Retrospective Analysis of EEG in Patients With COVID-19: EEG Recording in Acute and Follow-up Phases.

Background. Interest in electroencephalographic (EEG) coronavirus disease 2019 (COVID-19) findings has been growing, especially in the search for a specific-features EEG of encephalopathy. Methods. We made a retrospective analysis of 29 EEGs recorded in 15 patients with COVID-19 and neurological symptoms. We classified the EEGs as "Acute EEG" and "follow-up EEG." We did a statistical analysis between voltage and respiratory status of the patient, stay or not in the intensive care unit (ICU), days of stay in the ICU, sedative drugs, pharmacological treatment, type of symptoms predominating, and outcome. Results. We found EEG abnormalities in all patients studied. We observed the amplitude of background <20 µV at 93% of "acute EEG," versus only 21.4% of "follow-up EEG." The average voltage went from 12.33 ± 5.09 µV in the acute EEGs to 32.8 ± 20.13 µV in the follow-up EEGs. A total of 60% of acute EEGs showed an intermittent focal rhythmic. We have not found a statistically significant association between voltage of acute EEG and nonneurological clinical status (including respiratory) that may interfere with the EEG findings. Conclusions. Nonspecific diffuse slowing EEG pattern in COVID-19 is the most common finding reported, but we found in addition to that, as a distinctive finding, low voltage EEG, that could explain the low prevalence of epileptic activity published in these patients. A metabolic/hypoxic mechanism seems unlikely on the basis of our EEG findings. This pattern in other etiologies is reminiscent of severe encephalopathy states associated with poor prognosis. However, an unreactive low voltage pattern in COVID-19 patients is not necessarily related to poor prognosis.

Clinical and genetical study of a familial form of REM sleep behavior disorder.

OBJECTIVE: We report a kindred with a genetic form of REM behaviour disorder (RBD) with autosomal dominant transmission. PATIENTS AND METHODS: Clinical, polysomnography study, genetic study and brain MRI were performed to evaluate the index patients. The genetic study included exome sequencing of the index cases that detected 60,869 variants in the individuals examined. RESULTS: The kindred has a RBD with autosomal dominant transmission starting in second decade of life. After filtering out the exome variants shared by two affected cases the pool of variants could be reduced to thirteen; one of them is in PVALB, a calcium-binding albumin protein present in gabaergic interneurons in the nervous system that inhibit the pyramidal cell during REM sleep. CONCLUSIONS: RBD can have a genetic origin. The results of the exome study in this kindred suggest that gabaergic circuits may be altered in patients with RBD. Further studies in this family or in other pedigrees with familial RBD may clear the role of this gene in this disorder.

Parada cardiorrespiratoria en un paciente con SAHS / No disponible

El Síndrome de apnea hipopnea del sueño (SAHS) se contempla como una enfermedad crónica. Sin embargo, algunos pacientes con SAHS pueden presentar episodios agudos, en relación con alteraciones en la repolarización ventricular, como arritmias potencialmente mortales, parada cardiorrespiratoria e incluso muerte súbita. La repolarización ventricular se ha evaluado mediante mediciones de la onda T y el intervalo QT. El incremento de mortalidad en pacientes con SAHS, especialmente durante la noche, obliga a identificar parámetros predictores de trastornos de la repolarización miocárdica, así como evaluar un tratamiento eficaz en este tipo de pacientes donde la parada cardiorrespiratoria, puede ser el primer síntoma de esta enfermedad (AU)

Obstructive sleep apnea syndrome (OSAS) is a common chronic respiratory sleep disorder; however, patients with OSAS may occasionally present with severe cardiac arrhythmias and sudden cardiac death caused by electrical disturbances during ventricular repolarization. The assessment of ventricular repolarization has been evaluated by using T wave and QT interval measurements. Increased mortality in patients with OSAS, particularly at night, emphasizes the importance of identifying possible parameters by which OSAS could affect myocardial electrical stability and requires the study of an effective treatment in this kind of patients where the cardiac arrest, could be the first symptom of this disease (AU)