Epilepsy: traumatic

Buy now to access the full article, existing subscribers login

Sections available in full article Introduction, Presenting signs, Acute presentation, Age predisposition, Cost considerations, Special risks (e.g. anesthetic), Pathogenesis, Etiology, Predisposing factors, Pathophysiology, Timecourse (incubation, duration), Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Differential diagnosis, Treatment, Initial symptomatic treatment, Standard treatment, Sequelae, Prognosis, Expected response to treatment, Sources, Publications, Vetstream contributor(s),
Contributors Dr Rodney Bagley DVM DipACVIM
Dr Laurent Garosi DVM DipECVN MRCVS

Introduction

  • Seizure disorder that occurs secondary to head injury.
  • A seizure is defined as a paroxysmal, transitory disturbance of brain function that has a sudden onset, ceases spontaneously, and has a tendency to recur.
  • Seizures are usually associated with autonomic disturbances such as urination, salivation and defecation.
  • Epilepsy is a recurrent seizure disorder irrespective of cause.
  • Postulated to be associated with a previous contusion or damage resulting in a seizure focus.
  • Cause : trauma to head.
  • Signs : recurrent seizures, or may present in status epilepticus.
  • History of physical trauma to head, eg road traffic accident (RTA) or fall.
    In all cases of traumatic injury warn owner of potential complications at time of injury.
  • Diagnosis : recurrent seizures.
  • Treatment : symptomatic, anticonvulsant therapy.
  • Prognosis : guarded.

  • See the presenting problems mind map Seizures and quiz Seizures Quiz on seizures.

Diagnosis

Clinical signs

  • The neurological examination Neurological examination can be extremely informative in animals with seizures.
  • Idiopathic seizures are not associated with interictal neurological deficits.
    Some dogs may have neurological deficits in the postictal period often for days after the seizure.
  • Therefore, knowledge of when the seizure(s) occurred in relationship to the examination is important.
  • Metabolic causes may result in persistent neurological deficits, especially if the mental status is altered. These deficits are usually symmetric, however, very rarely may be asymmetric.
  • Dilated, fixed pupils/nystagmus → poor outcome.
  • Other neurological signs common in acute cases, eg depression, blindness, ataxia.
  • As for idiopathic epilepsy Epilepsy: idiopathic.
  • Evidence of trauma to head, eg lacerations, swellings if recent injury.

Diagnosis

Differential diagnosis

  • Seizures must be differentiated from other episodic disturbances including cataplexy/narcolepsy Narcolepsy , syncope, weakness, vestibular disturbances, and tremors.

Sequelae

Prognosis

  • The prognosis for dogs with other structural or metabolic causes depends upon appropriate management of the underlying disease.
  • Guarded (depends on severity of trauma).
  • Seizures likely to recur.

Expected response to treatment

  • Worsening neurological signs may indicate brain swelling or edema.
  • Acute seizures may resolve spontaneously.
  • Delayed onset seizures likely to be permanent.

Sources

Publications

Refereed papers

  • Berendt M, Gram L (1999) Epilepsy and seizure classfication in 63 dogs: A reappraisal of veterinary epilepsy terminology. JVIM 13 , 14-20.
  • March P A (1998) Seizures - classification, etiologies and pathophysiology. Clin Tech Small Anim Pract 13 (3), 119-131 (review).
  • Dyer K R, Shell L G (1993) Anticonvulsant therapy: a practical guide to medical management of epilepsy in pets. Vet Med 88 , 647-653.
  • Koestner A (1989) Neuropathology of canine epilepsy. Probl Vet Med 1 (4), 516-534 (review).

Other sources of information

  • Platt S R, Adams V, Garosi L S et al(2003) Gabapentin as adjunctive therapy for refractory idiopathic epilepsy in dogs. Proc ECVN Annual Symposium.

Sample content only, to unlock the full article login or buy now

Loading...