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Hanael E, Baruch S, Altman RK, Chai O, Rapoport K, Peery D, Friedman A, Shamir MH. Blood-brain barrier dysfunction and decreased transcription of tight junction proteins in epileptic dogs. J Vet Intern Med 2024; 38:2237-2248. [PMID: 38842297 PMCID: PMC11256172 DOI: 10.1111/jvim.17099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 04/25/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Epilepsy in dogs and humans is associated with blood-brain barrier (BBB) dysfunction (BBBD), which may involve dysfunction of tight junction (TJ) proteins, matrix metalloproteases, and astrocytes. Imaging techniques to assess BBB integrity, to identify potential treatment strategies, have not yet been evaluated in veterinary medicine. HYPOTHESIS Some dogs with idiopathic epilepsy (IE) will exhibit BBBD. Identifying BBBD may improve antiepileptic treatment in the future. ANIMALS Twenty-seven dogs with IE and 10 healthy controls. METHODS Retrospective, prospective cohort study. Blood-brain barrier permeability (BBBP) scores were calculated for the whole brain and piriform lobe of all dogs by using dynamic contrast enhancement (DCE) magnetic resonance imaging (MRI) and subtraction enhancement analysis (SEA). Matrix metalloproteinase-9 (MMP9) activity in serum and cerebrospinal fluid (CSF) was measured and its expression in the piriform lobe was examined using immunofluorescent staining. Gene expression of TJ proteins and astrocytic transporters was analyzed in the piriform lobe. RESULTS The DCE-MRI analysis of the piriform lobe identified higher BBBP score in the IE group when compared with controls (34.5% vs 26.5%; P = .02). Activity and expression of MMP9 were increased in the serum, CSF, and piriform lobe of IE dogs as compared with controls. Gene expression of Kir4.1 and claudin-5 in the piriform lobe of IE dogs was significantly lower than in control dogs. CONCLUSIONS AND CLINICAL IMPORTANCE Our findings demonstrate BBBD in dogs with IE and were supported by increased MMP9 activity and downregulation of astrocytic potassium channels and some TJ proteins. Blood brain barrier dysfunction may be a novel antiepileptic therapy target.
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Affiliation(s)
- Erez Hanael
- Koret School of Veterinary Medicine, Neurology and NeurosurgeryThe Hebrew University of JerusalemRehovotIsrael
| | - Shelly Baruch
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, Neurology and NeurosurgeryThe Hebrew University of JerusalemRehovotIsrael
| | - Rotem Kalev Altman
- Koret School of Veterinary MedicineThe Hebrew University of JerusalemRehovotIsrael
| | - Orit Chai
- Koret School of Veterinary MedicineThe Hebrew University of JerusalemRehovotIsrael
| | - Kira Rapoport
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, Neurology and NeurosurgeryThe Hebrew University of JerusalemRehovotIsrael
| | - Dana Peery
- Koret School of Veterinary MedicineThe Hebrew University of JerusalemRehovotIsrael
| | | | - Merav H. Shamir
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, Neurology and NeurosurgeryThe Hebrew University of JerusalemRehovotIsrael
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Zayed AA, Seleem MM, Darwish HA, Shaheen AA. Role of long noncoding RNAs; BDNF-AS and 17A and their relation to GABAergic dysfunction in Egyptian epileptic patients. Metab Brain Dis 2023; 38:1193-1204. [PMID: 36807083 PMCID: PMC10110666 DOI: 10.1007/s11011-023-01182-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 02/04/2023] [Indexed: 02/23/2023]
Abstract
Epilepsy is a chronic neurological disorder characterized by recurrent unprovoked seizures. Lately, long noncoding RNAs (lncRNAs) have been increasingly appreciated as regulators of epilepsy-related processes, however, their functional role in its pathogenesis is still to be explored. This study investigated the expression levels of lncRNAs; BDNF-AS and 17A in the sera of Egyptian patients with idiopathic generalized and symptomatic focal epilepsy and correlated their levels with brain-derived neurotrophic factor (BDNF), phosphorylated cAMP reaction element -binding protein (p-CREB), gamma- aminobutyric acid (GABA) and glutamate, to underline their related molecular mechanism. A total of 70 epileptic patients were divided into two clinical types, besides 30 healthy controls of matched age and sex. The expression levels of both lncRNAs were markedly upregulated in epileptic groups versus the healthy control group with predominance in the symptomatic focal one. Epileptic patients showed significantly lower levels of BDNF, p-CREB, GABA along with significant increase of glutamate levels and glutamate/ GABA ratio, especially in symptomatic focal versus idiopathic generalized epileptic ones. The obtained data raised the possibility that these lncRNAs might be involved in the pathogenesis of epilepsy via inhibition of GABA/p-CREB/BDNF pathway. The study shed light on the putative role of these lncRNAs in better diagnosis of epilepsy, particularly symptomatic focal epilepsy.
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Affiliation(s)
- Aya A Zayed
- Department of Pharmacology, Toxicology and Biochemistry, Faculty of Pharmacy, Future University in Egypt, Cairo, Egypt
| | - Mae M Seleem
- Department of Pharmacology, Toxicology and Biochemistry, Faculty of Pharmacy, Future University in Egypt, Cairo, Egypt
| | - Hebatallah A Darwish
- Department of Pharmacology, Toxicology and Biochemistry, Faculty of Pharmacy, Future University in Egypt, Cairo, Egypt.
- Department of Biochemistry, Faculty of Pharmacy, Cairo University, Cairo, Egypt.
| | - Amira A Shaheen
- Department of Biochemistry, Faculty of Pharmacy, Cairo University, Cairo, Egypt
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3
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Loncarica T, Balducci F, Bernardini M. Prevalence of idiopathic epilepsy and structural epilepsy in 74 Boxer dogs in a referral hospital. Front Vet Sci 2022; 9:956648. [PMID: 36061109 PMCID: PMC9437913 DOI: 10.3389/fvets.2022.956648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 08/02/2022] [Indexed: 11/26/2022] Open
Abstract
The prevalence of idiopathic epilepsy and structural epilepsy in Boxer dogs is unknown. The aim of this retrospective study was to evaluate the prevalence of structural and idiopathic epilepsy in the Boxer population. A total of 74 Boxer dogs were included in the study from the database of one referral hospital and the following were recorded: signalment, history, clinical findings and results of advanced diagnostic imaging. Five dogs (6.8%) were diagnosed with idiopathic epilepsy, of which one was in the <6 months age group, three were in the 6–72 months age group and one was in the >72 months age group. Sixty-nine dogs (93.2%) were diagnosed with structural epilepsy. Sixty-six had a suspected intracranial neoplasia: Eight were in the 6–72 months age group and represent 66.7% of the dogs in that age group. The other fifty-eight were in the >72 months age group and represent 96.7% of the dogs in that age group. In our Boxer population, 81.8% of the patients had a suspected intra-axial tumor and 22.7% of dogs with an intracranial pathology nevertheless had a normal neurological examination. In conclusion, in the majority of boxer patients the cause of epilepsy is a suspected intracranial neoplasia regardless of the age at presentation. Considering the finding in this study of a low prevalence of presumed idiopathic epilepsy in the Boxer breed, it is recommended that patients who satisfy Tier I confidence level of the “International Veterinary Epilepsy Task Force” (IVETF) also undergo an MRI study of the brain.
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Affiliation(s)
- Tina Loncarica
- Neurology Unit, Anicura Portoni Rossi Veterinary Hospital, Bologna, Italy
- *Correspondence: Tina Loncarica
| | - Federica Balducci
- Neurology Unit, Anicura Portoni Rossi Veterinary Hospital, Bologna, Italy
| | - Marco Bernardini
- Neurology Unit, Anicura Portoni Rossi Veterinary Hospital, Bologna, Italy
- Department of Animal Medicine, Production and Health, Clinical section, University of Padua, Legnaro, Italy
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4
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Hasegawa D, Saito M, Kitagawa M. Neurosurgery in canine epilepsy. Vet J 2022; 285:105852. [PMID: 35716888 DOI: 10.1016/j.tvjl.2022.105852] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 05/24/2022] [Accepted: 06/10/2022] [Indexed: 11/18/2022]
Abstract
Epilepsy surgery is functional neurosurgery applied to drug-resistant epilepsy. Although epilepsy surgery has been established and achieves fair to good outcomes in human medicine, it is still an underdeveloped area in veterinary medicine. With the spread of advanced imaging and neurosurgical modalities, intracranial surgery has become commonplace in the veterinary field, and, therefore, it is natural that expectations for epilepsy surgery increase. This review summarizes current standards of intracranial epilepsy surgery in human medicine and describes its current status and expectation in veterinary medicine. Intracranial epilepsy surgery is classified generally into resection surgery, represented by cortical resection, lobectomy, and lesionectomy, and disconnection surgery, such as corpus callosotomy and multiple subpial transection. In dogs with drug-resistant epilepsy, corpus callosotomy is available as a disconnection surgery for generalized epilepsy. However, other types of disconnection and resection surgeries for focal epilepsy are limited to experimental studies in laboratory dogs and/or anecdotal case reports of lesionectomy, such as tumor or encephalocele removal, without epileptogenic evidence. Veterinary epilepsy surgery is a new and challenging neurosurgery field; with the development of presurgical evaluations such as advanced electroencephalography and neuroimaging, it may become more readily practiced.
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Affiliation(s)
- Daisuke Hasegawa
- Laboratory of Veterinary Radiology, Nippon Veterinary and Life Science University, 1-7-1 Kyounancho, Musashino, Tokyo 180-8602, Japan; The Research Center for Animal Life Science, Nippon Veterinary and Life Science University, 1-7-1 Kyounancho, Musashino, Tokyo 180-8602, Japan.
| | - Miyoko Saito
- Laboratory of Small Animal Surgery (Neurology), School of Veterinary Medicine, Azabu University, 1-17-71 Fuchinobe, Sagamihara, Kanagawa 252-5201, Japan
| | - Masato Kitagawa
- Laboratory of Veterinary Neurology, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, 1866 Kameino, Fujisawa, Kanagawa 252-0880, Japan
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Drexlin JC, Schweizer D, Stein VM. [Diagnostics in epilepsy - potential of magnetic resonance imaging]. TIERARZTLICHE PRAXIS. AUSGABE K, KLEINTIERE/HEIMTIERE 2021; 49:29-42. [PMID: 33588463 DOI: 10.1055/a-1322-9439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Epilepsy is a common neurologic disease frequently encountered by small animal practitioners. The disease comprises a multiplicity of clinical presentations and etiologies and often necessitates a comprehensive as well as cost-intensive diagnostic workup. This is mandatory in order to be able to diagnose or exclude a metabolic cause of the seizures and to distinguish between idiopathic and structural epilepsy. The examination by means of magnetic resonance imaging (MRI) represents a central component of the diagnostic workup, which in turn has essential effects on treatment and prognosis. In order to achieve standardized examination and comparable results, it is of utmost importance to use defined MRI protocols. Accordingly, communication and interaction between clinical institutions may be facilitated and as of yet undetected structural changes might be recorded in future MRI techniques. This review article sets particularly emphasis on the definition and classification of epilepsy as well as its diagnostic imaging procedures and refers to statistics and specialists' recommendations for the diagnostic workup in dogs.
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Affiliation(s)
- Jana C Drexlin
- Abteilung für Klinische Neurologie, Departement für klinische Veterinärmedizin, Vetsuisse Fakultät, Universität Bern
| | - Daniela Schweizer
- Abteilung für Klinische Radiologie, Departement für klinische Veterinärmedizin, Vetsuisse Fakultät, Universität Bern
| | - Veronika M Stein
- Abteilung für Klinische Neurologie, Departement für klinische Veterinärmedizin, Vetsuisse Fakultät, Universität Bern
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6
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Erlen A, Potschka H, Volk HA, Sauter-Louis C, O'Neill DG. Seizures in dogs under primary veterinary care in the United Kingdom: Etiology, diagnostic testing, and clinical management. J Vet Intern Med 2020; 34:2525-2535. [PMID: 33128852 PMCID: PMC7694840 DOI: 10.1111/jvim.15911] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 09/11/2020] [Accepted: 09/15/2020] [Indexed: 12/16/2022] Open
Abstract
Background Although seizures are common in dogs, limited published information is available on the classifications of seizures, diagnostic approaches, or clinical management of seizure‐affected patients in the veterinary primary care setting. Objectives Explore seizure etiology, diagnostic testing, and clinical management of seizure‐affected dogs in the primary care veterinary setting. Animals A total of 455 553 dogs in VetCompass. Methods Cross‐sectional analysis by cohort clinical data. Results From 2834 incident seizure cases, we identified 579 (20.5%) dogs with epilepsy based on the International Veterinary Epilepsy Task Force (IVETF) classification system, including 484 (17.1%) with idiopathic epilepsy, 95 (3.4%) with structural epilepsy, and 179 dogs (6.3%) with reactive seizures. In their clinical first opinion records, 245 (8.6%) cases were recorded with epilepsy. Overall, 1415 (49.9%) cases received diagnostic evaluation equivalent to or higher than IVETF Tier 1 diagnostic testing. Being <12 years of age and being insured were risk factors for receiving IVETF Tier 1 or higher diagnostic evaluation among seizure cases. Anti‐seizure drug (ASD) treatment was not prescribed for 1960/2834 (69.2%) dogs in association with the incident seizure event. Of the remainder, 719 (25.3%) dogs received 1 ASD, whereas 155 (5.5%) an ASD combination. Conclusion and clinical importance The differences between seizure classifications in the clinical records and those retrospectively assigned by the researchers support the need for clearer diagnostic guidelines in clinical practice. Insured dogs and dogs <12 years of age were more likely to receive advanced diagnostic evaluation, suggesting that financial and perceived prognostic factors influence case management.
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Affiliation(s)
- Alexander Erlen
- Institute of Pharmacology, Toxicology, and Pharmacy, Ludwig-Maximilians-University, Munich, Germany
| | - Heidrun Potschka
- Institute of Pharmacology, Toxicology, and Pharmacy, Ludwig-Maximilians-University, Munich, Germany
| | - Holger A Volk
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | | | - Dan G O'Neill
- Pathobiology and Population Health, The Royal Veterinary College, Hatfield, United Kingdom
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7
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Farke D, Kolecka M, Czerwik A, Wrzosek M, Schaub S, Kramer M, Failing K, Schmidt MJ. Prevalence of seizures in dogs and cats with idiopathic internal hydrocephalus and seizure prevalence after implantation of a ventriculo-peritoneal shunt. J Vet Intern Med 2020; 34:1986-1992. [PMID: 32918850 PMCID: PMC7517859 DOI: 10.1111/jvim.15890] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 08/07/2020] [Accepted: 08/18/2020] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Seizures are considered a clinical sign in dogs with internal hydrocephalus but are not found in recent studies. Seizure prevalence due to ventricular enlargement and the prevalence of postoperative seizures in animals is not known. OBJECTIVES To determine seizure prevalence in dogs and cats with idiopathic internal hydrocephalus, to identify risk factors for seizure development, and to determine seizure prevalence in a 2-year period after ventriculo-peritoneal shunting (VPS). ANIMALS Records and MRIs of 197 animals from 2001 to December 2019 were investigated. A total of 121 animals (98 dogs and 23 cats) were included in the study. METHODS A retrospective multicenter case cohort study was conducted. Databases were searched for dogs and cats with internal hydrocephalus. MRI and CSF examinations were evaluated for signs of additional underlying disorders. Prevalence of seizures was estimated for animals showing only hydrocephalus internus. Risk factors were evaluated according to age, morphometric and morphological findings in the brain. All animals that underwent surgery were reexamined 2 years after surgery. RESULTS One hundred twenty-one animals (98 dogs and 23 cats) with internal hydrocephalus met the inclusion criteria. Seizure prevalence in dogs and cats with internal hydrocephalus was low (1.7%; <5.8% CI 95%). Seizures were not observed in the 2-year period after surgery. CONCLUSION AND CLINICAL IMPORTANCE Seizure prevalence in dogs and cats diagnosed with hydrocephalus internus is low. Seizures in association with VPS do not seem to be a complication of the procedure.
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Affiliation(s)
- Daniela Farke
- Department of Veterinary Clinical Sciences, Small Animal ClinicJustus‐Liebig‐UniversityGiessenGermany
| | - Malgorzata Kolecka
- Department of Veterinary Clinical Sciences, Small Animal ClinicJustus‐Liebig‐UniversityGiessenGermany
| | - Adriana Czerwik
- Department of Veterinary Clinical Sciences, Small Animal ClinicJustus‐Liebig‐UniversityGiessenGermany
| | - Marcin Wrzosek
- Department of Internal Medicine and Clinic for Horses, Dogs and Cats, The Faculty of Veterinary MedicineWrocław University of Environmental and Life SciencesWrocławPoland
| | - Sebastian Schaub
- Department of Veterinary Clinical Sciences, Small Animal ClinicJustus‐Liebig‐UniversityGiessenGermany
| | - Martin Kramer
- Department of Veterinary Clinical Sciences, Small Animal ClinicJustus‐Liebig‐UniversityGiessenGermany
| | - Klaus Failing
- Unit for Biomathematics and Data Processing, Faculty of Veterinary MedicineJustus Liebig‐University‐GiessenGiessenGermany
| | - Martin Jürgen Schmidt
- Department of Veterinary Clinical Sciences, Small Animal ClinicJustus‐Liebig‐UniversityGiessenGermany
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8
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Norona FE, Volk HA. Investigating the efficacy of medical management for canine structural epilepsy. Vet Rec 2020; 187:e63. [PMID: 32586969 DOI: 10.1136/vr.105708] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 05/01/2020] [Accepted: 05/28/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND Structural epilepsy in dogs is often treated medically with a combination of antiseizure drugs (ASDs) and other concurrent therapies for the primary condition. Unlike idiopathic epilepsy, there have been few studies on the efficacy of medical management in structural epilepsy. This study investigated factors affecting treatment outcomes in dogs medically managed for structural epilepsy. METHODS Cases of 71 dogs diagnosed with structural epilepsy were identified from a referral hospital database and data were analysed retrospectively. Efficacy of treatment was assessed by survival time, seizure-free period after diagnosis and overall seizure control. RESULTS Results showed that the most significant prognostic indicator was the occurrence of status epilepticus (SE) before diagnosis, with these dogs having reduced survival times, shorter seizure-free periods after diagnosis and overall worse seizure control. Cluster seizure history showed similar, although not statistically significant, trends in treatment efficacy. Treatment outcomes were not significantly impacted by ASD therapy used or by specific diagnosis, with the exception of meningoencephalitis of unknown aetiology cases surviving longer. CONCLUSION Overall, medical management of canine structural epilepsy achieves the best treatment outcomes when the patient has no history of SE. This study may provide a basis for future investigations into the treatment of canine structural epilepsies.
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Affiliation(s)
- Frances Eleanor Norona
- Department of Clinical Science and Services, Royal Veterinary College, Hertfordshire, UK
| | - Holger Andreas Volk
- Department of Clinical Science and Services, Royal Veterinary College, Hertfordshire, UK.,Department of Small Animal Disease, University of Veterinary Medicine Hannover, Hannover, Germany
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9
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Hanael E, Veksler R, Friedman A, Bar-Klein G, Senatorov VV, Kaufer D, Konstantin L, Elkin M, Chai O, Peery D, Shamir MH. Blood-brain barrier dysfunction in canine epileptic seizures detected by dynamic contrast-enhanced magnetic resonance imaging. Epilepsia 2020; 60:1005-1016. [PMID: 31032909 DOI: 10.1111/epi.14739] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 03/28/2019] [Accepted: 04/01/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Dogs with spontaneous or acquired epilepsy exhibit resemblance in etiology and disease course to humans, potentially offering a translational model of the human disease. Blood-brain barrier dysfunction (BBBD) has been shown to partake in epileptogenesis in experimental models of epilepsy. To test the hypothesis that BBBD can be detected in dogs with naturally occurring seizures, we developed a linear dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) analysis algorithm that was validated in clinical cases of seizing dogs and experimental epileptic rats. METHODS Forty-six dogs with naturally occurring seizures of different etiologies and 12 induced epilepsy rats were imaged using DCE-MRI. Six healthy dogs and 12 naive rats served as control. DCE-MRI was analyzed by linear-dynamic method. BBBD scores were calculated in whole brain and in specific brain regions. Immunofluorescence analysis for transforming growth factor beta (TGF-β) pathway proteins was performed on the piriform cortex of epileptic dogs. RESULTS We found BBBD in 37% of dogs with seizures. A significantly higher cerebrospinal fluid to serum albumin ratio was found in dogs with BBBD relative to dogs with intact blood-brain barrier (BBB). A significant difference was found between epileptic and control rats when BBBD scores were calculated for the piriform cortex at 48 hours and 1 month after status epilepticus. Mean BBBD score of the piriform lobe in idiopathic epilepsy (IE) dogs was significantly higher compared to control. Immunohistochemistry results suggested active TGF-β signaling and neuroinflammation in the piriform cortex of dogs with IE, showing increased levels of serum albumin colocalized with glial acidic fibrillary protein and pSMAD2 in an area where BBBD had been detected by linear DCE-MRI. SIGNIFICANCE Detection of BBBD in dogs with naturally occurring epilepsy provides the ground for future studies for evaluation of novel treatment targeting the disrupted BBB. The involvement of the piriform lobe seen using our linear DCE-MRI protocol and algorithm emphasizes the possibility of using dogs as a translational model for the human disease.
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Affiliation(s)
- Erez Hanael
- Hebrew University Koret School of Veterinary Medicine-Veterinary Teaching Hospital, Rehovot, Israel
| | - Ronel Veksler
- Departments of Physiology and Cell Biology, Brain, and Cognitive Sciences, Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Alon Friedman
- Departments of Physiology and Cell Biology, Brain, and Cognitive Sciences, Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer Sheva, Israel.,Department of Medical Neuroscience and Brain Repair Center, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Guy Bar-Klein
- Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Howard Hughes Medical Institute, Chevy Chase, Maryland
| | - Vladimir V Senatorov
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, California
| | - Daniela Kaufer
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, California.,Department of Integrative Biology, University of California, Berkeley, Berkeley, California
| | - Lilach Konstantin
- Hebrew University Koret School of Veterinary Medicine-Veterinary Teaching Hospital, Rehovot, Israel
| | - Maria Elkin
- Hebrew University Koret School of Veterinary Medicine-Veterinary Teaching Hospital, Rehovot, Israel
| | - Orit Chai
- Hebrew University Koret School of Veterinary Medicine-Veterinary Teaching Hospital, Rehovot, Israel
| | - Dana Peery
- Hebrew University Koret School of Veterinary Medicine-Veterinary Teaching Hospital, Rehovot, Israel
| | - Merav H Shamir
- Hebrew University Koret School of Veterinary Medicine-Veterinary Teaching Hospital, Rehovot, Israel
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10
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Hall R, Labruyere J, Volk H, Cardy TJ. Estimation of the prevalence of idiopathic epilepsy and structural epilepsy in a general population of 900 dogs undergoing MRI for epileptic seizures. Vet Rec 2020; 187:e89. [PMID: 32303666 DOI: 10.1136/vr.105647] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 03/12/2020] [Accepted: 03/29/2020] [Indexed: 12/25/2022]
Abstract
Due to variation in study designs the prevalence of idiopathic epilepsy (IE) and structural epilepsy (SE) in dogs is largely unknown. The objective was to provide estimates of the prevalence of IE and SE in a large population of dogs undergoing MRI for epileptic seizures. A retrospective study on 900 dogs undergoing MRI for seizures was performed. MRI scans, summary clinical history and neurological examination from the VetCT database were reviewed and a diagnosis assigned by board-certified radiologists. Structural lesions were identified as a cause of seizures in 45.1 per cent (n=406) of cases. No structural lesions were identified in 54.9 per cent (n=494) of cases with presumed IE diagnosed in 53.8 per cent (n=484) of dogs. Dogs between six months and six years were more often associated with IE (P<0.001), small breeds were overrepresented with suspected inflammatory brain disease (P=0.001) and large entire dogs more often diagnosed with extra-axial neoplasms (P=0.001). Over 31.0 per cent of dogs with suspected IE were six years or older. This study is the largest of its kind in dogs and provides accurate estimates of underlying causes of epilepsy. MRI findings should be considered in the context of a detailed clinical history and neurological examination.
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Affiliation(s)
- Rachel Hall
- Clinical Services Division, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | | | - Holger Volk
- Clinical Services Division, Royal Veterinary College, Hatfield, Hertfordshire, UK.,Small Animal Clinic, University of Veterinary Medicine Hannover, Hannover, Niedersachsen, Germany
| | - Thomas James Cardy
- Clinical Services Division, Royal Veterinary College, Hatfield, Hertfordshire, UK .,Neurology & Neurosurgery, Cave Veterinary Specialists, Wellington, Somerset, UK
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11
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Erlen A, Potschka H, Volk HA, Sauter-Louis C, O'Neill DG. Seizure occurrence in dogs under primary veterinary care in the UK: prevalence and risk factors. J Vet Intern Med 2018; 32:1665-1676. [PMID: 30216557 PMCID: PMC6189390 DOI: 10.1111/jvim.15290] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 05/03/2018] [Accepted: 06/27/2018] [Indexed: 12/22/2022] Open
Abstract
Background Primary‐care veterinary clinical records can offer data to determine generalizable epidemiological data on seizures occurrence in the dog population. Objectives To identify and examine epidemiologic characteristics of seizure occurrence in dogs under primary veterinary care in the UK participating in the VetCompass™ Programme. Animals 455,553 dogs in VetCompass™’. Methods A cross‐sectional analysis estimated the 1‐year period prevalence and risk factors for dogs with seizures during 2013. Results The overall 1‐year period prevalence for dogs having at least one seizure during 2013 was 0.82% (95% CI 0.79‐0.84). Multivariable modelling identified breeds with elevated odd ratios [OR] compared with the Labrador Retriever (e.g. Pug OR: 3.41 95% CI 2.71‐4.28, P < 0.001). Males had higher risk for seizures (Male/Entire OR: 1.47 95% CI 1.30–1.66; Male/Neutered OR: 1.34 95% CI 1.19–1.51) compared to entire females. Age (3.00 ‐ ≤ 6.00 OR: 2.13 95% CI 1.90‐2.39, P < 0.001, compared to animals aged 0.50–≤ 3.00 years), and bodyweight (≥ 40.00kg, OR: 1.24 95% CI 1.08–1.41, P = 0.002, compared to animals weighing < 10.0 kg) were identified as risk factors for seizures. Conclusion and clinical Importance Seizures are a relatively common clinical finding in dogs. The results for breed, age, sex and bodyweight as risk factors can assist veterinarians in refining differential diagnosis lists for dogs reported with behaviors that may have been seizures. In addition, the prevalence values reported here can support pharmacovigilance with baseline data from the overall population.
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Affiliation(s)
- Alexander Erlen
- Inst. of Pharmacology, Toxicology, and Pharmacy, Ludwig-Maximilians-University, Munich, Germany
| | - Heidrun Potschka
- Inst. of Pharmacology, Toxicology, and Pharmacy, Ludwig-Maximilians-University, Munich, Germany
| | - Holger A Volk
- Clinical Science and Services, The Royal Veterinary College, Hatfield, UK
| | | | - Dan G O'Neill
- Pathobiology and Population Health, The Royal Veterinary College, Hatfield, UK
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12
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Meland T, Carrera-Justiz S. A Review: Emergency Management of Dogs With Suspected Epileptic Seizures. Top Companion Anim Med 2018; 33:17-20. [PMID: 29793724 DOI: 10.1053/j.tcam.2018.03.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Revised: 03/16/2018] [Accepted: 03/17/2018] [Indexed: 11/11/2022]
Abstract
Dogs with seizure disorders are commonly presented to the general practitioner for initial evaluation. The most common diagnosis provided is idiopathic epilepsy. As witnessing seizures is often traumatic for owners, it is important for the practitioner to understand seizure classification, know when to initiate antiepileptic drug therapy and be comfortable with client education regarding seizures. This review briefly discusses the most up-to-date classification of seizures, the necessity to obtain accurate histories and complete examinations, base-line diagnostics to perform, the importance of owner education, and when to start medications. This is not intended to discuss detailed differential lists, in-depth information on antiepileptic drug therapy, long-term management of epileptics or those refractory to their current treatment.
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Affiliation(s)
- Tessa Meland
- Department of Small Animal Clinical Sciences, University of Florida College of Veterinary Medicine, Gainesville, FL, USA
| | - Sheila Carrera-Justiz
- Department of Small Animal Clinical Sciences, University of Florida College of Veterinary Medicine, Gainesville, FL, USA.
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13
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Fredsø N, Toft N, Sabers A, Berendt M. A prospective observational longitudinal study of new-onset seizures and newly diagnosed epilepsy in dogs. BMC Vet Res 2017; 13:54. [PMID: 28209153 PMCID: PMC5314480 DOI: 10.1186/s12917-017-0966-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 02/07/2017] [Indexed: 11/19/2022] Open
Abstract
Background Seizures are common in dogs and can be caused by non-epileptic conditions or epilepsy. The clinical course of newly diagnosed epilepsy is sparsely documented. The objective of this study was to prospectively investigate causes for seizures (epileptic and non-epileptic) in a cohort of dogs with new-onset untreated seizures, and for those dogs with newly diagnosed epilepsy to investigate epilepsy type, seizure type and the course of disease over time, including the risk of seizure recurrence. Untreated client-owned dogs experiencing new-onset seizures were prospectively enrolled in a longitudinal observational study including clinical investigations and long-term monitoring at the Copenhagen University Hospital for Companion Animals. A baseline clinical assessment was followed by investigator/owner contact every eight weeks from inclusion to death or end of study. Inclusion of dogs was conducted from November 2010 to September 2012, and the study terminated in June 2014. Results One hundred and six dogs were included in the study. Seventy-nine dogs (74.5%) were diagnosed with epilepsy: 61 dogs (77.2%) with idiopathic epilepsy, 13 dogs (16.5%) with structural epilepsy and five dogs (6.3%) with suspected structural epilepsy. A non-epileptic cause for seizures was identified in 13 dogs and suspected in 10 dogs. Four dogs in which no cause for seizures was identified experienced only one seizure during the study. In dogs with idiopathic epilepsy 60% had their second epileptic seizure within three months of seizure onset. Twenty-six dogs with idiopathic epilepsy (43%) completed the study without receiving antiepileptic treatment. The natural course of idiopathic epilepsy (uninfluenced by drugs) was illustrated by highly individual and fluctuating seizure patterns, including long periods of remission. Cluster seizures motivated early treatment. In a few dogs with a high seizure frequency owners declined treatment against the investigators advice. Conclusions Epilepsy is the most likely diagnosis in dogs presenting with new-onset seizures. The course of idiopathic epilepsy is highly individual and might not necessarily require long-term treatment. This must be considered when advising owners about what to expect with regard to treatment and prognosis.
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Affiliation(s)
- N Fredsø
- Department of Veterinary Clinical and Animal Sciences, University of Copenhagen, Dyrlaegevej 16, 1870, Frederiksberg C, Denmark.
| | - N Toft
- National Veterinary Institute, Section for Epidemiology, Technical University of Denmark, Frederiksberg C, Denmark
| | - A Sabers
- The Epilepsy Clinic, Department of Neurology, University State Hospital (Rigshospitalet), Copenhagen, Denmark
| | - M Berendt
- Department of Veterinary Clinical and Animal Sciences, University of Copenhagen, Dyrlaegevej 16, 1870, Frederiksberg C, Denmark
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14
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Abstract
A postmortem examination revealed a large brain cavity in the right cerebral hemisphere
of a 9-year-old male fennec (Vulpes zerda). The cavity was filled with
cerebrospinal fluid and extended to the right lateral ventricle. Swelling and displacement
of the right hippocampal area were also observed. Histologic examination revealed no
evidence of previous infarct lesions, hemorrhage, inflammation or invasive tumor cells.
Observation of the defective part suggested a local circulatory disorder during the fetal
stage, although the cause was not detected. No neurological symptoms that could enable a
provisional diagnosis were observed during the course of his life. This is the first
report of asymptomatic porencephaly in a fennec fox.
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Affiliation(s)
- Mutsumi Yamazaki
- Laboratory of Veterinary Pathology, Azabu University, 1-17-71 Fuchinobe, Chuo-ku, Sagamihara, Kanagawa 252-5201, Japan
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15
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Hamamoto Y, Hasegawa D, Mizoguchi S, Yu Y, Wada M, Kuwabara T, Fujiwara-Igarashi A, Fujita M. Retrospective epidemiological study of canine epilepsy in Japan using the International Veterinary Epilepsy Task Force classification 2015 (2003-2013): etiological distribution, risk factors, survival time, and lifespan. BMC Vet Res 2016; 12:248. [PMID: 27829458 PMCID: PMC5103468 DOI: 10.1186/s12917-016-0877-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 11/02/2016] [Indexed: 02/07/2023] Open
Abstract
Background Epilepsy is the most common neurological disease in veterinary practice. However, contrary to human medicine, epilepsy classification in veterinary medicine had not been clearly defined until recently. A number of reports on canine epilepsy have been published, reflecting in part updated proposals from the human epilepsy organization, the International League Against Epilepsy. In 2015, the International Veterinary Epilepsy Task Force (IVETF) published a consensus report on the classification and definition of canine epilepsy. The purpose of this retrospective study was to investigate the etiological distribution, survival time of dogs with idiopathic epilepsy (IdE) and structural epilepsy (StE), and risk factors for survival time, according to the recently published IVETF classification. We investigated canine cases with epilepsy that were referred to our teaching hospital in Japan during the past 10 years, and which encompassed a different breed population from Western countries. Results A total of 358 dogs with epilepsy satisfied our etiological study criteria. Of these, 172 dogs (48 %) were classified as IdE and 76 dogs (21 %) as StE. Of these dogs, 100 dogs (consisting of 65 with IdE and 35 with StE) were included in our survival study. Median survival time from the initial epileptic seizure in dogs with IdE and StE was 10.4 and 4.5 years, respectively. Median lifespan of dogs with IdE and StE was 13.5 and 10.9 years, respectively. Multivariable analysis demonstrated that risk factors for survival time in IdE were high seizure frequency (≥0.3 seizures/month) and focal epileptic seizures. Conclusions Focal epileptic seizures were identified as a risk factor for survival time in IdE. Clinicians should carefully differentiate seizure type as it is difficult to identify focal epileptic seizures. With good seizure control, dogs with IdE can survive for nearly the same lifespan as the general dog population. Our results using the IVETF classification are similar to previous studies, although some features were noted in our Japanese canine population (which was composed of mainly small-breed dogs), including a longer lifespan in dogs with epilepsy and a larger percentage of meningoencephalomyelitis of unknown origin in dogs with StE.
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Affiliation(s)
- Yuji Hamamoto
- Department of Clinical Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, 180-8602, Tokyo, Japan
| | - Daisuke Hasegawa
- Department of Clinical Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, 180-8602, Tokyo, Japan.
| | - Shunta Mizoguchi
- Department of Clinical Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, 180-8602, Tokyo, Japan
| | - Yoshihiko Yu
- Department of Clinical Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, 180-8602, Tokyo, Japan
| | - Masae Wada
- Department of Clinical Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, 180-8602, Tokyo, Japan
| | - Takayuki Kuwabara
- Department of Clinical Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, 180-8602, Tokyo, Japan
| | - Aki Fujiwara-Igarashi
- Department of Clinical Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, 180-8602, Tokyo, Japan
| | - Michio Fujita
- Department of Clinical Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, 180-8602, Tokyo, Japan
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16
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Diagnostic techniques to detect the epileptogenic zone: Pathophysiological and presurgical analysis of epilepsy in dogs and cats. Vet J 2016; 215:64-75. [DOI: 10.1016/j.tvjl.2016.03.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 02/24/2016] [Accepted: 03/05/2016] [Indexed: 12/17/2022]
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17
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Podell M, Volk HA, Berendt M, Löscher W, Muñana K, Patterson EE, Platt SR. 2015 ACVIM Small Animal Consensus Statement on Seizure Management in Dogs. J Vet Intern Med 2016; 30:477-90. [PMID: 26899355 PMCID: PMC4913615 DOI: 10.1111/jvim.13841] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 01/18/2016] [Accepted: 01/18/2016] [Indexed: 11/27/2022] Open
Abstract
This report represents a scientific and working clinical consensus statement on seizure management in dogs based on current literature and clinical expertise. The goal was to establish guidelines for a predetermined, concise, and logical sequential approach to chronic seizure management starting with seizure identification and diagnosis (not included in this report), reviewing decision‐making, treatment strategies, focusing on issues related to chronic antiepileptic drug treatment response and monitoring, and guidelines to enhance patient response and quality of life. Ultimately, we hope to provide a foundation for ongoing and future clinical epilepsy research in veterinary medicine.
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Affiliation(s)
- M Podell
- Medvet Chicago, Medical and Cancer Centers for Pets, Chicago, IL.,Department of Neurosurgery, Pritzker School of Medicine, The University of Chicago, Chicago, IL
| | - H A Volk
- Department of Clinical Sciences and Services, Small Animal Medicine and Surgery Group, The Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - M Berendt
- Department of Veterinary and Clinical Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - W Löscher
- Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine, Hannover, Germany.,Center for Systems Neuroscience, Hannover, Germany
| | - K Muñana
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
| | - E E Patterson
- Department of Veterinary Clinical Sciences, University of Minnesota College of Veterinary Medicine, St. Paul, MN
| | - S R Platt
- Department of Small Animal Medicine & Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA
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18
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De Risio L, Bhatti S, Muñana K, Penderis J, Stein V, Tipold A, Berendt M, Farqhuar R, Fischer A, Long S, Mandigers PJJ, Matiasek K, Packer RMA, Pakozdy A, Patterson N, Platt S, Podell M, Potschka H, Batlle MP, Rusbridge C, Volk HA. International veterinary epilepsy task force consensus proposal: diagnostic approach to epilepsy in dogs. BMC Vet Res 2015; 11:148. [PMID: 26316175 PMCID: PMC4552251 DOI: 10.1186/s12917-015-0462-1] [Citation(s) in RCA: 181] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 06/29/2015] [Indexed: 12/16/2022] Open
Abstract
This article outlines the consensus proposal on diagnosis of epilepsy in dogs by the International Veterinary Epilepsy Task Force. The aim of this consensus proposal is to improve consistency in the diagnosis of epilepsy in the clinical and research settings. The diagnostic approach to the patient presenting with a history of suspected epileptic seizures incorporates two fundamental steps: to establish if the events the animal is demonstrating truly represent epileptic seizures and if so, to identify their underlying cause. Differentiation of epileptic seizures from other non-epileptic episodic paroxysmal events can be challenging. Criteria that can be used to make this differentiation are presented in detail and discussed. Criteria for the diagnosis of idiopathic epilepsy (IE) are described in a three-tier system. Tier I confidence level for the diagnosis of IE is based on a history of two or more unprovoked epileptic seizures occurring at least 24 h apart, age at epileptic seizure onset of between six months and six years, unremarkable inter-ictal physical and neurological examination, and no significant abnormalities on minimum data base blood tests and urinalysis. Tier II confidence level for the diagnosis of IE is based on the factors listed in tier I and unremarkable fasting and post-prandial bile acids, magnetic resonance imaging (MRI) of the brain (based on an epilepsy-specific brain MRI protocol) and cerebrospinal fluid (CSF) analysis. Tier III confidence level for the diagnosis of IE is based on the factors listed in tier I and II and identification of electroencephalographic abnormalities characteristic for seizure disorders. The authors recommend performing MRI of the brain and routine CSF analysis, after exclusion of reactive seizures, in dogs with age at epileptic seizure onset <6 months or >6 years, inter-ictal neurological abnormalities consistent with intracranial neurolocalisation, status epilepticus or cluster seizure at epileptic seizure onset, or a previous presumptive diagnosis of IE and drug-resistance with a single antiepileptic drug titrated to the highest tolerable dose. This consensus article represents the basis for a more standardised diagnostic approach to the seizure patient. These recommendations will evolve over time with advances in neuroimaging, electroencephalography, and molecular genetics of canine epilepsy.
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Affiliation(s)
- Luisa De Risio
- Animal Health Trust, Lanwades Park, Kentford, Newmarket, CB8 7UU, Suffolk, UK.
| | - Sofie Bhatti
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, Merelbeke, 9820, Belgium.
| | - Karen Muñana
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1052 William Moore Drive, Raleigh, NC, 27607, USA.
| | - Jacques Penderis
- Vet Extra Neurology, Broadleys Veterinary Hospital, Craig Leith Road, Stirling, FK7 7LE, Stirlingshire, UK.
| | - Veronika Stein
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany.
| | - Andrea Tipold
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany.
| | - Mette Berendt
- Department of Veterinary and Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark.
| | - Robyn Farqhuar
- Fernside Veterinary Centre, 205 Shenley Road, Borehamwood, SG9 0TH, Hertfordshire, UK.
| | - Andrea Fischer
- Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-University, Veterinärstr. 13, 80539, Munich, Germany.
| | - Sam Long
- University of Melbourne, 250 Princes Highway, Weibee, 3015, VIC, Australia.
| | - Paul J J Mandigers
- Department of Clinical Sciences of Companion Animals, Utrecht University, Yalelaan 108, 3583 CM, Utrecht, The Netherlands.
| | - Kaspar Matiasek
- Section of Clinical & Comparative Neuropathology, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-University, Veterinärstr. 13, 80539, Munich, Germany.
| | - Rowena M A Packer
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, AL9 7TA, Hertfordshire, UK.
| | - Akos Pakozdy
- Clinical Unit of Internal Medicine Small Animals, University of Veterinary Medicine, Veterinärplatz 1, 1210, Vienna, Austria.
| | - Ned Patterson
- University of Minnesota College of Veterinary Medicine, D426 Veterinary Medical Center, 1352 Boyd Avenue, St. Paul, MN, 55108, USA.
| | - Simon Platt
- College of Veterinary Medicine, University of Georgia, 501 DW Brooks Drive, Athens, GA, 30602, USA.
| | - Michael Podell
- Chicago Veterinary Neurology and Neurosurgery, 3123 N. Clybourn Avenue, Chicago, IL, 60618, USA.
| | - Heidrun Potschka
- Department of Pharmacology, Toxicology and Pharmacy, Ludwig-Maximillians-University, Königinstr. 16, 80539, Munich, Germany.
| | - Martí Pumarola Batlle
- Department of Animal Medicine and Surgery, Veterinary Faculty, Universitat Autònoma de Barcelona, Campus UAB, Bellaterra, 08193, Barcelona, Spain.
| | - Clare Rusbridge
- Fitzpatrick Referrals, Halfway Lane, Eashing, Godalming, GU7 2QQ, Surrey, UK. .,School of Veterinary Medicine, Faculty of Health & Medical Sciences, University of Surrey, Guildford, GU2 7TE, Surrey, UK.
| | - Holger A Volk
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, AL9 7TA, Hertfordshire, UK.
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19
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Berendt M, Farquhar RG, Mandigers PJJ, Pakozdy A, Bhatti SFM, De Risio L, Fischer A, Long S, Matiasek K, Muñana K, Patterson EE, Penderis J, Platt S, Podell M, Potschka H, Pumarola MB, Rusbridge C, Stein VM, Tipold A, Volk HA. International veterinary epilepsy task force consensus report on epilepsy definition, classification and terminology in companion animals. BMC Vet Res 2015; 11:182. [PMID: 26316133 PMCID: PMC4552272 DOI: 10.1186/s12917-015-0461-2] [Citation(s) in RCA: 194] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 06/29/2015] [Indexed: 01/30/2023] Open
Abstract
Dogs with epilepsy are among the commonest neurological patients in veterinary practice and therefore have historically attracted much attention with regard to definitions, clinical approach and management. A number of classification proposals for canine epilepsy have been published during the years reflecting always in parts the current proposals coming from the human epilepsy organisation the International League Against Epilepsy (ILAE). It has however not been possible to gain agreed consensus, "a common language", for the classification and terminology used between veterinary and human neurologists and neuroscientists, practitioners, neuropharmacologists and neuropathologists. This has led to an unfortunate situation where different veterinary publications and textbook chapters on epilepsy merely reflect individual author preferences with respect to terminology, which can be confusing to the readers and influence the definition and diagnosis of epilepsy in first line practice and research studies.In this document the International Veterinary Epilepsy Task Force (IVETF) discusses current understanding of canine epilepsy and presents our 2015 proposal for terminology and classification of epilepsy and epileptic seizures. We propose a classification system which reflects new thoughts from the human ILAE but also roots in former well accepted terminology. We think that this classification system can be used by all stakeholders.
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Affiliation(s)
- Mette Berendt
- Department of Veterinary Clinical and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark.
| | - Robyn G Farquhar
- Fernside Veterinary Centre, 205 Shenley Road, Borehamwood, SG9 0TH, Hertfordshire, UK.
| | - Paul J J Mandigers
- Department of Clinical Sciences of Companion Animals, Utrecht University, Yalelaan 108, 3583 CM, Utrecht, The Netherlands.
| | - Akos Pakozdy
- Clinical Unit of Internal Medicine Small Animals, University of Veterinary Medicine, Veterinärplatz 1, 1210, Vienna, Austria.
| | - Sofie F M Bhatti
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, Merelbeke, 9820, Belgium.
| | - Luisa De Risio
- Animal Health Trust, Lanwades Park, Kentford, Newmarket, CB8 7UU, Suffolk, UK.
| | - Andrea Fischer
- Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-University, Veterinärstr. 13, 80539, Munich, Germany.
| | - Sam Long
- University of Melbourne, 250 Princes Highway, Weibee, 3015, Victoria, Australia.
| | - Kaspar Matiasek
- Section of Clinical & Comparative Neuropathology, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-University, Veterinärstr. 13, 80539, Munich, Germany.
| | - Karen Muñana
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1052 William Moore Drive, Raleigh, NC, 27607, USA.
| | - Edward E Patterson
- University of Minnesota College of Veterinary Medicine, D426 Veterinary Medical Center, 1352 Boyd Avenue, St. Paul, MN, 55108, USA.
| | - Jacques Penderis
- Vet Extra Neurology, Broadleys Veterinary Hospital, Craig Leith Road, Stirling, FK7 7LE, Stirlingshire, UK.
| | - Simon Platt
- College of Veterinary Medicine, University of Georgia, 501 DW Brooks Drive, Athens, GA, 30602, USA.
| | - Michael Podell
- Chicago Veterinary Neurology and Neurosurgery, 3123 N. Clybourn Avenue, Chicago, IL, 60618, USA.
| | - Heidrun Potschka
- Department of Pharmacology, Toxicology and Pharmacy, Ludwig-Maximillians-University, Königinstr. 16, 80539, Munich, Germany.
| | - Martí Batlle Pumarola
- Department of Animal Medicine and Surgery, Veterinary Faculty, Universitat Autònoma de Barcelona, Campus UAB, Bellaterra, 08193, Barcelona, Spain.
| | - Clare Rusbridge
- Fitzpatrick Referrals, Halfway Lane, Eashing, Godalming, GU7 2QQ, Surrey, UK.
- School of Veterinary Medicine, Faculty of Health & Medical Sciences, University of Surrey, Guildford, GU2 7TE, Surrey, UK.
| | - Veronika M Stein
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany.
| | - Andrea Tipold
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany.
| | - Holger A Volk
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, AL9 7TA, Hertfordshire, UK.
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20
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Bentley RT. Magnetic resonance imaging diagnosis of brain tumors in dogs. Vet J 2015; 205:204-16. [PMID: 25792181 DOI: 10.1016/j.tvjl.2015.01.025] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 01/19/2015] [Accepted: 01/24/2015] [Indexed: 02/02/2023]
Abstract
A great deal of information is now available regarding the range of magnetic resonance imaging (MRI) features of many primary and secondary brain tumors from dogs. In this review, these canine neoplasms are grouped into meningeal masses, ventricular masses, intra-axial enhancing lesions, intra-axial mildly to non-enhancing lesions, and multifocal lesions. For each of these patterns, the major and sporadic neoplastic differential diagnoses are provided, and guidance on how to rank differential diagnoses for each individual patient is presented. The implication of MRI features such as contrast-enhancement, signal intensities and location is discussed. However, the information garnered from MRI must be correlated with all available clinical information and with epidemiological data before creating a differential diagnosis.
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Affiliation(s)
- R Timothy Bentley
- Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, IN 47907-2026, USA.
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21
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Merbl Y, Sommer A, Chai O, Aroch I, Zimmerman G, Friedman A, Soreq H, Shamir M. Tumor necrosis factor-α and interleukin-6 concentrations in cerebrospinal fluid of dogs after seizures. J Vet Intern Med 2014; 28:1775-81. [PMID: 25308784 PMCID: PMC4895630 DOI: 10.1111/jvim.12462] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Revised: 06/06/2014] [Accepted: 08/21/2014] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Idiopathic and acquired epilepsy are common in dogs. Up to 30% of these dogs are refractory to pharmacological treatment. Accumulating experimental evidence indicates that brain immune response and presence of inflammatory mediators decrease the threshold for individual seizures and contribute to epileptogenesis. HYPOTHESIS Dogs with seizures have higher cerebrospinal interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) concentrations compared to dogs with no seizures. METHODS A prospective double blinded study; cerebrospinal fluid (CSF) and serum IL-6, TNF-α and total protein (TP) concentrations were measured by a blinded investigator for the study group and CSF IL-6 and TNF-α levels and TP concentrations were measured in the control group (CG). ANIMALS Dogs presented with seizures that had enough CSF collected to allow analysis were included in the study group. Twelve apparently healthy, quarantined, stray dogs served as control (CG). RESULTS Cerebrospinal fluid TNF-α and IL-6 concentrations were significantly higher (P = .011, P = .039) in dogs with seizures (0 ± 70.66, 0.65 ± 10.93 pg/mL) compared to the CG (0 ± 19, 0.73 ± 0.55 pg/mL). When assessing cytokine concentrations of specifically the idiopathic epilepsy (IE) dogs compared to the CG, only TNF-α concentrations (8.66 ± 62, 0 ± 19 pg/mL) were significantly higher (P = .01). CSF TP concentrations were not significantly higher in the study dogs compared to the CG. CONCLUSIONS AND CLINICAL IMPORTANCE Higher TNF-α and IL-6 concentration in the CSF of dogs with naturally occurring seizures. The higher supports the hypothesis that inflammatory processes through certain mediators play a role in the pathogenesis of seizures in dogs.
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Affiliation(s)
- Y. Merbl
- Koret School of Veterinary MedicineHebrew University of JerusalemRehovotIsrael
| | - A. Sommer
- Koret School of Veterinary MedicineHebrew University of JerusalemRehovotIsrael
| | - O. Chai
- Koret School of Veterinary MedicineHebrew University of JerusalemRehovotIsrael
| | - I. Aroch
- Koret School of Veterinary MedicineHebrew University of JerusalemRehovotIsrael
| | - G. Zimmerman
- Edmond and Lily Safra Center of Brain ScienceHebrew University of JerusalemJerusalemIsrael
| | - A. Friedman
- Department of Life SciencesBen‐Gurion University of the NegevBeer ShevaIsrael
| | - H. Soreq
- Edmond and Lily Safra Center of Brain ScienceHebrew University of JerusalemJerusalemIsrael
- Department of Biological ChemistryAlexander Silberman Institute of Life SciencesHebrew University of JerusalemJerusalemIsrael
| | - M.H. Shamir
- Koret School of Veterinary MedicineHebrew University of JerusalemRehovotIsrael
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22
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Bilaterally symmetric focal cortical dysplasia in a golden retriever dog. J Comp Pathol 2014; 151:375-9. [PMID: 25246180 DOI: 10.1016/j.jcpa.2014.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 07/26/2014] [Accepted: 08/03/2014] [Indexed: 11/21/2022]
Abstract
A 10-year-old golden retriever dog was referred with a 24-h history of generalized seizures. Magnetic resonance imaging of the brain found no abnormalities on 3 mm transverse sections and the dog was subsequently humanely destroyed. Microscopically there was bilaterally symmetrical focal disorganization of cortical grey matter within the tips of the right and left suprasylvian gyri of the temporal cortex. The focal abnormal cortical lamination was characterized by loss of pyramidal neurons with abnormal, irregular, angular, remaining neurons occasionally forming clusters, surrounded by fibrillary astrogliosis and microgliosis and vascular proliferation. These histological findings are consistent with focal cortical dysplasia, a cerebral cortical malformation that causes seizures in people, but not reported previously in the dog.
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23
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Moore SA. A clinical and diagnostic approach to the patient with seizures. Top Companion Anim Med 2014; 28:46-50. [PMID: 24070681 DOI: 10.1053/j.tcam.2013.07.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 07/07/2013] [Indexed: 11/11/2022]
Abstract
Seizures are one of the most common neurologic problems encountered by the small animal practitioner. Successful management of the patient with seizure is facilitated by an appropriate diagnostic workup to identify underlying causes when they exist. Veterinary patients with seizures can be divided in to 3 main categories based on underlying cause: those with primary epilepsy, those with structural epilepsy, and those with reactive seizures. Additionally, some patients may be given a label of unknown epilepsy when they do not meet the criteria for a diagnosis of primary epilepsy, but no structural or reactive cause of seizures can be identified. This article reviews the key clinical findings associated with each of the 3 main categories of seizures and suggests a standardized approach to the diagnostic workup for patients with seizure based on their signalment and neurologic examination findings.
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Affiliation(s)
- Sarah A Moore
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA.
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24
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Bilateral Hippocampal Malformation and Concurrent Granulomatous Meningoencephalitis in a Dog with Refractory Epilepsy. J Comp Pathol 2014; 150:424-8. [DOI: 10.1016/j.jcpa.2013.11.212] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 09/25/2013] [Accepted: 11/26/2013] [Indexed: 11/20/2022]
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Potschka H, Fischer A, von Rüden EL, Hülsmeyer V, Baumgärtner W. Canine epilepsy as a translational model? Epilepsia 2013; 54:571-9. [PMID: 23506100 DOI: 10.1111/epi.12138] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2013] [Indexed: 01/01/2023]
Abstract
Dogs with spontaneous diseases can exhibit a striking similarity in etiology, clinical manifestation, and disease course when compared to human patients. Therefore, dogs are intensely discussed as a translational model of human disease. In particular, genetic studies in selected dog breeds serve as an excellent tool to identify epilepsy disease genes. In addition, canine epilepsy is discussed as a translational platform for drug testing. On one hand, epileptic dogs might serve as an interesting model by allowing the evaluation of drug efficacy and potency under clinical conditions with a focus on chronic seizures resistant to standard medication, preventive strategies, or status epilepticus. On the other hand, several limitations need to be considered including owner-based seizure monitoring, species differences in pharmacokinetics and drug interactions, as well as cost-intensiveness. The review gives an overview on the current state of knowledge regarding the etiology, clinical manifestation, pathology, and drug response of canine epilepsy, also pointing out the urgent need for further research on specific aspects. Moreover, the putative advantages, the disadvantages, and limitations of antiepileptic drug testing in canine epilepsy are critically discussed.
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Affiliation(s)
- Heidrun Potschka
- Institute of Pharmacology, Toxicology and Pharmacy, Ludwig-Maximilians-University, Munich, Germany.
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Abstract
A 12-month-old female neutered crossbreed was referred for investigation of seizure-like episodes occurring only at intense exercise. Thorough medical, neurological and cardiac investigations were performed and excluded the most commonly known causes of seizure-like activity. The dog was fitted with an ambulatory electrocardiography device and underwent another exercise-induced seizure. The electrocardiogram during the episode revealed a sinus tachycardia at approximately 300 beats/minute. A video recording of the episode revealed generalised tonic clonic limb activity with jaw chomping and frothing at the mouth typical of seizure activity. Antiepileptic medications were not prescribed and the owner was advised not to exercise the dog intensely. The dog responded well and did not seizure after 12 months of mild-moderate off-lead exercise. As all the seizures in this case were triggered by intense physical activity, it is suggested that this may be a new form of reflex seizure activity.
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Affiliation(s)
- L Motta
- ChesterGates Animal Referral Hospital, Unit F, Telford Court, Chester, Cheshire CH1 6LT
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Milne ME, Anderson GA, Chow KE, O'Brien TJ, Moffat BA, Long SN. Description of technique and lower reference limit for magnetic resonance imaging of hippocampal volumetry in dogs. Am J Vet Res 2013; 74:224-31. [DOI: 10.2460/ajvr.74.2.224] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Steinmetz S, Tipold A, Löscher W. Epilepsy after head injury in dogs: a natural model of posttraumatic epilepsy. Epilepsia 2013; 54:580-8. [PMID: 23294259 DOI: 10.1111/epi.12071] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2012] [Indexed: 11/30/2022]
Abstract
PURPOSE In humans, traumatic brain injury (TBI) is one of the most common causes of acquired (symptomatic) epilepsy, but as yet there is no treatment to prevent the development of epilepsy after TBI. Animal models of posttraumatic epilepsy (PTE) are important to characterize epileptogenic mechanisms of TBI and to identify clinically effective antiepileptogenic treatments. The prevalence and phenomenology of naturally occurring canine epilepsy are similar to those in human epilepsy. However, the risk of epilepsy after TBI has not been systemically studied in dogs. We therefore performed a large retrospective study in 1,000 dogs referred to our clinical department over a period of 11.5 years with the aim to determine the incidence of early and late seizures after head trauma in this species. METHODS Two strategies were used: in group I (n = 392), we evaluated whether dogs referred for the treatment of a head trauma (group Ia) or other trauma (group Ib) developed seizures after the trauma, whereas in group II (n = 608) we evaluated whether dogs referred for the treatment of recurrent epileptic seizures had a history of head trauma. Data for this study were obtained from our clinical database, questionnaires sent to the dogs' owners, and owner interviews. KEY FINDINGS In group Ia, 6.6% of the dogs developed PTE, which was significantly different from group Ib (1.9%), indicating that head trauma increased the risk of developing epilepsy by a factor of 3.4. The risk of PTE increased with severity of TBI; 14.3% of the dogs with skull fracture developed PTE. In group II, 15.5% of the dogs with epilepsy had a history of head injury, which was significantly higher than the incidence of PTE determined for group Ia. SIGNIFICANCE Our study indicates that head trauma in dogs is associated with a significant risk of developing epilepsy. Therefore, dogs with severe TBI are an interesting natural model of PTE that provides a novel translational platform for studies on human PTE.
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Affiliation(s)
- Sonja Steinmetz
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine, Hannover, Germany
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Machado GF, Laranjeira MG, Schweigert A, de Melo GD. Porencephaly and cortical dysplasia as cause of seizures in a dog. BMC Vet Res 2012; 8:246. [PMID: 23269021 PMCID: PMC3538049 DOI: 10.1186/1746-6148-8-246] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 12/20/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Seizures are a common problem in small animal neurology and it may be related to underlying diseases. Porencephaly is an extremely rare disorder, and in Veterinary Medicine it affects more often ruminants, with only few reports in dogs. CASE PRESENTATION A one-year-old intact male Shih-Tzu dog was referred to Veterinary University Hospital with history of abnormal gait and generalized tonic-clonic seizures. Signs included hypermetria, abnormal nystagmus and increased myotatic reflexes. At necropsy, during the brain analysis, a cleft was observed in the left parietal and occipital lobes, creating a communication between the subarachnoid space and the left lateral ventricle, consistent with porencephaly; and also a focal atrophy of the caudal paravermal and vermal portions of the cerebellum. Furthermore, the histological examination showed cortical and cerebellar neuronal dysplasia. CONCLUSIONS Reports of seizures due to porencephaly are rare in dogs. In this case, the dog presented a group of brain abnormalities which per se or in assemblage could result in seizure manifestation.
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Affiliation(s)
- Gisele Fabrino Machado
- Department of Animal Clinics, Surgery and Reproduction, UNESP - Univ Estadual Paulista, College of Veterinary Medicine, Rua Clóvis Pestana, 793, Araçatuba, SP, CEP 16050-680, Brazil.
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Grohmann KS, Schmidt MJ, Moritz A, Kramer M. Prevalence of seizures in cats after head trauma. J Am Vet Med Assoc 2012; 241:1467-70. [DOI: 10.2460/javma.241.11.1467] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Arrol L, Penderis J, Garosi L, Cripps P, Gutierrez-Quintana R, Gonçalves R. Aetiology and long-term outcome of juvenile epilepsy in 136 dogs. Vet Rec 2012; 170:335. [DOI: 10.1136/vr.100316] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- L. Arrol
- Department of Veterinary Science; Small Animal Teaching Hospital; University of Liverpool, Leahurst; Chester High Road Neston CH64 7TE UK
| | - J. Penderis
- School of Veterinary Medicine; College of Medical; Veterinary and Life Sciences; University of Glasgow; Bearsden Road Glasgow G61 1QH UK
| | - L. Garosi
- Davies Veterinary Specialists; Manor Farm Business Park Higham Gobion Hertfordshire SG5 3HR UK
| | - P. Cripps
- Department of Veterinary Science; Small Animal Teaching Hospital; University of Liverpool, Leahurst; Chester High Road Neston CH64 7TE UK
| | - R. Gutierrez-Quintana
- School of Veterinary Medicine; College of Medical; Veterinary and Life Sciences; University of Glasgow; Bearsden Road Glasgow G61 1QH UK
| | - R. Gonçalves
- Department of Veterinary Science; Small Animal Teaching Hospital; University of Liverpool, Leahurst; Chester High Road Neston CH64 7TE UK
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Jambroszyk M, Tipold A, Potschka H. Add-on treatment with verapamil in pharmacoresistant canine epilepsy. Epilepsia 2011; 52:284-91. [PMID: 21219313 DOI: 10.1111/j.1528-1167.2010.02886.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE Verapamil add-on treatment has been suggested as a novel therapeutic concept for overcoming transporter-mediated pharmacoresistance. Efficacy data have been limited so far to case reports in individual epileptic patients. Therefore, we aimed to thoroughly evaluate the efficacy and tolerability of verapamil add-on treatment. METHODS In a prestudy in healthy Beagle dogs the tolerability of verapamil add-on treatment was investigated. The efficacy of verapamil was then evaluated in 11 dogs with phenobarbital-resistant epilepsy. KEY FINDINGS Verapamil add-on treatment (6.2-7.3 mg/kg) did not affect phenobarbital concentrations in plasma or cerebrospinal fluid. Side effects observed in healthy as well as in epileptic dogs comprised bradycardia and a decrease in blood pressure. Therefore, we had to limit the dosage to 1-1.5 mg/kg in the main study. In phenobarbital nonresponders, verapamil failed to improve seizure control. Verapamil treatment was discontinued prematurely in five animals due to worsening of seizure control or lack of an effect. In the remaining animals, seizure frequency tended to increase during the verapamil add-on phase, reaching a mean of two seizures per month compared to the pre-verapamil phase with phenobarbital monotherapy (mean of 1.4 seizures per month). In view of the detrimental effects in the majority of the dogs, the study had to be discontinued and no further animals were enrolled. SIGNIFICANCE The failure of the maximum tolerated dosage to improve seizure control in dogs with phenobarbital-resistant epilepsy argues against the suitability of verapamil add-on treatment to overcome pharmacoresistance. Deterioration of seizure control in some individual animals suggests that verapamil might also exert unfavorable effects on seizure thresholds or its spread.
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Affiliation(s)
- Melanie Jambroszyk
- Division Neurology, Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Germany
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Pákozdy A, Leschnik M, Sarchahi AA, Tichy AG, Thalhammer JG. Clinical comparison of primary versus secondary epilepsy in 125 cats. J Feline Med Surg 2010; 12:910-6. [PMID: 20822944 PMCID: PMC11135544 DOI: 10.1016/j.jfms.2010.07.001] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2010] [Accepted: 07/04/2010] [Indexed: 11/16/2022]
Abstract
In the present study 125 cats with recurrent seizures were analysed. The main goal was to investigate the aetiology and compare primary epilepsy (PE) with secondary epilepsy (SE) regarding signalment, history, ictal pattern, clinical and neurological findings. Seizure aetiology was classified as PE in 47 (38%) and SE in 78 (62%) cats. SE was caused mainly by intracranial neoplasia (16), hippocampal necrosis (14), toxicosis (eight), and encephalitis (seven). A significant difference between PE and SE was found in: age, body weight, duration of seizure, occurrence of status epilepticus and neurological deficits. Status epilepticus, altered interictal neurological status and seizure onset over the age of 7 years indicated SE more frequently than PE. If the seizures occurred during resting conditions and rapid running occurred the aetiology was more likely to be PE than SE.
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Affiliation(s)
- Akos Pákozdy
- Clinic for Internal Medicine and Infectious Diseases, University of Veterinary Medicine, Neurology Service, Veterinärplatz 1, A-1210 Vienna, Austria.
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Zimmermann R, Hülsmeyer VI, Sauter-Louis C, Fischer A. Status Epilepticus and Epileptic Seizures in Dogs. J Vet Intern Med 2009; 23:970-6. [DOI: 10.1111/j.1939-1676.2009.0368.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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