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Observational Study
. 2022 Aug;43(8):4627-4634.
doi: 10.1007/s10072-022-06100-0. Epub 2022 May 2.

Impact of COVID-19 vaccine on epilepsy in adult subjects: an Italian multicentric experience

Marina Romozzi  1   2 , Eleonora Rollo  1   2 , Paolo Quintieri  1 , Fedele Dono  3   4 , Giacomo Evangelista  5 , Stefano Consoli  5 , Luigi Veleno  5 , Francesca Anzellotti  5 , Carmen Calvello  6 , Cinzia Costa  6 , Serenella Servidei  1   7 , Paolo Calabresi  1   2 , Catello Vollono  1   7
Affiliations
Observational Study

Impact of COVID-19 vaccine on epilepsy in adult subjects: an Italian multicentric experience

Marina Romozzi et al. Neurol Sci. 2022 Aug.

Abstract

Objectives: To investigate the safety and tolerability of COVID-19 vaccines in people with epilepsy (PwE).

Methods: In this multicentric observational cohort study, we recruited adult patients (age > 18 years old) with epilepsy who attended the Outpatient Epilepsy Clinic from 1st July to 30th October 2021. We administered to the patients a structured questionnaire and interview on demographic and epilepsy characteristics, current treatment, previous SARS-CoV-2 infection, vaccine characteristics, post-vaccine seizure relapse, other side effect, variation of sleep habits, caffeine, or alcohol intake. Seizure frequency worsening was defined as a ratio between mean monthly frequency post-vaccination and mean monthly frequency pre-vaccination superior to 1. Patients were categorized in two groups: patients with seizure frequency worsening (WORSE) and patients with seizure stability (STABLE).

Results: A total of 358 people participated with a mean age of 47.46 ± 19.04. Focal seizure (79.1%), generalized epilepsy (20.4%), and unknown types of epilepsy (0.5%) were detected among participants. In total, 31 (8.7%) people expressed that they were not willing to receive a COVID-19 vaccine; 302 patients (92.35%) did not experience an increase in the seizure frequency (STABLE-group) whereas 25 patients (7.65%) had a seizure worsening (WORSE-group). Post-vaccine seizures occurred mainly in the 7 days following the administration of the vaccine. Patients in the WORSE-group were treated with a mean higher number of anti-seizure medication (ASMs) (p = 0.003) and had a higher pre-vaccine seizure frequency (p = 0.009) compared with patients in the STABLE-group. Drug-resistant epilepsy was also associated with seizure worsening (p = 0.01). One-year pre-vaccination seizure frequency pattern demonstrated that patients in the WORSE-group had a higher frequency pattern (p < 0.001). Multivariate analysis of the vaccinated group showed that only the seizure frequency pattern (confidence interval [CI] = 1.257-2.028; p < 0.001) was significantly associated with seizure worsening.

Conclusion: In our cohort of vaccinated PwE, only a little percentage had a transient short-term increase of seizure frequency. The present study demonstrates that COVID-19 vaccines have a good safety and tolerability profile in the short term in PwE.

Keywords: COVID-19; Coronavirus; Epilepsy; Seizures; Vaccine.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Flow-chart of the study depicting the enrolment process
Fig. 2
Fig. 2
Multivariate analysis with seizure worsening as dependent variable
See this image and copyright information in PMC

Comment in

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