Aim:

Concerns regarding the effects of mRNA-based COVID-19 vaccination on paediatric epilepsy course were raised by physicians and patients. This study aimed to evaluate such possible effects, and to characterise the manifestations of acute infection with SARS-CoV-2 in children with epilepsy.

Method:

This was an observational cross-sectional study. Patients between 5-18 years who visited our paediatric epilepsy clinic between 1 September and 30 November 2022 were recruited. The patient or their parent filled out an anonymous one-page questionnaire on the manifestations of SARS-CoV19 infection, the adverse events of COVID-19 vaccine, and some clinical and demographic information.

Results:

Overall, 160 patients completed the questionnaires. Symptoms of acute infection were mostly mild. Seizure exacerbation during the infection was reported in 17%, and three children were admitted to the hospital. No seizure exacerbation was reported in the week following 104 vaccination doses. The vaccination rate was significantly lower than the general population of the same age, especially in children under 12. 

Conclusions:

The risk for seizure exacerbation following vaccination was minimal. The risk for seizure exacerbation during an infection was substantial. Clinicians should reassure patients, parents, and caregivers regarding the low risk of seizures following COVID-19 vaccination.

Tal Gilboa is a Director, Pediatric Epilepsy Service at Hadasit Bio Holdings based in Jerusalem, Jerusalem. Previously, Tal was a Director, Child Neurology Unit at Surgical Innovation and Technology Center, Hadassah Medical Center and also held positions at Shaare Zedek, Shaare Zedek.