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Prevalence of SCN1A-related dravet syndrome among children reported with seizures following vaccination: a population-based ten-year cohort study.

Verbeek NE, van der Maas NA, Jansen FE, van Kempen MJ, Lindhout D, Brilstra EH - PLoS ONE (2013)

Bottom Line: In 21.9% (n = 279) of children, a diagnosis of Dravet syndrome could not be excluded based on available clinical data (median age at follow-up 16 months).Additional follow-up data were obtained in 83.9% (n = 234) of these children (median age 8.5 years). 15 (1.2% of 1,269; 95%CI:0.6 to 1.8%) children were diagnosed with SCN1A-related Dravet syndrome.Knowledge on the specific characteristics of vaccination-related seizures in this syndrome might promote early diagnosis and indirectly, public faith in vaccination safety.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands. n.verbeek@umcutrecht.nl

ABSTRACT

Objectives: To determine the prevalence of Dravet syndrome, an epileptic encephalopathy caused by SCN1A-mutations, often with seizure onset after vaccination, among infants reported with seizures following vaccination. To determine differences in characteristics of reported seizures after vaccination in children with and without SCN1A-related Dravet syndrome.

Methods: Data were reviewed of 1,269 children with seizures following immunization in the first two years of life, reported to the safety surveillance system of the Dutch national immunization program between 1 January 1997 and 31 December 2006. Selective, prospective follow-up was performed of children with clinical characteristics compatible with a diagnosis of Dravet syndrome.

Results: In 21.9% (n = 279) of children, a diagnosis of Dravet syndrome could not be excluded based on available clinical data (median age at follow-up 16 months). Additional follow-up data were obtained in 83.9% (n = 234) of these children (median age 8.5 years). 15 (1.2% of 1,269; 95%CI:0.6 to 1.8%) children were diagnosed with SCN1A-related Dravet syndrome. Of all reported seizures following vaccinations in the first year of life, 2.5% (95%CI:1.3 to 3.6%) were due to SCN1A-related Dravet syndrome, as were 5.9% of reported seizures (95%CI:3.1 to 8.7%) after 2(nd) or 3(rd) DTP-IPV-Hib vaccination. Seizures in children with SCN1A-related Dravet syndrome occurred more often with a body temperature below 38.5°C (57.9% vs. 32.6%, p = 0.020) and reoccurred more often after following vaccinations (26.7% vs. 4.0%, p = 0.003), than in children without a diagnosis of SCN1A-related Dravet Syndrome.

Conclusions: Although Dravet syndrome is a rare genetic epilepsy syndrome, 2.5% of reported seizures following vaccinations in the first year of life in our cohort occurred in children with this disorder. Knowledge on the specific characteristics of vaccination-related seizures in this syndrome might promote early diagnosis and indirectly, public faith in vaccination safety.

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Classification and distribution of reported seizures following vaccinations, according to age at vaccination.
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pone-0065758-g002: Classification and distribution of reported seizures following vaccinations, according to age at vaccination.

Mentions: The reported vaccinations (n = 1,327) included 64.5% (n = 856) DTP-IPV(-)Hib vaccinations, 33.2% (n = 440) MMR (+MenC) vaccinations, 1.2% (n = 16) combined DTP-IPV(-)Hib/MMR vaccinations and 1.1% (n = 15) other vaccinations (mainly single MenC vaccinations). 55.2% (n = 732) of reported seizures occurred after a vaccination in the first year of life. Of the reported seizures 50.1% (n = 665) were atypical seizures, 25.7% (n = 341) simple febrile seizures, 15.5% (n = 206) complex febrile seizures and 8.7% (n = 115) afebrile seizures (Figure 2).


Prevalence of SCN1A-related dravet syndrome among children reported with seizures following vaccination: a population-based ten-year cohort study.

Verbeek NE, van der Maas NA, Jansen FE, van Kempen MJ, Lindhout D, Brilstra EH - PLoS ONE (2013)

Classification and distribution of reported seizures following vaccinations, according to age at vaccination.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3675088&req=5

pone-0065758-g002: Classification and distribution of reported seizures following vaccinations, according to age at vaccination.
Mentions: The reported vaccinations (n = 1,327) included 64.5% (n = 856) DTP-IPV(-)Hib vaccinations, 33.2% (n = 440) MMR (+MenC) vaccinations, 1.2% (n = 16) combined DTP-IPV(-)Hib/MMR vaccinations and 1.1% (n = 15) other vaccinations (mainly single MenC vaccinations). 55.2% (n = 732) of reported seizures occurred after a vaccination in the first year of life. Of the reported seizures 50.1% (n = 665) were atypical seizures, 25.7% (n = 341) simple febrile seizures, 15.5% (n = 206) complex febrile seizures and 8.7% (n = 115) afebrile seizures (Figure 2).

Bottom Line: In 21.9% (n = 279) of children, a diagnosis of Dravet syndrome could not be excluded based on available clinical data (median age at follow-up 16 months).Additional follow-up data were obtained in 83.9% (n = 234) of these children (median age 8.5 years). 15 (1.2% of 1,269; 95%CI:0.6 to 1.8%) children were diagnosed with SCN1A-related Dravet syndrome.Knowledge on the specific characteristics of vaccination-related seizures in this syndrome might promote early diagnosis and indirectly, public faith in vaccination safety.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands. n.verbeek@umcutrecht.nl

ABSTRACT

Objectives: To determine the prevalence of Dravet syndrome, an epileptic encephalopathy caused by SCN1A-mutations, often with seizure onset after vaccination, among infants reported with seizures following vaccination. To determine differences in characteristics of reported seizures after vaccination in children with and without SCN1A-related Dravet syndrome.

Methods: Data were reviewed of 1,269 children with seizures following immunization in the first two years of life, reported to the safety surveillance system of the Dutch national immunization program between 1 January 1997 and 31 December 2006. Selective, prospective follow-up was performed of children with clinical characteristics compatible with a diagnosis of Dravet syndrome.

Results: In 21.9% (n = 279) of children, a diagnosis of Dravet syndrome could not be excluded based on available clinical data (median age at follow-up 16 months). Additional follow-up data were obtained in 83.9% (n = 234) of these children (median age 8.5 years). 15 (1.2% of 1,269; 95%CI:0.6 to 1.8%) children were diagnosed with SCN1A-related Dravet syndrome. Of all reported seizures following vaccinations in the first year of life, 2.5% (95%CI:1.3 to 3.6%) were due to SCN1A-related Dravet syndrome, as were 5.9% of reported seizures (95%CI:3.1 to 8.7%) after 2(nd) or 3(rd) DTP-IPV-Hib vaccination. Seizures in children with SCN1A-related Dravet syndrome occurred more often with a body temperature below 38.5°C (57.9% vs. 32.6%, p = 0.020) and reoccurred more often after following vaccinations (26.7% vs. 4.0%, p = 0.003), than in children without a diagnosis of SCN1A-related Dravet Syndrome.

Conclusions: Although Dravet syndrome is a rare genetic epilepsy syndrome, 2.5% of reported seizures following vaccinations in the first year of life in our cohort occurred in children with this disorder. Knowledge on the specific characteristics of vaccination-related seizures in this syndrome might promote early diagnosis and indirectly, public faith in vaccination safety.

Show MeSH
Related in: MedlinePlus