It has now been several weeks since the confinement began and we have some solid impressions of the impact of the COVID-19 pandemic on patients with epilepsy. Confirming what has been published by all scientific societies, it does not appear that patients with epilepsy have had more COVID-19 infections than the general population, nor more severe. Epileptic seizures have also not been seen more frequently in infected patients.
An increase in the frequency of seizures.
However, some of the patients have shown some decompensation in their seizures, with increased frequency these days. In general, this is not due to fever, nor is it because they have forgotten their medication. Many of the patients have felt stressed, anxious and worried and have slept worse than normal, so it is very likely that this is the cause of the worsening.
The patients with intellectual disabilities have also had important alterations (crisis and behavioral), due to the great change in their routines caused by this anomalous situation of confinement.
What to do in this situation?
First of all, antiepileptic medication can be temporarily increased or rescue drugs such as benzodiazepines (Noiafren, Rivotril or Orfidal), which are also tranquilizers, can be prescribed. This should always be done under medical supervision. On the other hand, it is important, as far as possible, to relax, live in the moment and not anticipate negative things that may happen in the future. There are many muscle relaxation and mindfulness videos on the web that can help.
Regarding sleep, we must try to keep the usual schedule, because going to bed and getting up very late alters the rhythm of sleep and then it can be difficult to return to normal. It is also advisable to disconnect from screens for a while before going to sleep, so that the brain stops receiving stimuli, and so we can relax and prepare for sleep. Substances such as melatonin can also help to initiate and maintain sleep without worsening epilepsy.
Even so, patients can of course benefit from a consultation, face-to-face or online, with their neurologist to discuss these issues, or from psychological or psychiatric assistance if needed.