Although COVID-19 has no direct clinical effect on epilepsy, the European Association of Neurology (EAN) has published guidance on clinicians the impact of the pandemic on management of epilepsy.
“To our knowledge, no publication covering epilepsy, seizures or paroxysmal events has so far been published in relation to COVID-19. However, there are several general aspects to address,” it states.
EAN’s 5 recommendations:
- People with epilepsy (PwE) may stop taking their medicine because of social isolation or because of difficulty or concerns about seeking medical assistance during the pandemic.
- The high fever associated with COVID-19 infection may be a risk for trigger of seizures in some people. Antipyretic treatment with paracetamol should be advised (or ibuprofen if deemed necessary, despite concerns raised by French doctors).
- Closure or restriction of access to neurology outpatient clinics may disrupt continuity of care for people with epilepsy. Phone or telehealth consultations should be used where possible, and clinicians should identify high risk patients who will still require face-to-face consultations.
- Use of immunomodulatory or immunosuppressive therapy in epilepsy is rare, but risk stratification should be used in situations where they are used such as in infancy and childhood (e.g. ACTH) or autoimmune encephalitis.
- Consider potential drug interactions and possible dose adjustment for anti-epileptic medication if novel therapies for COVID-19 are used such as antivirals and immunomodulatory drugs, as well as supportive therapies.
The EAN also recommends the European Reference Network (ERN) Epilepsy Care Recommendations for patients be distributed to people with epilepsy.