Status epilepticus as a complication of SARS-CoV-2 vaccination: Two case reports and systematic review with individual patients' data analysis.

Autor:	Dasara M; Department of Neuroscience, Imaging and Clinical Science, 'G. d'Annunzio' University of Chieti-Pescara, Via dei Vestini 1, Chieti 6610, Italy; Epilepsy Center, Neurology Institute 'SS Annunziata' University Hospital, University of Chieti-Pescara, Chieti, Italy., Dono F; Department of Neuroscience, Imaging and Clinical Science, 'G. d'Annunzio' University of Chieti-Pescara, Via dei Vestini 1, Chieti 6610, Italy; Epilepsy Center, Neurology Institute 'SS Annunziata' University Hospital, University of Chieti-Pescara, Chieti, Italy; Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies and Technology (CAST) and Institute for Advanced Biomedical Technologies (ITAB), University of Chieti-Pescara, Chieti, Italy University 'G. d'Annunzio' of Chieti-Pescara, Italy. Electronic address: fedele.dono@unich.it., Evangelista G; Department of Neuroscience, Imaging and Clinical Science, 'G. d'Annunzio' University of Chieti-Pescara, Via dei Vestini 1, Chieti 6610, Italy; Epilepsy Center, Neurology Institute 'SS Annunziata' University Hospital, University of Chieti-Pescara, Chieti, Italy; Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies and Technology (CAST) and Institute for Advanced Biomedical Technologies (ITAB), University of Chieti-Pescara, Chieti, Italy University 'G. d'Annunzio' of Chieti-Pescara, Italy., Quintieri P; Department of Neuroscience, Imaging and Clinical Science, 'G. d'Annunzio' University of Chieti-Pescara, Via dei Vestini 1, Chieti 6610, Italy; Epilepsy Center, Neurology Institute 'SS Annunziata' University Hospital, University of Chieti-Pescara, Chieti, Italy; Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies and Technology (CAST) and Institute for Advanced Biomedical Technologies (ITAB), University of Chieti-Pescara, Chieti, Italy University 'G. d'Annunzio' of Chieti-Pescara, Italy., Liviello D; Department of Neuroscience, Imaging and Clinical Science, 'G. d'Annunzio' University of Chieti-Pescara, Via dei Vestini 1, Chieti 6610, Italy; Epilepsy Center, Neurology Institute 'SS Annunziata' University Hospital, University of Chieti-Pescara, Chieti, Italy; Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies and Technology (CAST) and Institute for Advanced Biomedical Technologies (ITAB), University of Chieti-Pescara, Chieti, Italy University 'G. d'Annunzio' of Chieti-Pescara, Italy., Cipollone S; Department of Neuroscience, Imaging and Clinical Science, 'G. d'Annunzio' University of Chieti-Pescara, Via dei Vestini 1, Chieti 6610, Italy; Epilepsy Center, Neurology Institute 'SS Annunziata' University Hospital, University of Chieti-Pescara, Chieti, Italy; Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies and Technology (CAST) and Institute for Advanced Biomedical Technologies (ITAB), University of Chieti-Pescara, Chieti, Italy University 'G. d'Annunzio' of Chieti-Pescara, Italy., Tomassini V; Department of Neuroscience, Imaging and Clinical Science, 'G. d'Annunzio' University of Chieti-Pescara, Via dei Vestini 1, Chieti 6610, Italy; Epilepsy Center, Neurology Institute 'SS Annunziata' University Hospital, University of Chieti-Pescara, Chieti, Italy; Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies and Technology (CAST) and Institute for Advanced Biomedical Technologies (ITAB), University of Chieti-Pescara, Chieti, Italy University 'G. d'Annunzio' of Chieti-Pescara, Italy., Sensi SL; Department of Neuroscience, Imaging and Clinical Science, 'G. d'Annunzio' University of Chieti-Pescara, Via dei Vestini 1, Chieti 6610, Italy; Epilepsy Center, Neurology Institute 'SS Annunziata' University Hospital, University of Chieti-Pescara, Chieti, Italy; Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies and Technology (CAST) and Institute for Advanced Biomedical Technologies (ITAB), University of Chieti-Pescara, Chieti, Italy University 'G. d'Annunzio' of Chieti-Pescara, Italy.
Jazyk:	angličtina
Zdroj:	Seizure [Seizure] 2024 Oct; Vol. 121, pp. 8-16. Date of Electronic Publication: 2024 Jul 18.
DOI:	10.1016/j.seizure.2024.07.013
Abstrakt:	Introduction: Status Epilepticus (SE) stands as a prominent neurological emergency, showing a mortality rate of approximately 20%. Since February 2021, a worldwide vaccination campaign has been launched against the Coronavirus 19 disease (COVID-19) pandemic. Several possible vaccine-related adverse events have been identified, including neurological manifestations. SE is beginning to surface in literature as an emergent condition in COVID-19-vaccinated individuals, though defined reasons accounting for this correlation are still missing. Methods: We report two cases of SE related to the SARS-CoV-2 vaccine. In addition, we performed a systematic search of the literature to identify the consistency of the association between the SARS-CoV-2 vaccine and the SE onset. The following databases were consulted: PubMed and Google Scholar. Results: Two novel super-refractory status epilepticus (SRSE) cases associated with the BNT162b2 mRNA COVID-19 vaccine were identified. Both patients received the second dose of the vaccine about 14 days prior to SE onset. Patients showed a non-convulsive semiology and were treated with a combined anesthetic and immunomodulant therapy, leading to SE resolution in both cases. The literature review identified seven additional cases, primarily non-convulsive SE. Four patients received the Spikevax (ex-COVID-19 Moderna mRNA -1273 vaccine), 2 patients the BNT162b2 (Pfizer/Biotech), and 1 patient the ChAdOx1-s (AstraZeneca) vaccine. The first vaccine dose (5/7, 71.4%) emerged as the most frequently associated with SE onset, which manifested at an average of 4.5 days (± 3.4) following vaccination. Five patients presented RSE and required continuous intravenous anesthetic drug administration. Resolution of SE was achieved in all cases. Conclusions: Status Epilepticus is a rare complication associated with Sars-CoV-2 vaccines. Additional studies are needed to ascertain the potential association between Sars-CoV-2 vaccines and status epilepticus. Competing Interests: Declaration of competing interest None of the authors has any conflict of interest to disclose. (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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