Epilepsia en medicina veterinaria

In: Braund's Clinical Neurology in Small Animals: Localization, Diagnosis and Treatment, C.H. Vite (Ed.) Publisher: International Veterinary Information Service (www.ivis.org), Ithaca, New York, USA.

Epilepsy (13-Jul-2004)
M. Berendt Small Animal Veterinary Teaching Hospital, Department of Clinical Studies, Royal Veterinary and Agricultural University, Frederiksberg, Copenhagen, Denmark.Introduction Epilepsy is one of the most common neurological disorders in canines and felines. Epilepsy is an episodic illness caused by repeated excessive and hypersynchronous abnormal electrical activity of neurons in the brain. Epilepsy is more than convulsions. A broad variety of clinical phenomena may reflect epileptic seizure activity e.g., behavioural or gastrointestinal signs. Therefore, therecognition of epilepsy implies knowledge of the phenomenology representing different types of seizures. Observations of suspected seizure activity, seizure symptomatology reported by the owner and video documentation of seizures are essential when trying to establish a diagnosis of epilepsy. Electroencephalography, brain imaging and cerebrospinal fluid (CSF) examination among others, maydisclose underlying pathological processes causing epilepsy. Animals with epilepsy are time consuming patients. A continued evaluation of the owners’ compliance with given instructions concerning actual seizure frequency, antiepileptic treatment, measurement of antiepileptic drug levels, monitoring of potential adverse effects and additional owner counseling is required to manage these patientssuccessfully.
History Definition of Epilepsy Epidemiology Pathophysiology Genetics Classification of Epilepsy and Epileptic Seizures Classification of Epilepsy Classification of Epileptic Seizures Primary Generalized Seizures Partial Seizures Simple and Complex Partial Seizures Partial Seizures with Secondary Generalization - Clinical Signs in Partial Seizures - Prodromes - Postictal Signs -Classification - Future Perspectives Diagnostic Evaluation Differential Diagnosis Diagnostic Work-up Long-term Therapy of Epilepsy General Therapeutic Considerations Antiepileptic Drugs Complications Associated with Long-term Phenobarbital (Primidone) and Potassium Bromide Treatment Therapeutic Failure Withdrawal of Antiepileptic Drugs Instructions to Owners Non-medical Treatment for Epilepsy EpilepsySurgery Vagal Nerve Stimulation Ketogenic Diet Status Epilepticus (SE) Classification of SE Convulsive SE The Pathophysiology of Convulsive SE Management of Convulsive SE Anticonvulsive Drugs in SE Therapetic Failure in SE Instructions to Owners Closing Remarks

History The word epilepsy originates from the Greek word epilepsia meaning to be taken, seized or attacked. This condition has beenrecognized in Man since antiquity. The Greek physician and philosopher Hippokrates (460 - 377 B.C.) believed that the cause of epileptic seizures should be found in the brain. The Greek physician Galén (130 - 210 A.D.) viewed epileptic seizures as a symptom of intracranial dysfunction or systemic disease, caused by an accumulation of mucous in the arterial system. During the Middle Ages epilepsy wasthought to be associated with supernatural forces, because of the vigorous symptomatology, especially of convulsions. Humans suffering from epilepsy have been thought to be insane, or possessed by demons in the 16th and 17th centuries. As a consequence, treatment of epilepsy included exorcism and bloodletting, and a variety of substances e.g,. brew of mistletoe, blood from a decapitated man and apulverized cranium were given to aid the

sick person. In the 19th century the gap between ignorance and understanding of epilepsy began to close. The physician Calmeil in 1824 made the first attempt to classify epileptic seizures according to their symptomatology. The neurologist John Hughlings Jackson proposed that a classification of epilepsy should be based upon anatomical localization,...