Impact of Rotavirus Vaccine Introduction on Rotavirus-Associated Seizures and a Related Possible Mechanism

To determine whether clinical features of rotavirus-associated seizures have been altered by rotavirus vaccination, we compared clinical and laboratory data of 2 groups of patients with rotavirus-associated seizures: pre– and post–vaccine introduction groups. The seizure characteristics differed significantly between the groups, with a lower incidence of fever at seizure onset, longer interval between the onset of gastroenteritis and seizures, and more frequent seizures in the postintroduction group. These characteristics may suggest that seizure susceptibility was increased in the postintroduction group. Based on the lower serum Cl– (102.1 ± 4.1 vs 98.2 ± 3.2 mg/dL; P < .01) and Ca2+ levels (9.2 ± 0.4 vs 9.0 ± 0.3 mg/dL; P = .12) in the postintroduction group, we propose that a change in the subjects’ susceptibility to the rotavirus enterotoxin may have played a role in increasing the seizure susceptibility in this group. Our results suggest that a rotavirus vaccination program may modulate the manifestations of rotavirus-associated seizures.