Neurocysticercosis, Epilepsy, COVID-19 and a Novel Hypothesis: Cases Series and Systematic ReviewAuthor(s): Humberto Foyaca Sibat*
Background: There have been many patients with neurological manifestations reported in medical literature following a COVID-19 infection. We conducted a literature review to identify patients with coronavirus disease (COVID-19) who presented with Neurocysticercosis (NCC) and associated seizure disorders/ epilepsy. Currently, there is a new variant of the COVID-19 virus strain invading South Africa and no indication when this pandemic will end and what kind of tardive sequelae may occur going forward.
Case: We searched the medical literature looking for all publications regarding NCC, Status Epilepticus (SE), Epileptic Seizures (ES), and Epilepsy (Ep), in patients infected by COVID-19. Based on the therapeutic response of our series, we propose a novel approach for patients presenting NCC, epilepsy and associated with COVID-19. We have hypothesized on the pathogenesis of ES and SE from the NCC/Cytokine Release Syndrome (CRS), SARS-CoV-2/CRS, including the role played by gut microbiota from the enteric nervous system (gut hormones, gut metabolites, inflammatory factors, neuroactive substances, and microbiota-derived products) to the medulla oblongata/hypothalamus-pituitary-adrenal axis via microbiota gut brain axis in ES, Ep and associated depression, plus the mechanism of hyperferritinemia on the overall process. This article is the first publication approaching this comorbidity as far as we know.
Abbreviations: AED: Antiepileptic Drug; AD: Alzheimer's Disease; ANS: Autonomic Nervous System; ASD: Autism Spectrum Disorder; ASM: Anti-seizure Medication; BBB: Bloodbrain Barrier; BDNF: Brain-derived Neurotrophic Factor; BT: Baricitinib; CBZ: Carbamazepine; CPEC: Choroid Plexus Epithelial Cells; CNS: Central Nervous System; COVID-19: Coronavirus Disease 19; CRP: C-reactive Protein; CRS: Cytokine Release Syndrome; COVID-19: Coronavirus Disease 2019; CSF: Cerebrospinal Fluid; CT: Computer Tomography; DRE: Drug-resistant Ep; EAE: Experimental Autoimmune Encephalomyelitis; Ep: Epilepsy; ES: Epileptic Seizure; FMT: Faecal Microbiota Transplantations; GBA: Gut-Brain Axis; GI: Gastrointestinal GM: Gut Microbiota; HCoV-229E: Human Coronavirus 229E; HCoV-OC43: Human Coronavirus OC43; HCoV-NL63: Human Coronavirus NL63; HCoV-HKU1: Human Coronavirus HKU1; HF: Hyperferritinemia; HPA: Hypothalamic-pituitary-adrenal Axis; HRV: Heart Rate Variability; ICU: Intensive Care Unit; IEC: Intestinal Epithelial Cell; IFN-γ: Interferon-gamma; IL-6: Interleukin 6; IMB: Itestinal Mucosa Barrier; IVIG: Intravenous Immunoglobulin; LCS: Lacosamide; LEV: Levetiracetam; LMT: Lamotrigine; MA: Microglial Activation; MCA: Middle Cerebral Artery; MERS-CoV: Mild Encephalitis/Encephalopathy with a Reversible Splenial Lesion and Coronavirus; MDD: Major Depressive Disorder; MO: Medulla Oblongata; MOG: Myelin-oligodendrocyte Glycoprotein; MPTP: 1-Methyl-4-Phenyl-1,2,3,6-Tetrahydropyridine; MS: Multiple Sclerosis; NLRs: NOD-like Receptors; NPS: Neuropsychiatric Disorders; OCP: Obsessive-compulsive Disorder; PAM: Perivascular-activated Microglia; PHB: Phenobarbital; PBMCs: Peripheral Blood Mononuclear Cells; PD: Parkinson's Disease; PHE: Phenobarbital; PHY: Phenytoin; PSA: Polysaccharide A; PSD: Posttraumatic Stress Disorder; RA: Rheumatoid Arthritis; SARS: Severe Acute Respiratory Syndrome; SCFAs: Short-chain Fatty Acids; SE: Status Epilepticus; SLE: Systemic Lupus Erythematosus; SSD: Schizophrenia Spectrum Disorders; TCGS: tonic-clonic-Generalized Seizures; TCR: T Cell Receptor; Th: T Helper; TNF-α: Tumour Necrotizing Factor-alpha; Treg: T Regulatory; VA: Valproic Acid; 5-HT: 5-Hydroxytryptophan.