Department of Pediatric Neurology, Ospedali Riuniti, Ancona, Italy.
Department of Pediatric Neurology, Ospedali Riuniti, Ancona, Italy.
Pediatr Neurol. 2014 Mar;50(3):228-32. doi: 10.1016/j.pediatrneurol.2013.09.016. Epub 2013 Oct 5.
The relation between epileptic seizures and vaccinations is sometimes debated. In the present work, the impact of vaccination on seizure onset and clinical outcome of SCN1A mutation-positive patients is addressed.
Seventy-two patients diagnosed with Dravet syndrome or generalized epilepsy with febrile seizure plus, carrying SCN1A mutations or not, were included. Details on vaccination type, temporal relationship between vaccination and seizure occurrence, seizure type at onset and during development, cognitive functioning, and vaccination completion was obtained by reviewing clinical records. Patients were divided into two groups based on the temporal window between vaccination and seizure onset (proximate group: <48 hours; distant group: >48 hours).
Vaccination-related seizures occurred in 25% of patients with SCN1A mutation and 18% of patients without the mutation (no significant difference). The proximate group showed an earlier age at seizure onset and a higher frequency of status epilepticus during development than did the distant group. No other significant differences were found. Subsequent vaccinations did not significantly alter the evolution of the disease.
Results from this relatively small series provide evidence that vaccinations do not significantly affect clinical and cognitive evolution of Dravet syndrome and generalized epilepsy with febrile seizure plus patients even if they carry SCN1A mutations.
癫痫发作与疫苗接种之间的关系有时存在争议。本研究旨在探讨疫苗接种对 SCN1A 基因突变阳性患者癫痫发作起始和临床结局的影响。
共纳入 72 例诊断为 Dravet 综合征或热性惊厥附加症伴全面性癫痫的患者,携带或不携带 SCN1A 基因突变。通过回顾临床记录,获得疫苗类型、疫苗接种与癫痫发作发生之间的时间关系、起始时和进展期的癫痫发作类型、认知功能以及疫苗接种完成情况等详细信息。根据疫苗接种与癫痫发作起始之间的时间窗口(近期组:<48 小时;远期组:>48 小时)将患者分为两组。
SCN1A 基因突变患者中有 25%发生了与疫苗接种相关的癫痫发作,而无基因突变的患者中有 18%发生了这种癫痫发作(无显著差异)。近期组的癫痫发作起始年龄更早,进展期癫痫持续状态的发生率更高。未发现其他显著差异。随后的疫苗接种并未显著改变疾病的进展。
本小样本系列研究结果表明,即使患者携带 SCN1A 基因突变,疫苗接种也不会显著影响 Dravet 综合征和热性惊厥附加症伴全面性癫痫患者的临床和认知演变。