Abstract
Objectives 12 months since the implementation of the COVID vaccination, over 94% of the Australian population over 16 years old are fully vaccinated. Although vaccines are generally safe in persons with epilepsy (PWE), seizure-like events are a known complication of vaccinations, including COVID vaccines. This study assessed the rate of COVID vaccination-related exacerbation of seizures in PWE.
Methods Adult PWE who had received at least one COVID vaccine were prospectively recruited at the epilepsy clinic between June 2021 and February 2022. Patient demographics, including epilepsy history, vaccination details and side effects were recorded. The rate of seizure exacerbation, defined as within one week of vaccination, was assessed.
Results 364 PWE received the COVID vaccine, with 352 patients (97%) receiving two doses, with 73% receiving the Pfizer vaccine as their initial dose. 31% of patients were 12-months seizure free at baseline. The median number of antiseizure medications (ASM) was 2, with 65% of patients on 2 or more ASM. Most patients (62%) had focal epilepsy. 10 patients (2.8%) reported an exacerbation of seizures following their first vaccination. None were seizure-free at baseline. One patient required admission for seizure exacerbation. 4 patients had other systemic side effects and 3 patients had exacerbation of seizures after their second dose.
Conclusion Exacerbation of seizures are an infrequent complication of COVID vaccination and mainly occur in non-seizure free patients. It appears, the reported rate of seizure exacerbation and other complications due to COVID outweighs the risk of exacerbation due to vaccinations.
