Coronavirus in a patient with positive PCR test in cerebrospinal fluid led to an acute generalized tonic-clonic convulsion without brain lesion in computed tomography scan: a case report

SARS-CoV-2 which first was observed in Wuhan region, China in December 2019 has affected many organs, such as central nervous system. We describe a case of a 57-year-old male patient, in the hospital with the loss of consciousness, in the form of lack of verbal and visual communication. He got a seizure attack for about 3 minutes in the form of generalized tonic-clonic seizure (GTS) and admitted to the neurological department and was intubated. Since, the patient was not aware, awake, did not obey, corneal reflexes test was positive and his pupils were isochoric and reactive therefore, the primary diagnosis was cerebrovascular accident (CVA). On the second day after admission, although the brain computed tomography (CT) did not show brain lesion, but the chest X-ray (CXR) revealed lung involvement. In addition, on third day the RT-PCR test for coronavirus RNA in and the cerebrospinal fluid and nasopharyngeal swap done and the result was positive for both of them. Therefore, treatment for the covid-19 was started.

Since, the treatment for the covid-19 was started with Atazanavir, Clindamycin and Ceftriaxone. Ten days after hospitalization, the lung involvement and general condition of patient got better and after two weeks he was released from the hospital.

GTS should be considered as a neurological outcome of COVID-19 and medications against the coronavirus, such as Atazanavir, Clindamycin and ceftriaxone can recover the neurological deficits in these patients.