An international study of the effects of the COVID-19 pandemic on characteristics of functional seizures

• Authors: Ali A. Asadi-Pooya, Shiraz University of Medical Science; Eugen Trinka, Paracelsus Medical University; Coraline Hingray, Pôle universitaire adulte du Grand Nancy; Ahmad Fawaz, IbnSina Hospital; Ioannis Karakis, Emory University; Nirmeen A. Kishk, Cairo University; Mohsen Farazdaghi, Shiraz University of Medical Science; Julia Hoefler, Paracelsus Medical University; Alexis Tarrada, University of Paris; Abdulaziz Ashkanani, New Ahmadi Hospital; Aida Risman, Emory University; Haytham Rizk, Cairo University
• Journal Title: EPILEPSY & BEHAVIOR
• Volume: Volume 127
• Publisher: ACADEMIC PRESS INC ELSEVIER SCIENCE | 2022-02-01, Pages 108530-108530
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1016/j.yebeh.2021.108530
• Subjects: Biology, Neuroscience; Biology, Virology; Psychology, Clinical
• Keywords: Science & Technology; Life Sciences & Biomedicine; Behavioral Sciences; Clinical Neurology; Psychiatry; Neurosciences & Neurology; COVID; Coronavirus; Dissociative; PNES; Seizure; PSYCHOGENIC NONEPILEPTIC SEIZURES; RISK-FACTORS; SEMIOLOGY; ETIOLOGY

Abstract

Objective: We investigated whether the COVID-19 pandemic has affected the clinical characteristics of patients with functional seizure (FS) (at the time of diagnosis) in a large multicenter international study. Methods: This was a retrospective study. We investigated all patients with FS, who were admitted at the epilepsy monitoring units at six centers in the world: 1. Shiraz, Iran; 2. Salzburg, Austria; 3. Nancy, France; 4. Atlanta, USA; 5. Kuwait City, Kuwait; and 6. Cairo, Egypt. Patients were studied during two time periods: admitted in 2018–2019 (pre-COVID era) and 2020–2021 (COVID era). Results: Three hundred and twenty-six patients were studied. Two hundred and twenty-four (68.7%) patients were diagnosed before and 102 (31.3%) persons during the COVID-19 pandemic. Only, a history of family dysfunction was significantly associated with the COVID-19 pandemic era (Odds Ratio: 1.925, 95% Confidence Interval: 1.099–3.371; p = 0.022). A low level of education might also be associated with FS during the COVID-19 pandemic, at least in some cultures (e.g., the Middle-East). Conclusion: The COVID-19 pandemic has not affected the clinical characteristics of patients with FS (at the time of diagnosis). However, a history of family dysfunction was significantly more frequently associated with FS during the COVID-19 pandemic. Multiagency integration of law enforcement responses, social services, and social awareness is recommended to address family dysfunction and domestic violence and support the victims during this pandemic.