Risk of seizures after immunization in children with epilepsy: a risk interval analysis.
Risk of seizures after immunization in children with epilepsy: a risk interval analysis.
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DOI：
10.1186/s12887-018-1112-0
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发表时间：
2018-04-11
期刊：
影响因子：
2.4
通讯作者：
Smith B
中科院分区：
文献类型：
--
作者：
Top KA;Brna P;Ye L;Smith B
在癫痫儿童中，发烧和感染可引发癫痫发作。免疫接种也会引起炎症和发烧，理论上可能引发癫痫发作。对于既存癫痫的儿童，免疫接种后癫痫发作的风险尚不清楚。本研究的目的是确定< 7岁癫痫儿童免疫接种后药物治疗癫痫发作的风险。我们对2010年至2014年加拿大新斯科舍省7岁以下癫痫儿童进行了一项回顾性研究。从医疗记录中提取住院、急诊、计划外门诊和癫痫发作电话。在知情同意的情况下，从家庭医生和公共卫生部门获得免疫记录。我们进行了风险区间分析，以估计在免疫后0-14天、0-2天和5-14天的风险期与免疫后21-83天的对照期癫痫发作的相对风险（RR）。共有302名癫痫儿童符合研究条件。检索了147例患者（49%）的免疫记录，其中80例（54%）在癫痫诊断日期至7岁之间进行了一次或多次免疫接种。这80名儿童接受了161次免疫接种，197次癫痫发作接受了医疗护理。有免疫接种的儿童比没有免疫接种或没有记录的儿童癫痫发作更多（平均2.5比0.7比0.9，p < 0.001）。与免疫后21-83天相比，接种任何疫苗后0-14天（RR = 1.1，95%置信区间（CI）：0.5-2.8）或灭活疫苗后0-2天（RR = 0.9，95% CI：0.1-7.1），医疗护理癫痫发作的风险未增加。活疫苗接种后5-14天未发生癫痫发作事件。癫痫儿童在免疫接种后出现癫痫发作的风险似乎没有增加。这些发现表明，免疫接种对癫痫儿童是安全的，其益处大于风险。本文的在线版本（10.1186/s12887-018-1112-0）包含补充材料，可供授权用户使用。
In children with epilepsy, fever and infection can trigger seizures. Immunization can also induce inflammation and fever, which could theoretically trigger a seizure. The risk of seizure after immunization in children with pre-existing epilepsy is not known. The study objective was to determine the risk of medically attended seizure after immunization in children with epilepsy < 7 years of age. We conducted a retrospective study of children < 7 years of age with epilepsy in Nova Scotia, Canada from 2010 to 2014. Hospitalizations, emergency visits, unscheduled clinic visits, and telephone calls for seizures were extracted from medical records. Immunization records were obtained from family physicians and Public Health with informed consent. We conducted a risk interval analysis to estimate the relative risk (RR) of seizure during risk periods 0–14, 0–2, and 5–14 days post-immunization versus a control period 21–83 days post-immunization. There were 302 children with epilepsy who were eligible for the study. Immunization records were retrieved on 147 patients (49%), of whom 80 (54%) had one or more immunizations between the epilepsy diagnosis date and age 7 years. These 80 children had 161 immunization visits and 197 medically attended seizures. Children with immunizations had more seizures than either those with no immunizations or those with no records (mean 2.5 versus 0.7 versus 0.9, p < 0.001). The risk of medically attended seizure was not increased 0–14 days after any vaccine (RR = 1.1, 95% confidence interval (CI): 0.5–2.8) or 0–2 days after inactivated vaccines (RR = 0.9, 95% CI: 0.1–7.1) versus 21–83 days post-immunization. No seizure events occurred 5–14 days after live vaccines. Children with epilepsy do not appear to be at increased risk of medically attended seizure following immunization. These findings suggest that immunization is safe in children with epilepsy, with benefits outweighing risks. The online version of this article (10.1186/s12887-018-1112-0) contains supplementary material, which is available to authorized users.
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影响因子：
8
作者：
Klein, Nicola P.;Lewis, Edwin;Fireman, Bruce
通讯作者：
Fireman, Bruce
DOI：
10.1136/bmj.e7594
发表时间：
2012-12-18
期刊：
BMJ (Clinical research ed.)
影响因子：
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作者：
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作者：
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影响因子：
5.5
作者：
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影响因子：
9.9
作者：
Verbeek, Nienke E.;van der Maas, Nicoline A. T.;Brilstra, Eva H.
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Brilstra, Eva H.