COVID-19 and Recurrent Status Epilepticus.

To the Editor,

we would like to discuss on “Recurrent Status Epilepticus and SARS-CoV-2 infection: the “perfect storm (1).” Pauletto et al. mentioned for “the possibility of SE recurrence in patients with pre-vious SE as clinical manifestation or consequence of SARS-CoV-2 disease (1).” The clinical association between SE and COVID-19 is interesting. COVID-19 might aggravate recurrence of SE or the recurrence might be a co-incidence. The pathogenesis of SE is interesting. The viral infection might direct cause neurological problem or the problem might be due to immunopathological process. From a previous EEG study, it is evidenced that infection did not cause “increased propensity of epileptiform discharges on EEG (2)”. Another possible underlying pathogenesis might be due to increased blood viscosity due to COVID-19 (3). COVID-19 can induced hyperviscosity (3) and hyperviscosity is a known trigger factor for SE (4, 5).