RT Journal Article SR Electronic T1 COVID-19 encephalopathy: an unusual presentation with new-onset seizure causing convulsive status epilepticus JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e245387 DO 10.1136/bcr-2021-245387 VO 15 IS 3 A1 Aisha Fareed Siddiqui A1 Sheema Saadia A1 Taymmia Ejaz A1 Zain Mushtaq YR 2022 UL http://casereports.bmj.com/content/15/3/e245387.abstract AB Although neurological manifestations such as headache and myalgias have been observed with COVID-19, presentation with more serious neurological illness is uncommon and rare. We report a case of a middle-aged woman who presented to the emergency department of a tertiary care hospital. Her clinical presentation was primarily neurological rather than the more common presentation with respiratory manifestations. She presented with generalised tonic–clonic seizures, along with history of undocumented low-grade fever and generalised body aches. The positive SARS-CoV-2 RT-PCR nasal swab, the cerebrospinal fluid analysis (lymphocytic pleocytosis) and electroencephalogram were consistent with viral encephalitis; brain imaging was unremarkable. This case highlights the variable presenting features of COVID-19 infection as patients can primarily present with neurological manifestations in the absence of significant respiratory symptoms. We believe it is important to recognise neurological disease associated with SARS-CoV-2 in patients with asymptomatic respiratory infection.