Immunization stress-related responses presenting as psychogenic non-epileptic seizures following HPV vaccination in Rio Branco, Brazil

Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSPMARCHETTI, Renato LuizGALLUCCI-NETO, JoseKURCGANT, DanielaPROENCA, Inah Carolina Galatro FariaVALIENGO, Leandro da Costa LaneFIORE, Lia ArnoPINTO, Lecio FigueiraMARANHAO, Ana Goretti KalumeOLIVEIRA, Maria Tereza da CostaOLIVEIRA, Lucia Helena de2020-12-162020-12-162020VACCINE, v.38, n.43, p.6714-6720, 20200264-410Xhttps://observatorio.fm.usp.br/handle/OPI/38651Importance: The absence of a positive diagnosis of psychogenic non-epileptic seizures (PNES) in immunization stress-related response (ISRR) clusters may have not only a direct impact on affected patients' health but may also reduce compliance to national vaccination programs. It is therefore crucial to develop efficient diagnostic tools and a feasible proposal for proper communication and treatment of ISRR. Purpose: To explore the psychogenic nature of patients' convulsive seizures in a suspected outbreak of an ISRR cluster following human papillomavirus vaccination in Rio Branco, Brazil. Methods: Twelve patients with convulsive seizures were submitted to prolonged intensive videoelectroencephalography monitoring, brain magnetic resonance imaging, cerebrospinal fluid diagnostic testing, laboratory subsidiary examinations, and complete neurological and psychiatric evaluations. Results: Ten patients received the positive diagnosis of PNES, and two patients received the diagnosis of idiopathic generalized epilepsy. No biological association was found between the HPV vaccine and the clinical problems presented by the patients. Conclusions: Prolonged VEEG monitoring can contribute significantly to the positive diagnosis of PNES in ISRR clusters and to avoid hesitancy to vaccinate.engrestrictedAccessHPV vaccinationHPV immunizationPsychogenic non-epileptic seizuresImmunization stress-related responseImmunization anxiety-related reactionMass psychogenic illnessinternational leaguesick individualsilae commissionposition paperdiagnosisepilepsyillnesshysteriaclassificationoutbreakImmunization stress-related responses presenting as psychogenic non-epileptic seizures following HPV vaccination in Rio Branco, BrazilarticleCopyright ELSEVIER SCI LTD10.1016/j.vaccine.2020.08.044ImmunologyMedicine, Research & Experimental1873-2518