Phua Chun Seng, Raymond Azman Ali, Bhaskar Shalini
Monash University, Department of Neurosciences, Wellington Road, Clayton 3800, Victoria, Australia.
Faculty of Medicine, Universiti Teknologi MARA, JLN Hospital, Sungai Buloh 47000, Selangor, Malaysia.
Case Rep Neurol Med. 2024 Oct 16;2024:8808334. doi: 10.1155/2024/8808334. eCollection 2024.
An 18-year-old male presented with new-onset focal to bilateral tonic-clonic seizures 5 days after receiving the first dose of COVID-19 vaccine. 3 days later, an identical seizure occurred lasting 1 min, leading to an acute presentation to the hospital. In hospital, the patient was loaded with intravenous phenytoin and started on levetiracetam with no further seizure recurrence. CT venogram and scalp EEG were unremarkable. MRI brain revealed generalised atrophy with mild bilateral hippocampal atrophy. The patient was maintained on 500 mg levetiracetam twice daily and advised to proceed with subsequent doses of vaccination. Vaccinations have been associated with breakthrough seizures. In this case, COVID-19 vaccination possibly unmasked an underlying predisposition for epilepsy.
一名18岁男性在接种第一剂新冠疫苗5天后出现新发局灶性至双侧强直阵挛性癫痫发作。3天后，再次出现相同发作，持续1分钟，随后紧急入院。在医院，患者静脉注射苯妥英钠负荷量，并开始服用左乙拉西坦，此后未再出现癫痫发作。CT静脉造影和头皮脑电图检查未见异常。脑部MRI显示广泛性萎缩，双侧海马轻度萎缩。患者继续每日两次服用500mg左乙拉西坦，并被建议继续后续剂量的疫苗接种。疫苗接种与突破性癫痫发作有关。在本病例中，新冠疫苗接种可能揭示了潜在的癫痫易感性。
