The effect of the coronavirus vaccinations on seizures in patients with epilepsy

Information on COVID-19 vaccine tolerance and complications in patients with epilepsy is not yet sufficient to provide a recommendation for vaccination guidelines. The aim of this study was to investigate the effect of two types of COVID vaccines currently used in Turkey (mRNA vaccine from Pfizer/BioNTech and inactivated vaccine from Sinovac) on epileptic seizures.

We included 318 patients with epilepsy who were admitted to our epilepsy outpatient clinic. Clinical characteristics such as age, gender, age at seizure onset and the duration of epilepsy were noted. Types and the numbers of the anti-seizure drugs were recorded. Patients were evaluated either by face-to-face or by teleconference interviews. The seizure frequency in the first thirty days after any dose of vaccination was questioned.

A total of 318 patients (149 females, 46.8%) with a confirmed diagnosis of epilepsy were enrolled in the study. An increase in seizure frequency was reported after the COVID-19 vaccine in 19 patients. Of these 19 patients, 2 were vaccinated with Sinovac, while 17 were vaccinated with BioNTech/Pfizer mRNA vaccine. There was no significant relationship between age, age at seizure onset, duration of epilepsy, type of seizures, seizure frequency or seizure induction. Status epilepticus was not reported in any of the participants.

Physicians need strong scientific evidence to advocate the importance of vaccine for COVID-19, that's why accumulation of knowledge related to this issue is important not only from medical but also from medico-legal point of interest. We aimed to contribute the current literature with our study to strengthen the physicians' hand while recommending COVID vaccines to PWE. Our results show that there is no significant increase in the risk of triggering seizures with COVID-19 vaccines. These data show that vaccination against COVID-19 with both vaccine types in patients with epilepsy is safe and well tolerated.