Vaccination and the onset of dravet syndrome.

Commentary Imagine you have an adorable baby, the birth went well, and he/she is developing nicely; laughing, smiling, making eye contact, and playing. You are worried because you heard about complications from immunizations, but your pediatri-cian reassures you. In fact, all of your friends have immunized their children without problem. After the injection, your baby has a fever and experiences a seizure. From that moment in time, your life is never the same nor is the life of your child or the whole family. No wonder many parents think that it was the vaccination itself that created this terrible situation. Wouldn't you? Therefore, studies such as the McIntosh paper (1) have important implications. Several relevant questions arise: 1) How should doctors advise parents before vaccinations? What should be said to parents? Should all parents be warned about the potential triggering of Dravet syndrome, a rare disorder affecting about 1 of 30,000? 2) How can we identify children that might be susceptible to developing Dravet syndrome? 3) Do all children with the SCN1A genetic mutation develop the full expression of the disease? 4) Can a vaccination be deferred or not given, thereby possibly preventing or delaying the onset or expression of Dravet syndrome? None of these questions have answers at this time, but prospective studies and treatment protocols are needed to try to find the answers. At present, retrospective chart reviews like the cited study are all we have, but, at least, it is a beginning. The trouble (or the good news) is that Dravet syndrome (severe myoclonic epilepsy of infancy) is a very rare disease, and most cases are sporadic with a high rate of de novo sodium-channel gene (SCN1A) mutations. This means that the mutation most often appears spontaneously rather than being inherited. Onset age is around 6 months, with prolonged febrile or afebrile generalized clonic or hemiclonic seizures. This occurs, coinci-dentally, just at the same time as the vaccinations are commonly given. The Center for Disease Control (CDC) recommends that vaccinations are given at 2, 4, and 6 months. Affected children BACKGROUND: Pertussis vaccination has been alleged to cause an encephalopathy that involves seizures and subsequent intellectual disability. In a previous retrospective study, 11 of 14 patients with so-called vaccine encephalopathy had Dravet syndrome that was associated with de-novo mutations of the sodium channel gene SCN1A. In this study, we aimed to establish whether the apparent association of …