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Certain factors related to lockdown, such as insomnia, anxiety or reduction in economic income can worsen the control of epileptic seizures.
COVID-19 is causing negative effects in epilepsy patients, especially related to lockdown measures during the peak of the pandemic. That has been demonstrated by a study carried out by the Epilepsy Unit of the Neurology Service at Vall d’Hebron University Hospital and the Epilepsy Research Group at Vall d’Hebron Institute of Research (VHIR), which has observed that insomnia, anxiety or reduction in economic income makes the seizures control difficult.
The work, published in Acta Neurologica Scandinavica, consisted on telephone surveys to 255 patients with epilepsy during their control visits that were carried out between March 16 and April 17. The survey’s aim was to find out the impact that COVID-19 pandemic and lockdown were having on these patients. During the month-long study, the researchers found that seizure control worsened in 25 of the participating patients.
On the other hand, about half of those surveyed had anxiety and/or depression during the lockdown period, and a high percentage of patients experienced changes in their sleep patterns, especially insomnia. This finding corresponds to previous studies that relate sleep deprivation with the appearance of epileptic seizures. In addition, about a third of the patients explained that the economic income of their family environment had been reduced due to the pandemic. “With this study we have observed that these factors associated with lockdown would be related to a worse control of epileptic seizures in patients”, explains Dr. Elena Fonseca, clinical researcher at the Epilepsy Research Group at VHIR, Neurology associate at Vall d’Hebron University Hospital and first author of the work.
Regarding the origin of epilepsy, there are some types that would pose a greater risk when lockdown, such as epilepsies caused by a tumor. “These cases are usually more serious already and are more likely to worsen from various causes. These patients are more vulnerable and tend to suffer more anxiety or depression”, says Dr. Fonseca. Researchers emphasize that knowing the profile of the most vulnerable cases is important to help clinicians guide medical visits and improve their care for each patient.
With the idea of improving patient care, the survey also included questions about the perception of the care received through telemedicine during lockdown. In this sense, the vast majority of the respondents were satisfied with these visits. Therefore, this tool could be helpful for healthcare professionals to have greater contact with their patients during the pandemic, especially with those who are at higher risk or who are more vulnerable.
Regarding COVID-19, five of the surveyed patients were diagnosed with COVID-19 through a PCR test, two of whom died. “All patients in our study who were diagnosed with COVID-19 had other important risk factors, such as advanced age, that predispose to severe symptoms. Although the study design does not allow definitive conclusions in this regard, these data are in line with the idea that epilepsy in itself would not increase the risk of severe COVID-19”, points out Dr. Fonseca. Based on other studies, SARS-CoV-2 infection also does not seem to be associated with complications of epilepsy.
These findings should be confirmed in new studies since in this case only the data of patients with a PCR positive result were analyzed. At the time of work, this test was not routinely performed in the majority of mild cases of COVID-19. In the same way, a prospective study would be necessary to understand in depth the effects of lockdown in COVID-19 in epilepsy.
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