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Effects of coronavirus disease 2019 vaccination on seizures in patients with epilepsy.
Fang, Xiqin; Qiao, Shan; Zhang, Ranran; Yang, Tingting; Wang, Zhihao; Kong, Qingxia; Sun, Meihua; Geng, Jianhong; Fang, Chunyan; Chen, Yanxiu; Sun, Yanping; Zhang, Dongmei; Qu, Lixing; Shang, Wei; Wang, Jianguo; Liu, Xuewu.
  • Fang X; Department of Neurology, Qilu Hospital of Shandong University, Jinan, Shandong 250000, China.
  • Qiao S; Department of Neurology, Institute of Epilepsy, Shandong University, Jinan, Shandong 250000, China.
  • Zhang R; Department of Neurology, Institute of Epilepsy, Shandong University, Jinan, Shandong 250000, China.
  • Yang T; Department of Neurology, The First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong 250000, China.
  • Wang Z; Department of Neurology, Qilu Hospital of Shandong University, Jinan, Shandong 250000, China.
  • Kong Q; Department of Neurology, Institute of Epilepsy, Shandong University, Jinan, Shandong 250000, China.
  • Sun M; Department of Neurology, Qilu Hospital of Shandong University, Jinan, Shandong 250000, China.
  • Geng J; Department of Neurology, Institute of Epilepsy, Shandong University, Jinan, Shandong 250000, China.
  • Fang C; Department of Neurology, Qilu Hospital of Shandong University, Jinan, Shandong 250000, China.
  • Chen Y; Department of Neurology, Institute of Epilepsy, Shandong University, Jinan, Shandong 250000, China.
  • Sun Y; Department of Neurology, Affiliated Hospital of Jining Medical College, Jining, Shandong 272000, China.
  • Zhang D; Department of Neurology, Tengzhou Central People's Hospital, Jining, Shandong 277599, China.
  • Qu L; Department of Neurology, Affiliated Hospital of Weifang Medical College, Weifang, Shandong 261000, China.
  • Shang W; Department of Neurology, Zhucheng People's Hospital, Weifang, Shandong 262200, China.
  • Wang J; Department of Neurology, Liaocheng People's Hospital, Liaocheng, Shandong 252000, China.
  • Liu X; Department of Neurology, Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, China.
Chin Med J (Engl) ; 136(5): 571-577, 2023 Mar 05.
Article in English | MEDLINE | ID: covidwho-2258721
ABSTRACT

BACKGROUND:

Given that seizures may be triggered by vaccination, this study aimed to evaluate the risk and correlative factors of seizures in patients with epilepsy (PWE) after being vaccinated against coronavirus disease 2019 (COVID-19).

METHODS:

This study retrospectively enrolled PWE who were vaccinated against COVID-19 in the epilepsy centers of 11 hospitals in China. We divided the PWE into two groups as follows (1) patients who developed seizures within 14 days of vaccination were assigned to the SAV (with seizures after vaccination) group; (2) patients who were seizure-free within 14 days of vaccination were assigned to the SFAV (seizure-free after vaccination) group. To identify potential risk factors for seizure reccurence, the binary logistic regression analysis was performed. Besides, 67 PWE who had not been vaccinated were also included for elucidating the effects of vaccination on seizures recurrence, and binary logistic regression analysis was performed to determine whether vaccination would affect the recurrence rate of PWE who had drug reduction or withdrawal.

RESULTS:

The study included a total of 407 patients; of which, 48 (11.8%) developed seizures within 14 days after vaccination (SAV group), whereas 359 (88.2%) remained seizure-free (SFAV group). The binary logistic regression analysis revealed that duration of seizure freedom ( P  < 0.001) and withdrawal from anti-seizure medications (ASMs) or reduction in their dosage during the peri-vaccination period were significantly associated with the recurrence of seizures (odds ratio = 7.384, 95% confidence interval = 1.732-31.488, P  = 0.007). In addition, 32 of 33 patients (97.0%) who were seizure-free for more than three months before vaccination and had a normal electroencephalogram before vaccination did not have any seizures within 14 days of vaccination. A total of 92 (22.6%) patients experienced non-epileptic adverse reactions after vaccination. Binary logistic regression analysis results showed that vaccine did not significantly affect the recurrence rate of PWE who had the behavior of ASMs dose reduction or withdrawal ( P  = 0.143).

CONCLUSIONS:

PWE need protection from the COVID-19 vaccine. PWE who are seizure-free for >3 months before vaccination should be vaccinated. Whether the remaining PWE should be vaccinated depends on the local prevalence of COVID-19. Finally, PWE should avoid discontinuing ASMs or reducing their dosage during the peri-vaccination period.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Epilepsy / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Vaccines Limits: Humans Language: English Journal: Chin Med J (Engl) Year: 2023 Document Type: Article Affiliation country: CM9.0000000000002558

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Epilepsy / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Vaccines Limits: Humans Language: English Journal: Chin Med J (Engl) Year: 2023 Document Type: Article Affiliation country: CM9.0000000000002558