must make treasure of the lessons learned during this period of social restrictions and employ the recent technological advances to improve PwE assistance, in particular telemedicine and electronic media for patients’ education.

KEYWORDS:

• COVID-19
• anti-seizure medications
• epilepsy
• anxiety
• depression
• sleep
• telemedicine

Article highlights

• The coronavirus disease 2019 (COVID-19) pandemic exposed people with epilepsy (PwE) to harmful consequences mainly coming from medical shortenings.

• Scientific evidence does not support a direct pathophysiologic relationship between severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and seizures.

• Worsening of seizures in PwE is indirectly related to SARS-CoV-2 through medical shortenings and behavioral consequences of social restrictions.

• Medical care system revealed as technologically inadequate to face with these issues.

• Telemedicine, digital remote assistance and electronic media should be exploited to renew medical assistance to PwE, reducing in-persons examinations and increasing resilience of medical care system.

Declaration of interests

G Assenza received honoraria for expert testimony by Livanova LFC. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or conflict with the subject matter or materials discussed in this manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

Funding This paper was not funded.