Seizures in Patients with Epilepsy Receiving COVID -19 Vaccination: A Retrospective Review in A Level 4 Epilepsy Center

Objective: To identify the incidence of seizures within 48 hours of COVID-19 vaccination in PWE Methods: This is a retrospective cross-sectional observational study performed at two Northern Virginia neurology clinics. PWE that had been vaccinated against COVID-19 were surveyed to report occurrence of a seizure within 48 hours of COVID-19 vaccination and the presence of additional triggers surrounding the seizure. Results: Of the 189 patients included in the analysis, 13 (7%) reported a seizure within 48 hours of vaccination. Of the 13 participants with reported seizures, 10 identified possible triggers present at the time of their seizure. Additionally, patients with intractable epilepsy were found to have a non-statistically significant (p = 0.16) increased risk of seizure (odds ratio = 2.2) within 48 hours of vaccination. Conclusion: The results show a low incidence of seizure within 48 hours of receiving a COVID-19 vaccination in this cohort of PWE. Those that reported seizures had additional provoking factors present that may have triggered the seizure. For patients with intractable epilepsy it appears they may have some increased risk of breakthrough seizures within 48 hours of vaccination. It is recommended that clinicians counsel their epilepsy patients, especially those with an intractable diagnosis, to mitigate potential seizure triggers prior to vaccine administration. Further research is recommended to observe for long term effects if present and to control for provoking seizure factors/triggers.