[Survey of vaccination and viral infections for children with severe myoclonic epilepsy in infancy].
A study group for establishment of a proposed immunization program for neurologically high risk children (Chief, Kihei Maekawa) sponsored by the Ministry of Health, Labour and Welfare of Japan is preparing a proposal for patients with epilepsy. Severe myoclonic eplepsy in infancy (SMEI) is an intractable epilepsy which often presents with status epilepticus and triggered by hyperthermia and viral infections. In this study we investigated the history of vaccination in children with SMEI to compare the risk of vaccination with that of natural contraction of infection. Fifty-eight patients with SMEI, aged from 2 to 25 years, were enrolled in this study. A total of 359 vaccines were given to these subjects. The vaccination rates were high for BCG (71%) and polio (1st; 71%, 2nd; 53%), and then fell gradually after the onset of SMEI (DPT-1st; 48%. DPT-2nd; 45%, DPT-3rd; 38%, DPT-4th; 24%, mumps; 21%, varicella; 19%, rubella 31%). However, the measles vaccine was given at a relatively high rate (55%) before the age of three. When patients suffered from measles, rubella, mumps or influenza, they had a high risk of severe neurological complications, such as convulsive status, disturbance of consciousness and encephalopathy. These complications were documented in 63% of all episodes of naturally contracted infections. This rate was significantly higher (p < 0.0001) than that associated with vaccination (7.2%). However, hyperthermia and convulsion developed more frequently (p = 0.012) after measles vaccine was given, as compared to other vaccines. Thus, administration of these vaccines to patients with SMEI in conjunction with other preventive measures against seizure induced by hyperthermia, may meet the needs of their parents.
Division of Pediatrics, Hirakata Municipal Hospital, Hirakata, Osaka. tanabemapa@pop01.odn.ne.jp
Takuya
T
Tanabe
Yutaka
Y
Awaya
Toyojiro
T
Matsuishi
Toshisaburo
T
Nagai
Katsuya
K
Yamamoto
Mana
M
Kurihara
Kuniaki
K
Iyoda
Kihei
K
Maekawa
D000293:Adolescent; D000328:Adult; D001500:BCG Vaccine; D002648:Child; D002675:Child, Preschool; D004831:Epilepsies, Myoclonic / Q000150:complications*; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D008297:Male; D023321:Poliovirus Vaccines; D014611:Vaccination / Q000706:statistics & numerical data; D014765:Viral Vaccines / Q000009:adverse effects; D014777:Virus Diseases / Q000517:prevention & control*
D001500:BCG Vaccine; D023321:Poliovirus Vaccines; D014765:Viral Vaccines