School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Neuroscience Research Center, Iran University of Medical Sciences, Tehran, Iran.
Epilepsia. 2024 Oct;65(10):3010-3027. doi: 10.1111/epi.18102. Epub 2024 Aug 27.
Seizures have been reported as an adverse event of the COVID-19 vaccine. However, there is no solid evidence of increased seizure occurrence compared to the general population. This study was undertaken to investigate seizure occurrence among COVID-19 vaccine recipients compared to unvaccinated controls.
A systematic search was made of PubMed, Web of Science, Scopus, and Cochrane Library up to April 9, 2024. Studies reporting seizure occurrence following COVID-19 vaccination were included. This study is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework and was conducted using random- and common-effect models. The risk of bias in the studies was evaluated by the Newcastle-Ottawa Scale. The outcome of interest was new onset seizure incidence proportion compared among (1) COVID-19 vaccine recipients, (2) unvaccinated cohorts, and (3) various types of COVID-19 vaccines.
Forty studies were included, of which seven entered the meta-analysis. Results of the pooled analysis of the new onset seizure incidence (21- or 28-day period after vaccination) in 13 016 024 vaccine recipients and 13 013 262 unvaccinated individuals by pooling the cohort studies did not show any statistically significant difference between the two groups (odds ratio [OR] = .48, 95% confidence interval [CI] = .19-1.20, p = .12, I = 95%, τ = .7145). Pooling four studies accounting for 19 769 004 mRNA versus 47 494 631 viral vector vaccine doses demonstrated no significant difference in terms of new onset seizure incidence between the groups (OR = 1.18, 95% CI = .78-1.78, p = .44, I = 0%, τ = .004).
This systematic review and meta-analysis shows no statistically significant difference in the risk of new onset seizure incidence between COVID-19 vaccinated individuals and unvaccinated individuals.
已有报道称，COVID-19 疫苗会引起癫痫发作。然而，与普通人群相比，COVID-19 疫苗接种后癫痫发作发生率增加并无确凿证据。本研究旨在调查 COVID-19 疫苗接种者与未接种疫苗对照者的癫痫发作发生率。
系统检索了 PubMed、Web of Science、Scopus 和 Cochrane Library，截至 2024 年 4 月 9 日。纳入了报告 COVID-19 疫苗接种后癫痫发作发生情况的研究。本研究按照系统评价和荟萃分析的首选报告项目进行报告，并使用随机效应和固定效应模型进行。通过 Newcastle-Ottawa 量表评估研究的偏倚风险。感兴趣的结局是比较（1）COVID-19 疫苗接种者、（2）未接种疫苗队列和（3）各种类型的 COVID-19 疫苗中新发癫痫发作发生率比例。
纳入了 40 项研究，其中 7 项研究纳入荟萃分析。对 13016024 名疫苗接种者和 13013262 名未接种者的队列研究进行荟萃分析，结果显示在 21 或 28 天的接种后新发病例发生率（21 或 28 天）两组之间无统计学显著差异（比值比[OR] =.48，95%置信区间[CI] =.19-1.20，p =.12，I = 95%，τ =.7145）。对 4 项研究（共 19769004 例 mRNA 疫苗与 47494631 例病毒载体疫苗）进行荟萃分析，结果显示两组之间新发病例发生率无统计学显著差异（OR = 1.18，95% CI =.78-1.78，p =.44，I = 0%，τ =.004）。
本系统评价和荟萃分析显示，COVID-19 疫苗接种者与未接种者新发癫痫发作风险无统计学显著差异。
