Epilepsy Unit, Child Neuropsychiatry Department, University Hospital, Cagliari, Italy.
Epilepsia. 2013 Oct;54 Suppl 7:13-22. doi: 10.1111/epi.12306.
Reports of childhood epilepsies in temporal association with vaccination have had a great impact on the acceptance of vaccination programs by health care providers, but little is known about this possible temporal association and about the types of seizures following vaccinations. For these reasons the Italian League Against Epilepsy (LICE), in collaboration with other Italian scientific societies, has decided to generate Guidelines on Vaccinations and Epilepsy. The aim of Guidelines on Vaccinations and Epilepsy is to present recent unequivocal evidence from published reports on the possible relationship between vaccines and epilepsy in order to provide information about contraindications and risks of vaccinations in patients with epilepsy. The following main issues have been addressed: (1) whether contraindications to vaccinations exist in patients with febrile convulsions, epilepsy, and/or epileptic encephalopathies; and (2) whether any vaccinations can cause febrile seizures, epilepsy, and/or epileptic encephalopathies. Diphtheria-tetanus-pertussis (DTP) vaccination and measles, mumps, and rubella vaccination (MMR) increase significantly the risk of febrile seizures. Recent observations and data about the relationships between vaccination and epileptic encephalopathy show that some cases of apparent vaccine-induced encephalopathy could in fact be caused by an inherent genetic defect with no causal relationship with vaccination.
有关儿童癫痫与疫苗接种之间存在关联的报道极大地影响了医疗保健提供者对接种疫苗计划的接受程度，但人们对此类可能的时间关联以及接种疫苗后发生的癫痫发作类型知之甚少。出于这些原因，意大利癫痫协会（LICE）与其他意大利科学协会合作，决定制定关于疫苗接种和癫痫的指南。制定《疫苗接种和癫痫指南》的目的是提供最近发表的关于疫苗与癫痫之间可能存在关联的明确证据，以提供有关癫痫患者接种疫苗的禁忌症和风险的信息。本指南涉及以下主要问题：（1）是否存在发热性惊厥、癫痫和/或癫痫性脑病患者的疫苗接种禁忌症；（2）是否有任何疫苗接种可引起发热性癫痫发作、癫痫和/或癫痫性脑病。白喉、破伤风、百日咳（DTP）疫苗接种和麻疹、腮腺炎、风疹（MMR）疫苗接种会显著增加热性惊厥的风险。最近关于疫苗接种与癫痫性脑病之间关系的观察和数据表明，一些明显的疫苗诱导性脑病病例实际上可能是由内在遗传缺陷引起的，与疫苗接种没有因果关系。
