De Stefano P Nencha U De Stefano L Mégevand P Seeck M 2020 Objectives We describe a patient suffering from Covid19-related acute respiratory distress syndrome (ARDS), highlighting the diagnostic role of the EEG in ICU. History A Covid-19 patient undergoing mechanical ventilation due to related acute respiratory distress syndrome (ARDS), presented altered mental status in the ICU. Video-EEG revealed a focal monomorphic theta slowing in bilateral frontal-central regions. Concordant with the EEG localization, MRI showed abundant microbleeds located in bilateral white matter junction, various regions of corpus callosum and internal capsule, suggestive of Critical Illness-Associated Cerebral Microbleeds. CSF analysis excluded the presence of encephalitis, SARS-Cov2 RNA-PCR in CSF was negative. Clinical and biological picture was suggestive of cytokine release syndrome. Conclusion This is the first reported case of Critical Illness-Associated Cerebral Microbleeds in the context of Covid-19. Knowledge of Covid-19 is still partial and acute neurological complications should be explored systematically. In our case, EEG helped to rule out non-convulsive status epilepticus, but revealed focal dysfunction, justifying further investigations.EEG plays a crucial role in these patients, allowing investigating the presence of focal or diffuse cerebral dysfunction. This is particularly helpful for Covid-19 patients in the ICU, where the neurological examination is challenging by the severity of the respiratory illness. https://sonar.ch/global/documents/46773 eng info:eu-repo/semantics/altIdentifier/doi/10.1016/j.cnp.2020.05.004 info:eu-repo/semantics/altIdentifier/pmid/32607454 Clinical neurophysiology practice. - 2020 Brain Coma Covid-19 Cytokine EEG ICU Inflammation Microbleeds SARS-CoV2 Focal EEG changes indicating critical illness associated cerebral microbleeds in a Covid-19 patient. http://purl.org/coar/resource_type/c_6501