Epilepsy in dogs five years of age and older: 99 cases (2006–2011)

• Autores: Tara M. Ghormley
• Localización: JAVMA: Journal of the American Veterinary Medical Association, ISSN-e 0003-1488, Vol. 246, Nº. 4, 2015, págs. 447-450
• Idioma: inglés
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• Resumen

  • Objective—To classify the etiology of epilepsy and evaluate use of abnormal neurologic examination findings to predict secondary epilepsy in dogs ≥ 5 years of age.

    Design—Retrospective case series.

    Animals—99 dogs with epilepsy.

    Procedures—Medical records were reviewed to identify client-owned dogs evaluated for seizures at ≥ 5 years of age with a diagnosis of primary or secondary epilepsy. Dogs were stratified by age; prevalence of primary and secondary epilepsy and the proportion of dogs with secondary epilepsy that had a diagnosis of neoplasia (on the basis of MRI findings) versus other disease were evaluated. Sensitivity and specificity of abnormal neurologic findings to detect secondary epilepsy were determined.

    Results—7 of 30 (23%) dogs 5 to 7 years of age, 13 of 29 (45%) dogs 8 to 10 years of age, 13 of 33 (39%) dogs 11 to 13 years of age, and 2 of 7 dogs ≥ 14 years of age had primary epilepsy. Prevalence of primary vs secondary epilepsy did not differ among age groups. The proportion of dogs with neoplasia at 5 to 7 years of age was lower than that of dogs in other age groups. Abnormal neurologic examination results had 74% sensitivity and 62% specificity to predict secondary epilepsy.

    Conclusions and Clinical Relevance—A substantial proportion of dogs ≥ 5 years of age had primary epilepsy. Results indicated that lack of abnormalities on neurologic examination does not exclude the possibility of intracranial lesions, and MRI with CSF analysis (when applicable) should be recommended for all dogs with onset of seizures at ≥ 5 years of age.

    Epilepsy is a disorder of the brain characterized by a predisposition to generate seizures and is the most common neurologic disorder found in dogs.1,2 The term is limited to seizures that result from an intracranial cause and is only applied to patients that have ≥ 1 seizure and a likelihood of future seizures.1,2 The International League Against Epilepsy has defined categories of seizures according to their etiology.3,4 Idiopathic, or primary, epilepsy is a recurrent seizure disorder without any known cause3 and no interictal deficits.4,5 The seizures are caused by molecular or microscopic abnormalities6–8 that cannot be detected with common diagnostic techniques and often have a genetic predisposition.1,4,9 Secondary or symptomatic epilepsy is a result of structural brain disease.10 Cryptogenic epilepsy, also known as probable symptomatic epilepsy, is defined as seizures that are suspected to be caused by pathological structural brain changes with no lesions detectable through complete diagnostic evaluation.11,12 Finally, reactive epilepsy is a response in the brain to systemic alterations, such as electrolyte derangements, uremia, or abnormalities resulting from hepatic disease, anesthesia-related events, or toxin exposure.9,10 Most dogs with seizures have primary epilepsy.12 In veterinary medicine, there is an anecdotal impression that dogs ≥ 5 years of age that develop epilepsy most likely have intracranial lesions,13 and advanced diagnostic methods such as MRI and CSF analysis are strongly recommended in evaluation of these patients.11 Although primary epilepsy is thought to develop less commonly in dogs after 5 years of age,14 to our knowledge, the proportion of dogs in this category that have seizures without structural brain disease has not been reported. Therefore, the purpose of the study reported here was to classify the etiology of epilepsy in dogs ≥ 5 years of age, assess differences in type (primary or secondary) and etiology (neoplasia or other disease) of epilepsy among dogs stratified by age, and evaluate use of abnormal neurologic examination findings to predict secondary epilepsy in this population of dogs.