Department of Neurology, Albacete University Hospital Complex, C/Hermanos, Falcó 37, E-02002 Albacete, Spain.
Department of Neurology, Albacete University Hospital Complex, C/Hermanos, Falcó 37, E-02002 Albacete, Spain.
Epilepsy Behav. 2022 Sep;134:108808. doi: 10.1016/j.yebeh.2022.108808. Epub 2022 Jun 22.
We aimed to assess the risk of developing new-onset seizures or seizure decompensations in people with epilepsy (PWE) associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines.
A retrospective observational study in a tertiary hospital was conducted. Clinical records of all patients attended because of seizures or epilepsy at outpatient clinics, emergency department, or admitted to our hospital from January to December 2021 were reviewed, including patients older than 16 years who received some dose of coronavirus disease 2019 (COVID-19) vaccines.
A total of 418 vaccinated PWE were analyzed: 6.2% presented an increase in seizure frequency and 1% reported different seizure types during the next month after vaccination. However, 61.5% had another possible cause for this decompensation. Having monthly seizures (1-3/month) was the only associated risk factor (OR 4.9, p < 0.001) while being seizure free > 1 year had a protective role (OR 0.36, p = 0.019). Patients with epileptic encephalopathies or a history of COVID-19 infection were not at increased risk of seizure decompensation. Besides this, 15 patients presented new-onset seizures within the first month post-vaccination, mean time from vaccination 15 ± 8 days, 67% after the second dose. Again, 53.3% had another possible trigger for seizures. Eight debuted with status epilepticus or cluster of seizures.
A small proportion of PWE (6.2%) had an increase in seizure frequency after COVID-19 vaccination and 15 patients had new-onset seizures during the first month after vaccination, though another reason for seizure exacerbation was identified in 61.5% and 53.3%, respectively. Severe acute respiratory syndrome COVID-19 vaccines appear to have little impact on the generation or decompensation of seizures.
我们旨在评估与严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）疫苗相关的癫痫患者（PWE）新发发作或发作恶化的风险。
在一家三级医院进行了一项回顾性观察性研究。对 2021 年 1 月至 12 月期间因癫痫发作或癫痫在门诊、急诊或我院住院的所有患者的临床记录进行了回顾性分析，包括接受过某种剂量的新型冠状病毒病 2019（COVID-19）疫苗的 16 岁以上患者。
共分析了 418 例接种疫苗的 PWE：6.2%的患者在接种后 1 个月内出现发作频率增加，1%的患者报告出现不同类型的发作。然而，61.5%的患者有其他可能导致这种恶化的原因。每月发作 1-3 次（1-3 次/月）是唯一相关的危险因素（OR 4.9，p < 0.001），而无发作超过 1 年则具有保护作用（OR 0.36，p = 0.019）。患有癫痫性脑病或有 COVID-19 感染史的患者癫痫恶化的风险没有增加。此外，15 例患者在接种疫苗后 1 个月内出现新发发作，从接种疫苗到发作的平均时间为 15 ± 8 天，其中 67%发生在第二剂之后。同样，53.3%的患者有另一种可能导致癫痫发作的诱因。有 8 例患者出现癫痫持续状态或癫痫发作群。
少数 PWE（6.2%）在 COVID-19 疫苗接种后出现发作频率增加，15 例患者在接种疫苗后 1 个月内出现新发发作，但在分别有 61.5%和 53.3%的患者中发现了发作恶化的另一个原因。严重急性呼吸综合征 COVID-19 疫苗似乎对发作的发生或恶化影响不大。
