Vaccination and childhood epilepsies.

The evidence relating vaccination to febrile seizures and epilepsy is evaluated with an emphasis on febrile seizures (FS), Dravet syndrome (DS), West syndrome, and other developmental and epileptic encephalopathies. A systematic literature review using search words vaccination/immunization AND febrile seizures/epilepsy/Dravet/epileptic encephalopathy/developmental encephalopathy was performed. The role of vaccination as the cause/trigger/aggravation factor for FS or epilepsies and preventive measures were analyzed. From 1428 results, 846 duplicates and 447 irrelevant articles were eliminated; 120 were analyzed. There is no evidence that vaccinations cause epilepsy in healthy populations. Vaccinations do not cause epileptic encephalopathies but may be non-specific triggers to seizures in underlying structural or genetic etiologies. The first seizure in DS may be earlier in vaccinated versus non-vaccinated patients, but developmental outcome is similar in both groups. Children with a personal or family history of FS or epilepsy should receive all routine vaccinations. This recommendation includes DS. The known risks of the infectious diseases prevented by immunization are well established. Vaccination should be deferred in case of acute illness. Acellular pertussis DTaP (diphtheria-tetanus-pertussis) is recommended. The combination of certain vaccine types may increase the risk of febrile seizures however the public health benefit of separating immunizations has not been proven. Measles-containing vaccine should be administered at age 12-15 months. Routine prophylactic antipyretics are not indicated, as there is no evidence of decreased FS risk and they can attenuate the antibody response following vaccination. Prophylactic measures (preventive antipyretic medication) are recommended in DS due to the increased risk of prolonged seizures with fever.

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Déclaration de conflit d'intérêts

Declaration of competing interest There are no conflicts of interest for any of the authors related to this article. Sophia Bakhtadze declares no conflicts of interest in relation to this manuscript. Cristina Cazacu declares no conflicts of interest in relation to this manuscript. Dana Craiu reports educational grants from BioMarin, Sanofi, research grant from Novartis Pharma and advisory board consulting fee from UCB, not related to the submitted article. Tanja Golli has no conflicts of interest in relation to this manuscript. Lieven Lagae declares no conflicts of interest in relation to this manuscript. Zvonka Rener Primec declares no conflicts of interest in relation to this manuscript. Nicola Specchio declares no conflicts of interest in relation to this manuscript. Eugen Trinka reports personal fees from EVER Pharma, Marinus, Argenix, Arvelle, Angelini, Abbott, Medtronic, Bial – Portela & C(a), S.A., Epilog, NewBridge, GL Pharma, GlaxoSmithKline, Hikma, Boehringer Ingelheim, LivaNova, Eisai, UCB, Biogen, Genzyme Sanofi, GW Pharmaceuticals, and Actavis; his institution received grants from Biogen, UCB Pharma, Eisai, Red Bull, Merck, Bayer, the European Union, FWF Österreichischer Fond zur Wissenschaftsforderung, Bundesministerium für Wissenschaft und Forschung, and Jubiläumsfond der Österreichischen Nationalbank in no relation to the submitted work. Federico Vigevano declares no conflicts of interest in relation to this manuscript. Sameer Zuberi declares no conflicts of interest in relation to this manuscript.