Etiologies for Seizures Around the Time of Vaccination

Abstract

OBJECTIVES: This study was an assessment of the incidence, course, and etiology of epilepsy with vaccination-related seizure onset in a population-based cohort of children. METHODS: The medical data of 990 children with seizures after vaccination in the first 2 years of life, reported to the National Institute for Public Health and Environment in the Netherlands in 1997 through 2006, were reviewed. Follow-up data were obtained of children who were subsequently diagnosed with epilepsy and had had seizure onset within 24 hours after administration of an inactivated vaccine or 5 to 12 days after a live attenuated vaccine. RESULTS: Follow-up was available for 23 of 26 children (median age: 10.6 years) with epilepsy onset after vaccination. Twelve children developed epileptic encephalopathy, 8 had benign epilepsy, and 3 had encephalopathy before seizure onset. Underlying causes were identified in 15 children (65%) and included SCN1A–related Dravet syndrome (formerly severe myoclonic epilepsy of infancy) or genetic epilepsy with febrile seizures plus syndrome (n = 8 and n = 1, respectively), a protocadherin 19 mutation, a 1qter microdeletion, neuronal migration disorders (n = 2), and other monogenic familial epilepsy (n = 2). CONCLUSIONS: Our results suggest that in most cases, genetic or structural defects are the underlying cause of epilepsy with onset after vaccination, including both cases with preexistent encephalopathy or benign epilepsy with good outcome. These results have significant added value in counseling of parents of children with vaccination-related first seizures, and they might help to support public faith in vaccination programs.

Vaccination Status of Children with Neurological Disorders and Associated Factors

“…Bu çalışmada, aşı sonrası konvülziyon geçiren 6 hastada epilepsi tanı grubunda yer alıyordu. Bu hastalarda aşı dışında başka bir uyaranda, ateş ya da enfeksiyon gibi, kronik nörolojik disfonksiyonu tetikleyebilir (17)(18)(19)(20). Ayrıca aşı sonrası konvülziyon geçiren çocukların değerlendirildiği başka bir çalış-mada çoğu çocuğun altta yatan nörolojik ya da nörogelişimsel kolaylaştırıcı bir yatkınlığı olduğu gösterilmiştir (18).…”

“…Bu hastalarda aşı dışında başka bir uyaranda, ateş ya da enfeksiyon gibi, kronik nörolojik disfonksiyonu tetikleyebilir (17)(18)(19)(20). Ayrıca aşı sonrası konvülziyon geçiren çocukların değerlendirildiği başka bir çalış-mada çoğu çocuğun altta yatan nörolojik ya da nörogelişimsel kolaylaştırıcı bir yatkınlığı olduğu gösterilmiştir (18). Bu nedenle nörolojik problemleri olan hastalarda bireysel değerlendirme yapılarak aşılamanın yararları ve hastanın riskleri düşünülerek dikkatli bir planlanma yapılmalıdır.…”

Vaccination Triggers, Rather than Causes, Seizures

“…These observations provide further evidence for an underlying genetic cause for which the vaccine triggers the initial seizure. Further, they emphasize that the outcome of vaccine-related seizures may be excellent in patients without encephalopathy (7).…”

Vaccine-Induced Developmental Delay: A Case Report

“…The etiologies and pathophysiology may vary depending on the patient and the risk factors (head trauma, central nervous system infections, febrile seizures, developmental history, and medications/toxin exposures) [7]. Recent studies reported that genetic or structural defects are the underlying causes of seizures, which may be activated after vaccination presumably due to the interplay of the innate biology of the body [8].…”