Available data suggests that people with epilepsy alone or with seizures as their main symptoms do not have a higher risk of getting COVID-19. We encourage you to learn more about COVID-19 symptoms, safety, treatment, and risk factors that may affect your immune system when living with epilepsy.

Preparing For Any Emergency

Preparing for potential emergencies such as COVID-19 is part of life for all of us. Whether you’re preparing for natural disasters, extreme weather conditions, or medical emergencies, it is important to be ready for anything.

Be prepared with the following steps:

Keep an adequate supply of anti-seizure medication available.
Make sure you have a seizure action plan and keep it updated.
Ask your epilepsy team if you should have a rescue medicine to use in case of a change in seizures.

Are people with epilepsy at higher risk of developing COVID-19 (coronavirus)?

Epilepsy is a “family” of many different disorders that lead to seizures. Some people will have easily controlled seizures, have no other health problems, and become seizure-free on medications. Or, they may have epilepsy with occasional seizures but no other health problems. For these people, the available data suggests that just having epilepsy alone:

1. Does not increase the risk of getting COVID-19

AND

2. Does not increase the severity of COVID-19

There is no evidence that people with epilepsy alone have a weakened immune system. They should not be considered “immunocompromised” and would not have an “immune deficiency” from having seizures. People with certain types of epilepsy, specific causes of epilepsy, or other health conditions may have factors affecting their immune system.

What Factors May Increase the Risk from COVID-19 for a Person with Epilepsy?

Regardless of seizure control, some people may have other health conditions that put them at higher risk from COVID-19. They may be taking medicines to control seizures that also affect their immune system (for example, ACTH, steroids, everolimus, immunotherapies). It is important to note that most seizure medicines do not affect the immune system.

Other neurological or developmental issues can affect immunity. People in these situations are at greater risk of developing more severe symptoms with viral illnesses.

Other medical problems could place someone at higher risk of developing more severe symptoms with COVID-19, such as those with:

Problems swallowing or frequently inhaling food or liquids into their lungs (higher risk for pneumonia)
Diabetes or underlying heart or lung problems
Intellectual and developmental disabilities

No matter your situation, it is important for anyone with epilepsy to talk to their treating healthcare provider about their individual risks and if any specific medical precautions are needed.

What should I do if I think I have COVID-19?

Symptoms of COVID-19 may be similar to the flu or common cold. Symptoms can include fever, cough, or difficulty breathing, loss of smell, sore throat, and cold-like symptoms. Follow CDC guidance for what to do if you think you may have COVID. If your seizures increase, call your epilepsy team or neurologist.

Treatments for People Who Are sick with COVID-19

Oral Medications

Nirmatrelvir with ritonavir (PaxlovidTM) has been FDA approved for the treatment of COVID-19 infection. It may be prescribed in other settings. Your healthcare provider will decide whether this treatment is right for you based on your medical history and the severity of your infection. Important considerations for people with epilepsy regarding the use of Paxlovid include:

The effectiveness of Paxlovid decreases for those taking the following anti-seizure medications: carbamazepine, phenobarbital, phenytoin or primidone.
Paxlovid may increase the blood concentration of many anti-seizure medications, including: carbamazepine, clobazam, clonazepam, diazepam, ethosuximide, everolimus, felbamate, lacosamide, lamotrigine, oxcarbazepine, perampanel, stiripentol, tiagabine and zonisamide.

Talk to your doctor or pharmacist for any possible medication interactions. People with epilepsy should contact their healthcare provider to monitor for any symptoms that could indicate higher blood levels of anti-seizure medications while being treated with Paxlovid. Other treatment options are available.

The FDA also issued an EUA for molnupiravir (LagevrioTM) for the treatment of mild to moderate COVID-19 in adults. This drug does not have any interactions with anti-seizure medications and could be an alternative to Paxlovid. However, Lagevrio appears to be less effective in treating COVID-19 and cannot be used in pregnancy.

Intravenous (IV) Medications

The FDA has approved remdesivir (VekluryTM) an intravenous (IV) antiviral drug for treatment of COVID-19. It is approved for adults and children that weigh at least three pounds who are in the hospital or not yet hospitalized. There is no data on anti-seizure medication interactions with Veklury at this time.

Preventative Medication for Use Prior to Exposure of COVID-19

There are no preventative medications currently available.

Following the advice of the CDC is the best way to protect yourself before exposure to COVID-19.

COVID-19 and Epilepsy