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Tästensen C, Gutmann S, Loderstedt S, Flegel T, Demeny H, Baum P. Prevalence of nonconvulsive seizures and nonconvulsive status epilepticus in dogs and cats with a history of cluster seizures: A retrospective study. J Vet Intern Med 2024; 38:238-246. [PMID: 38006289 PMCID: PMC10800195 DOI: 10.1111/jvim.16953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 11/13/2023] [Indexed: 11/27/2023] Open
Abstract
BACKGROUND Nonconvulsive seizures (NCS) and nonconvulsive status epilepticus (NCSE) are frequently observed in human patients. Diagnosis of NCS and NCSE only can be achieved by the use of electroencephalography (EEG). Electroencephalographic monitoring is rare in veterinary medicine and consequently there is limited data on frequency of NCS and NCSE. OBJECTIVES Determine the prevalence of NCS and NCSE in dogs and cats with a history of cluster seizures. ANIMALS Twenty-six dogs and 12 cats. METHODS Retrospective study. Medical records of dogs and cats with cluster seizures were reviewed. Electroencephalography was performed in order to identify electrographic seizure activity after the apparent cessation of convulsive seizure activity. RESULTS Nonconvulsive seizures were detected in 9 dogs and 2 cats out of the 38 patients (29%). Nonconvulsive status epilepticus was detected in 4 dogs and 2 cats (16%). Five patients had both NCS and NCSE. A decreased level of consciousness was evident in 6/11 patients with NCS, 3/6 also had NCSE. Mortality rate for patients with NCS (73%) and NCSE (67%) was much higher than that for patients with no seizure activity on EEG (27%). CONCLUSION AND CLINICAL IMPORTANCE Prevalence of NCS and NCSE is high in dogs and cats with a history of cluster seizures. Nonconvulsive seizures and NCSE are difficult to detect clinically and are associated with higher in hospital mortality rates. Results indicate that prompt EEG monitoring should be performed in dogs and cats with cluster seizures.
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Affiliation(s)
- Carina Tästensen
- Department for Small Animals, Leipzig University, Leipzig, Germany
| | - Sarah Gutmann
- Department for Small Animals, Leipzig University, Leipzig, Germany
| | | | - Thomas Flegel
- Department for Small Animals, Leipzig University, Leipzig, Germany
| | - Helga Demeny
- Demed-Veterinary Neurology, Cluj-Napoca, Romania
| | - Petra Baum
- Department of Neurology, Leipzig University, Leipzig, Germany
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Luca J, McCarthy S, Parmentier T, Hazenfratz M, Linden AZ, Gaitero L, James FMK. Survey of electroencephalography usage and techniques for dogs. Front Vet Sci 2023; 10:1198134. [PMID: 37520003 PMCID: PMC10374286 DOI: 10.3389/fvets.2023.1198134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 05/16/2023] [Indexed: 08/01/2023] Open
Abstract
Background Canine epilepsy is a chronic common neurologic condition where seizures may be underreported. Electroencephalography (EEG) is the patient-side test providing an objective diagnostic criterion for seizures and epilepsy. Despite this, EEG is thought to be rarely used in veterinary neurology. Objectives This survey study aims to better understand the current canine EEG usage and techniques and barriers in veterinary neurology. Methods The online Qualtrics link was distributed via listserv to members of the American College of Veterinary Internal Medicine (ACVIM) Neurology Specialty and the European College of Veterinary Neurology (ECVN), reaching at least 517 veterinary neurology specialists and trainees worldwide. Results The survey received a 35% response rate, for a total of 180 participant responses. Fewer than 50% of veterinary neurologists are currently performing EEG and it is performed infrequently. The most common indication was to determine a discrete event diagnosis. Other reasons included monitoring treatment, determining brain death, identifying the type of seizure or epilepsy, localizing foci, sleep disorders, for research purposes, and post-op brain surgery monitorization. Most respondents interpreted their own EEGs. Clinical barriers to the performance of EEG in dogs were mainly equipment availability, insufficient cases, and financial costs to clients. Conclusion This survey provides an update on EEG usage and techniques for dogs, identifying commonalities of technique and areas for development as a potential basis for harmonization of canine EEG techniques. A validated and standardized canine EEG protocol is hoped to improve the diagnosis and treatment of canine epilepsy.
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Affiliation(s)
- Julia Luca
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Samantha McCarthy
- Medical Science, Canadian Academy of Osteopathy, Hamilton, ON, Canada
| | - Thomas Parmentier
- Département de sciences cliniques, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Michal Hazenfratz
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Alex Zur Linden
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Luis Gaitero
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Fiona M. K. James
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
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Knipe MF, Bush WW, Thomas KE, Williams DC. Periodic discharges in veterinary electroencephalography-A visual review. Front Vet Sci 2023; 10:1037404. [PMID: 36777678 PMCID: PMC9909489 DOI: 10.3389/fvets.2023.1037404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 01/03/2023] [Indexed: 01/27/2023] Open
Abstract
First described in human EEG over 60 years ago, there are very few examples of periodic discharges in the veterinary literature. They are associated with a wide variety of etiologies, both intracranial and systemic, making interpretation challenging. Whether these patterns are indicative of ictal, interictal, or postictal activity is a matter of debate and may vary depending on the clinical features in an individual patient. Periodic discharges have a repeated waveform occurring at nearly regular intervals, with varying morphology of individual discharges from simple sharp waves or slow waves to more complex events. Amplitudes, frequencies, and morphologies of the discharges can fluctuate, occasionally evolving, or resolving over time. This study presents a visual review of several veterinary cases with periodic discharges on EEG similar to those described in human EEG, and discusses the current known pathophysiology of these discharges.
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Affiliation(s)
- Marguerite F. Knipe
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States,*Correspondence: Marguerite F. Knipe ✉
| | - William W. Bush
- Bush Veterinary Neurology Service, Leesburg, VA, United States
| | | | - D. Colette Williams
- School of Veterinary Medicine, William R. Pritchard Veterinary Medical Teaching Hospital, University of California, Davis, Davis, CA, United States
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Sasaoka K, Ohta H, Ishizuka T, Kojima K, Sasaki N, Takiguchi M. Transcranial Doppler ultrasonography detects the elevation of cerebral blood flow during ictal-phase of pentetrazol-induced seizures in dogs. Am J Vet Res 2022; 83:331-338. [DOI: 10.2460/ajvr.21.06.0085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Abstract
OBJECTIVE
To investigate the association between changes in cerebral blood flow and electrographic epileptic seizure in dogs using transcranial Doppler ultrasonography (TCD).
ANIMALS
6 healthy Beagle dogs.
PROCEDURES
Each dog was administered pentetrazol (1.5 mg/kg/min) or saline (0.9% NaCl) solution under general anesthesia with continuous infusion of propofol. Both pentetrazol and saline solution were administered to all 6 dogs, with at least 28 days interval between the experiments. Blood flow waveforms in the middle cerebral artery and the basilar artery were obtained using TCD at baseline, after pentetrazol administration, and after diazepam administration. TCD velocities, including peak systolic velocity, end-diastolic velocity, and mean velocity and resistance variables, were determined from the Doppler waveforms.
RESULTS
During ictal-phase of pentetrazol-induced seizures, the TCD velocities significantly increased in the basilar and middle cerebral arteries while TCD vascular resistance variables did not change in either artery. The TCD velocities significantly decreased after diazepam administration. Systemic parameters, such as the heart rate, mean arterial pressure, systemic vascular resistance, cardiac index, end-tidal carbon dioxide, oxygen saturation, and body temperature, did not change significantly during seizures.
CLINICAL RELEVANCE
This study showed that cerebral blood flow, as obtained from TCD velocities, increased by 130% during ictal-phase of pentetrazol-induced seizures in dogs. The elevated velocities returned to baseline after seizure suppression. Thus, TCD may be used to detect electrographic seizures during the treatment of status epilepticus in dogs, and further clinical studies clarifying the association between changes in cerebral blood flow and non-convulsive seizure cases are needed.
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Affiliation(s)
- Kazuyoshi Sasaoka
- 1Veterinary Teaching Hospital, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Hokkaido, Japan
| | - Hiroshi Ohta
- 2Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Hokkaido, Japan
| | - Tomohito Ishizuka
- 1Veterinary Teaching Hospital, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Hokkaido, Japan
| | - Kazuki Kojima
- 2Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Hokkaido, Japan
| | - Noboru Sasaki
- 2Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Hokkaido, Japan
| | - Mitsuyoshi Takiguchi
- 2Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Hokkaido, Japan
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Parmentier T, Monteith G, Cortez MA, Wielaender F, Fischer A, Jokinen TS, Lohi H, Sanders S, Sammut V, Tai T, James FMK. Effect of prior general anesthesia or sedation and antiseizure drugs on the diagnostic utility of wireless video electroencephalography in dogs. J Vet Intern Med 2020; 34:1967-1974. [PMID: 33463773 PMCID: PMC7517491 DOI: 10.1111/jvim.15856] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 06/26/2020] [Accepted: 06/26/2020] [Indexed: 01/27/2023] Open
Abstract
Background Ambulatory wireless video electroencephalography (AEEG) is the method of choice to discriminate epileptic seizures from other nonepileptic episodes. However, the influence of prior general anesthesia (GA), sedation, or antiseizure drug (ASD) on the diagnostic ability of AEEG is unknown. Hypothesis/Objectives The use of sedation/GA or ASD treatment before AEEG recording may affect the diagnostic ability of AEEG and the time to first abnormality on AEEG. Animals A total of 108 client‐owned dogs undergoing ambulatory AEEG for paroxysmal episodes. Methods Retrospective cohort study. Proportions of diagnostic AEEG and time to first abnormality were compared between dogs that received sedation/GA or neither for instrumentation as well as dogs receiving at least 1 ASD and untreated dogs. Results Ambulatory EEG was diagnostic in 60.2% of all dogs including 49% of the sedation/GA dogs and 68% of dogs that received neither (odds ratio [OR], 2.25; 95% confidence interval [CI], 1.02‐5.00; P = .05). The AEEG was diagnostic in 51% of dogs receiving at least 1 ASD and 66% of untreated dogs (OR, 1.95; 95% CI, 0.9‐4.3; P = .11). No difference was found in time to first abnormality between sedation/GA or neither or ASD‐treated or untreated dogs (P = .1 and P = .3 respectively). Ninety‐five percent of dogs had at least 1 abnormality within 277 minutes. Conclusion and Clinical Importance Sedation/GA and concurrent ASD administration were not identified as confounding factors for decreasing AEEG diagnostic capability nor did they delay the time to first abnormality. A 4‐hour minimal recording period is recommended.
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Affiliation(s)
- Thomas Parmentier
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Gabrielle Monteith
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Miguel A Cortez
- Division of Neurology, Department of Paediatrics, Faculty of Medicine, University of Toronto, Peter Gilgan Center Research Learning, SickKids Research Institute, Toronto, Ontario, Canada
| | - Franziska Wielaender
- Clinic of Small Animal Medicine, Ludwig-Maximilians Universität München, Munich, Germany
| | - Andrea Fischer
- Clinic of Small Animal Medicine, Ludwig-Maximilians Universität München, Munich, Germany
| | - Tarja S Jokinen
- Department of Equine and Small Animal Medicine, University of Helsinki, Helsinki, Finland
| | - Hannes Lohi
- Department of Veterinary Biosciences and Department of Medical and Clinical Genetics, University of Helsinki and the Folkhälsan Research Center, Helsinki, Finland
| | - Sean Sanders
- Seattle Veterinary Specialists, Seattle, Washington, USA
| | | | - Tricia Tai
- VCA West LA, Los Angeles, California, USA
| | - Fiona M K James
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
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