Acta Epileptologica | 2021
Special issue on the battle against complex virus world in the human brain: seizure as a result of viral infection
Abstract
The corona virus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a big threat to human health. Studies have shown that SARS-CoV-2 can also invade the central nervous system (CNS) [1]. Currently, it remains unclear if SARS-CoV-2 infection could cause status epilepticus [2]. However, some viruses or their sub-classes have been known to cause brain damage, which would then initiate or worsen seizure attacks (Table 1). A comprehensive understanding of the relationship between viral infection and seizure would provide insight into the effects of SARS-CoV-2 on seizures, in this particular COVID-19 crisis. In this special issue, we provide a collection of papers discussing on the following questions: which viruses can induce epileptic seizures? In what way do viruses invade human body? What are the vectors for different viruses? Is seizure directly caused by a virus or indirectly induced by immune response? What are the seizure features and electroencephalogram findings after virus infection? What is the treatment and prognosis for viral infection? Can we develop specific vaccines for viral infection? Acta Epileptologica is an international academic journal that publishes advances in epileptic research. Viruses are an important cause for seizures. To highlight the important roles of viruses in epilepsy, especially under the current COVID-19 pandemic, Acta Epileptologica publishes this special issue on “Virus and Epilepsy”, focusing on four viruses: arbovirus, human immunodeficiency virus (HIV), picornavirus, and human herpes virus 6 (HHV6), from perspectives of pathogenesis, pathogenicity, clinical characteristics, treatment, and prognosis of seizure induction or enhancement after viral infection. Most importantly, the mechanisms underlying viral association with epileptogenesis are also discussed. In the paper entitled “Arbovirus and seizures”, Mingrui Zheng et al. summarized the most common arboviruses associated with epidemic viral encephalitis. Viral encephalitis affects both children and adults, usually leading to severe neurological sequelae. Arboviruses of the genus Flavivirus are usually transmitted by mosquitoes and other host animals. Among various arboviruses, the Japanese encephalitis virus, West Nile virus, Zika virus, Dengue virus and Chikungunya virus can induce seizures. Seizures may not be the major manifestation, but may predict a poor prognosis. The occurrence of seizure is mainly caused by direct cell damage by the virus, secondary glial and immune responses producing inflammatory cytokines, and damage to the blood-brain barrier. Different virus infections may lead to mild or severe symptoms, with varied occurrence of epilepsy. The seizure type can usually be focal or generalized, or even status epilepticus. The generalized tonic-clonic seizures are the most common type. EEG recordings have consistently found a pattern of diffuse slow activity. During occurrence of seizure, patients typically manifest with abnormalities including theta and delta coma, burst suppression, an isoelectric pattern, or occasionally alpha coma. Effective treatment of associated epileptic seizures, mostly symptomatic support and anti-virus therapy, enables good supportive care and optimal control of CNS-related comorbidities. However, usually there is a lack of effective treatment methods.(https://aepi.