Revaccination outcomes of children with vaccine proximate seizures

Deng, Lucy; Danchin, Margie; Lewis, Georgina; Cheung, Abigail; Campbell, Anita J.; Wadia, Ushma; Ewe, Krist; Wood, Nicholas

doi:10.1016/j.vaccine.2021.02.016

Cited by 9 publications

(10 citation statements)

References 25 publications

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“…Seizures that occur within 14 days after vaccination are highly correlated with vaccination. [10][11][12][13][14] Therefore, the primary observation indicator was whether patients experienced seizures within 14 days after vaccination (for a multi-dose vaccine, patients are classi ed into SAV group as long as they experienced seizures within 14 days after any dose). Based on this, we de ned the peri-vaccination period as 14 days before and after any dose of vaccination…”

Section: Primary Observation Indicatormentioning

confidence: 99%

Effect of COVID-19 Vaccination on Seizures in Patients With Epilepsy: a Multicenter, Retrospective Study

Fang

Qiao

Zhang

et al. 2021

Preprint

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Background: Previous study have shown that seizures may occur as a result of vaccination. This study aimed to evaluate the risk and correlative factors of seizures in patients with epilepsy (PWE) after being vaccinated with COVID-19 and to provide reference opinions for PWE to receive COVID-19 vaccine.Methods: We retrospectively enrolled PWE patients who were vaccinated against COVID-19 in the epilepsy centers of nine hospitals in China. The binary logistic regression analysis included variables with a P-value less than 0.1 in the univariate analysis.Results: The study included 290 patients, of which 40 (13.8%) developed seizures within 14 days after vaccination, whereas 250 (86.2%) remained seizure-free. The binary logistic regression analysis revealed statistical significance in seizures within three months before vaccination (P<0.001, OR=10.121, 95% CI: 4.301-23.816) and withdrawal or reduction of anti-seizures medications (ASM) during the peri-vaccination period (P=0.027, OR=4.452, 95% CI: 1.182-16.768). In addition, 32 of 33 patients (97.0%) who were seizure-free within three months before vaccination and had normal EEG results before vaccination did not have any seizures within 14 days following vaccination.Conclusions: SARS-CoV-2 may induce epilepsy through an inflammatory cascade. It is recommended to provide the COVID-19 vaccine to seizure-free patients for at least three months before vaccination, and the vaccination is safer if EEG result is normal. During peri-vaccination period, all PWE should be prohibited from reducing ASM dosage. PWE with well-controlled seizures who have discontinued ASM might consider resuming ASM during the peri-vaccination period if their EEG results are aberrant.

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Section: Primary Observation Indicatormentioning

confidence: 99%

Effect of COVID-19 Vaccination on Seizures in Patients With Epilepsy: a Multicenter, Retrospective Study

Fang

Qiao

Zhang

et al. 2021

Preprint

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“…The term vaccine proximate seizures (VPS) defines episodes of seizures as febrile or afebrile occurring 14 days after vaccination. In a retrospective study conducted by Deng et al ( 33 ) on 119 children with VPS as the first seizure episode, the chance of further seizures with revaccination was uncommon. According to these authors ( 33 ), in children who had a single VPS as their only seizure, the recurrence of VPS was uncommon.…”

Section: Fever-associated Seizures or Epilepsy (Fase)mentioning

confidence: 99%

“…In a retrospective study conducted by Deng et al ( 33 ) on 119 children with VPS as the first seizure episode, the chance of further seizures with revaccination was uncommon. According to these authors ( 33 ), in children who had a single VPS as their only seizure, the recurrence of VPS was uncommon. Children who had multiple non-vaccine proximate seizures after their initial VPS (VPS+) were more likely to have afebrile VPS at a younger age and have a VPS recurrence with vaccination.…”

Section: Fever-associated Seizures or Epilepsy (Fase)mentioning

confidence: 99%

Fever-Associated Seizures or Epilepsy: An Overview of Old and Recent Literature Acquisitions

et al. 2022

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In addition to central nervous system infections, seizures and fever may occur together in several neurological disorders. Formerly, based on the clinical features and prognostic evolution, the co-association of seizure and fever included classical febrile seizures (FS) divided into simple, complex, and prolonged FS (also called febrile status epilepticus). Later, this group of disorders has been progressively indicated, with a more inclusive term, as “fever-associated seizures or epilepsy” (FASE) that encompasses: (a) FS divided into simple, complex, and prolonged FS; (b) FS plus; (c) severe myoclonic epilepsy in infancy (Dravet syndrome); (d) genetic epilepsy with FS plus; and (e) febrile infection-related epilepsy syndrome (FIRES). Among the FASE disorders, simple FS, the most common and benign condition, is rarely associated with subsequent epileptic seizures. The correlation of FS with epilepsy and other neurological disorders is highly variable. The pathogenesis of FASE is unclear but immunological and genetic factors play a relevant role and the disorders belonging to the FASE group show to have an underlying common clinical, immunological, and genetic pathway. In this study, we have reviewed and analyzed the clinical data of each of the heterogeneous group of disorders belonging to FASE.

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“…FK können auch als "vaccine proximate febrile seizures (VP-FS)" innerhalb 48 h nach Impfungen mit inaktivierten Impf- auftreten. Die Häufigkeit beträgt 6 bis 9/100.000 geimpfter Kinder bei DPT und 25-34/100.000 bei MMR [7][8][9]11].…”

Section: Klinische Charakteristikaunclassified

“…In diesen Fällen sollte die Diagnose einer GEFS+ (z. B. Dravet-Syndrom) in Betracht gezogen/ausgeschlossen werden [7][8][9].…”

Section: Management Und Behandlungunclassified

Fieberkrämpfe – Diagnostik und Behandlung

2021

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ZusammenfassungObwohl nicht unmittelbar den Epilepsien zuzuordnen, gehören Fieberkrämpfe (FK) zu den häufigsten Anfallserkrankungen des Kindesalters (Lebenszeitprävalenz: 2–5 %). Entsprechend Definitionsvorschlag der Internationalen Liga gegen Epilepsie (ILAE) sind FK epileptische Anfälle, die im Rahmen fieberhafter Infekte (Temperatur > 38 °C) bei neurologisch gesunden Kindern zwischen 6 und 60 Monaten auftreten. Drei Subkategorien sind beschrieben: einfacher FK (70–90 % aller FK), komplizierter FK (10–35 % aller FK) und febriler Status epilepticus (FSE). Die Pathophysiologie von FK ist unklar, aktuell wird eine multifaktorielle – (poly)genetische und durch Umweltfaktoren bedingte – Genese favorisiert. Die Langzeitprognose ist günstig (Spontanremission in 95 %). Rezente Studien berichten jedoch über gehäuft auftretende neuropsychiatrische Störungen. Das Risiko, nach FK eine Epilepsie zu entwickeln, variiert je nach FK-Typ, ist aber generell nicht wesentlich höher als jenes in der Allgemeinbevölkerung. Folgende, mit FK assoziierte Syndrome weisen ein erhöhtes Risiko für eine nachfolgende Epilepsie bzw. irreversible neurologische Folgeschäden auf: die fieberinduzierte refraktäre epileptische Enzephalopathie von Schulkindern (FIRES), das Hemikonvulsions-Hemiplegie-Epilepsie(HHE)-Syndrom und die genetische/generalisierte Epilepsie mit Fieberkrämpfen plus (GEFS+). Die kausale Rolle komplizierter FK oder FSE für nachfolgende Ammonshornsklerose (AHS) und pharmakoresistente mesiale Temporallappenepilepsie (mTLE) ist aktuellen experimentellen und klinischen Daten zufolge nicht bewiesen, eine primäre Vorschädigung des Hippocampus als wahrscheinlicher anzunehmen. Das folgende Update beinhaltet – basierend auf aktueller Evidenz – Empfehlungen für (Differenzial‑)Diagnostik und Management von FK.

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Revaccination outcomes of children with vaccine proximate seizures

Cited by 9 publications

References 25 publications

Effect of COVID-19 Vaccination on Seizures in Patients With Epilepsy: a Multicenter, Retrospective Study

Effect of COVID-19 Vaccination on Seizures in Patients With Epilepsy: a Multicenter, Retrospective Study

Fever-Associated Seizures or Epilepsy: An Overview of Old and Recent Literature Acquisitions

Fieberkrämpfe – Diagnostik und Behandlung

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