One hundred and ten cases of infantile spasms with detailed information about immunization
available were selected as the material to evaluate the significance of immunization
as an etiological factor of infantile spasms. In 80% of the cases, immunization could
not be considered to have any relation with causation of infantile spasms, because
44 cases (40%) never had innoculations as yet, and other 44 cases (40%) had been immunized
by some vaccines over one month before or after the onset of the disease. The remaining
22 cases, in whom immunization had been performed within one month before the onset
of the disease, constituted the candidates for further study. The age of onset of
the disease of the candidate group ranged from 3 to 9 months of age with peak incidence
at 4 to 5 months old, exactly identical with that of patients with infantile spasms
in general. The kind of vaccines concerned included DPT triple vaccines in 15 cases,
smallpox vaccine in 4, antipolio live vaccine in 1, anti-Japanese encephalitis vaccine
in 2. Causal relationship of immunization with infantile spasms in each patient was
evaluated on the basis of the following three aspects:
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Any other causal factors except immunization should be absent.
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Psychomotor development before onset of the disease should be normal.
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Interval from immunization to onset of the disease should be lied:
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a) Within 48 hours, in the case of pertussis vaccine,
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b) within 18 days, in the case of smallpox vaccine or anti-Japanese encephalitis vaccine
or antipolio vaccine.
Only five cases (4.8% of the total) were able to classify into the compatible group
which should fulfill all the above three criteria. The small figure may easily be
explicable on the assumption that the natural onset of spasm is chronologically superposed
by chance over immunizations which have to be done within the first year of life.
Infantile spasms - pertussis vaccine - smallpox vaccination
