Epilepsy: idiopathic

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Sections available in full article Introduction, Presenting signs, Acute presentation, Geographic incidence, Age predisposition, Cost considerations, Special risks (e.g. anesthetic), Pathogenesis, Etiology, Pathophysiology, Timecourse (incubation, duration), Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Treatment, Standard treatment, Monitoring, Subsequent management, Sequelae, Prognosis, Expected response to treatment, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors Dr Laurent Garosi DVM DipECVN MRCVS RCVS and European Specialist in Veterinary Neurology
Dr Agnes Delauche DVM MRCVS DACVIM DECVN AdvCertCIM
Mr David Godfrey BVetMed CertSAD CertSAM DipABVP(Feline practice) CBiol FSB FRCVS
Dr Rosanna Marsella DVM DipACVD
Synonyms Recurrent seizure Recurrent convulsion

Introduction

  • Rare disorder.
  • Cause : primary cerebral dysfunction.
  • Tend to occur when animal relaxed or asleep.
  • Signs : recurrent seizures, or may present in status epilepticus  Status epilepticus  .
  • Treatment : anticonvulsant therapy.
  • Prognosis : guarded.

Diagnosis

Clinical signs

  • Prodromal, ictal and postictal phases characterize the seizure episodes.
  • Brief loss of consciousness.
  • Ictal phase: rhythmic limb movements, salivation, chewing, defecation, urination .
  • No interictal signs (neurological examination  Neurological examination   normal between seizures).
  • Prodromal phase: abnormal behavior for several minutes or more before episode .
  • Postictus: altered behavior lasting a period of several hours after the episode.

Sequelae

Prognosis

  • Good, if can control seizures.
  • Bad, if seizure clustering.
    Drug tolerance may develop over several months.
    Concurrent disease, eg vomiting, diarrhea may affect anticonvulsant absorption.

Expected response to treatment

  • Reduction in seizure frequency and severity with negligible side effects.
  • Often will not prevent seizures completely.

Reasons for treatment failure

  • Standard reasons  Standard reasons for failure in a treatment  .
  • Medication: wrong dose, inappropriate choice.
  • Interaction with drugs given for other conditions may affect efficacy.
  • Development of tolerance to drug.
  • Refractory form of seizure (cluster seizures often particularly difficult to control).
  • Concurrent disease.
  • Wrong diagnosis - re-assess diagnosis of idiopathic epilepsy.

Sources

Publications

Refereed papers

  • Recent references fromPubMed.
  • Rusbridge C (2005)Diagnosis and control of epilepsy in the cat.In Practice27, 208-214.
  • Podell M (1998)Antiepileptic drug therapy.Clin Tech Small An Pract13(3), 185-192.PubMed
  • Kline K L (1998)Feline epilepsy.Clin Tech Small Anim Pract13(3), 152-158.PubMed
  • Knowles K (1998)Idiopathic epilepsy.Clin Tech Small Anim Pract13(3), 144-151.PubMed
  • March P A (1998)Seizures - classification, etiologies and pathophysiology.Clin Tech Small Anim Pract13(3), 119-131.PubMed
  • Schwartz-Porsche Det al(1989)Feline epilepsy.Probl Vet Med1(4), 628-649.PubMed
  • LeCouteur RA & Child G (1989)Clinical management of epilepsy of dogs and cats. Probl Vet Med1, 578-595.PubMed

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