Risk analysis of vaccination in children with genetic epilepsy combined with febrile seizures plus

Objective To assess the risk of vaccination in children with genetic epilepsy combined with febrile seizures plus (GEFS+). Methods Sixty-seven children with GEFS+, admitted to our hospital from May 2016 to May 2019, were enrolled in our study; using targeted second-generation sequencing technology, these patients were divided into positive SCN1A gene mutation group (SCN1A+ group, n=11) and negative SCN1A gene mutation group (SCN1A- group, n=51) after kicking out 5 patients with other gene mutations. The frequencies of convulsion and changes of body temperature after vaccination were analyzed retrospectively in the two groups from birth to age of 7 years. The levels of interleukin (IL)-2, IL-6, IL-10 and tumor necrosis factor (TNF)-α in peripheral blood were measured by flow cytometry in both groups after seizures. Results Children from SCN1A+ group were vaccinated for 34 times, with incidence of post-vaccine convulsion reaching 47% (16/34); children from SCN1A- group were vaccinated for 186 times, with incidence of post-vaccine convulsions reaching 6.45% (12/186); incidence of post-vaccine convulsion was statistically significant between the two groups (P<0.05). The mean body temperature in children from the SCN1A+ group ([38.06±0.57] ℃) during convulsion was significantly lower than that in SCN1A- group ([39.49±0.49] ℃, P<0.05). Expressions of IL-6 and IL-10 in peripheral blood after convulsion in children from SCN1A+ group (96.80±25.05 and 74.90±18.28) were significantly higher than those in SCN1A- group(72.97±4.81 and 43.99±10.63, P<0.05). Conclusion GEFS+ children in the SCN1A+ group are more prone to convulsion after vaccination than those in the SCN1A- group; cytokines may be involved in the development of convulsion. Key words: SCN1A gene; Epilepsy; Convulsion; Vaccine; Heat-sensitivity