tetano
Editor, Senior Moderator
Seizure
. 2024 Jul 18:121:8-16.
doi: 10.1016/j.seizure.2024.07.013. Online ahead of print. Status epilepticus as a complication of SARS-CoV-2 vaccination: Two case reports and systematic review with individual patients' data analysis
Michelangelo Dasara[SUP] 1 [/SUP], Fedele Dono[SUP] 2 [/SUP], Giacomo Evangelista[SUP] 3 [/SUP], Paolo Quintieri[SUP] 3 [/SUP], Davide Liviello[SUP] 3 [/SUP], Sara Cipollone[SUP] 3 [/SUP], Valentina Tomassini[SUP] 3 [/SUP], Stefano L Sensi[SUP] 3 [/SUP]
Affiliations
Introduction: Status Epilepticus (SE) stands as a prominent neurological emergency, showing a mortality rate of approximately 20%. Since February 2021, a worldwide vaccination campaign has been launched against the Coronavirus 19 disease (COVID-19) pandemic. Several possible vaccine-related adverse events have been identified, including neurological manifestations. SE is beginning to surface in literature as an emergent condition in COVID-19-vaccinated individuals, though defined reasons accounting for this correlation are still missing.
Methods: We report two cases of SE related to the SARS-CoV-2 vaccine. In addition, we performed a systematic search of the literature to identify the consistency of the association between the SARS-CoV-2 vaccine and the SE onset. The following databases were consulted: PubMed and Google Scholar.
Results: Two novel super-refractory status epilepticus (SRSE) cases associated with the BNT162b2 mRNA COVID-19 vaccine were identified. Both patients received the second dose of the vaccine about 14 days prior to SE onset. Patients showed a non-convulsive semiology and were treated with a combined anesthetic and immunomodulant therapy, leading to SE resolution in both cases. The literature review identified seven additional cases, primarily non-convulsive SE. Four patients received the Spikevax (ex-COVID-19 Moderna mRNA -1273 vaccine), 2 patients the BNT162b2 (Pfizer/Biotech), and 1 patient the ChAdOx1-s (AstraZeneca) vaccine. The first vaccine dose (5/7, 71.4%) emerged as the most frequently associated with SE onset, which manifested at an average of 4.5 days (± 3.4) following vaccination. Five patients presented RSE and required continuous intravenous anesthetic drug administration. Resolution of SE was achieved in all cases.
Conclusions: Status Epilepticus is a rare complication associated with Sars-CoV-2 vaccines. Additional studies are needed to ascertain the potential association between Sars-CoV-2 vaccines and status epilepticus.
Keywords: COVID-19; Epilepsy; Neuro-inflammation; Systematic review; Vaccine.
. 2024 Jul 18:121:8-16.
doi: 10.1016/j.seizure.2024.07.013. Online ahead of print. Status epilepticus as a complication of SARS-CoV-2 vaccination: Two case reports and systematic review with individual patients' data analysis
Michelangelo Dasara[SUP] 1 [/SUP], Fedele Dono[SUP] 2 [/SUP], Giacomo Evangelista[SUP] 3 [/SUP], Paolo Quintieri[SUP] 3 [/SUP], Davide Liviello[SUP] 3 [/SUP], Sara Cipollone[SUP] 3 [/SUP], Valentina Tomassini[SUP] 3 [/SUP], Stefano L Sensi[SUP] 3 [/SUP]
Affiliations
- PMID: 39038383
- DOI: 10.1016/j.seizure.2024.07.013
Introduction: Status Epilepticus (SE) stands as a prominent neurological emergency, showing a mortality rate of approximately 20%. Since February 2021, a worldwide vaccination campaign has been launched against the Coronavirus 19 disease (COVID-19) pandemic. Several possible vaccine-related adverse events have been identified, including neurological manifestations. SE is beginning to surface in literature as an emergent condition in COVID-19-vaccinated individuals, though defined reasons accounting for this correlation are still missing.
Methods: We report two cases of SE related to the SARS-CoV-2 vaccine. In addition, we performed a systematic search of the literature to identify the consistency of the association between the SARS-CoV-2 vaccine and the SE onset. The following databases were consulted: PubMed and Google Scholar.
Results: Two novel super-refractory status epilepticus (SRSE) cases associated with the BNT162b2 mRNA COVID-19 vaccine were identified. Both patients received the second dose of the vaccine about 14 days prior to SE onset. Patients showed a non-convulsive semiology and were treated with a combined anesthetic and immunomodulant therapy, leading to SE resolution in both cases. The literature review identified seven additional cases, primarily non-convulsive SE. Four patients received the Spikevax (ex-COVID-19 Moderna mRNA -1273 vaccine), 2 patients the BNT162b2 (Pfizer/Biotech), and 1 patient the ChAdOx1-s (AstraZeneca) vaccine. The first vaccine dose (5/7, 71.4%) emerged as the most frequently associated with SE onset, which manifested at an average of 4.5 days (± 3.4) following vaccination. Five patients presented RSE and required continuous intravenous anesthetic drug administration. Resolution of SE was achieved in all cases.
Conclusions: Status Epilepticus is a rare complication associated with Sars-CoV-2 vaccines. Additional studies are needed to ascertain the potential association between Sars-CoV-2 vaccines and status epilepticus.
Keywords: COVID-19; Epilepsy; Neuro-inflammation; Systematic review; Vaccine.