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Abstract A 3-year-old, male neutered toy Chinese crested powderpuff dog was presented with an acute onset obtundation that progressed to status epilepticus. On presentation, neurological examination was localized to a right forebrain lesion. Bizarre episodes, consisting of disconjugate nystagmus of the left eye, medial strabismus of the right eye with convergent-retraction movements in both eyes, were recorded. Head magnetic resonance imaging revealed intra-axial multifocal lesions affecting the right fronto-temporal cortices and dorsal paramedian thalamus. Cerebrospinal fluid analysis revealed a marked mononuclear pleocytosis. Electroencephalographic recordings revealed recurrent medium-amplitude interictal isolated spikes, and suspected epileptic spikes alongside with eye movement that were mainly visible in the right hemisphere. The presumptive diagnosis was meningoencephalitis of unknown origin. Despite treatment, the dog died. This is a report of monocular nystagmus with a presumptive epileptic origin in veterinary medicine, a rare clinical sign in human patients.

Seizure forecasting has the potential to create new therapeutic strategies for epilepsy, such as providing patient warnings and delivering preemptive therapy. Progress on seizure forecasting, however, has been hindered by lack of sufficient data to rigorously evaluate the hypothesis that seizures are preceded by physiological changes, and are not simply random events. We investigated seizure forecasting in three dogs with naturally occurring focal epilepsy implanted with a device recording continuous intracranial EEG (iEEG). The iEEG spectral power in six frequency bands: delta (0.1-4 Hz), theta (4-8 Hz), alpha (8-12 Hz), beta (12-30 Hz), low-gamma (30-70 Hz), and high-gamma (70-180 Hz), were used as features. Logistic regression classifiers were trained to discriminate labeled pre-ictal and inter-ictal data segments using combinations of the band spectral power features. Performance was assessed on separate test data sets via 10-fold cross-validation. A total of 125 spontaneous seizures were detected in continuous iEEG recordings spanning 6.5 to 15 months from 3 dogs. When considering all seizures, the seizure forecasting algorithm performed significantly better than a Poisson-model chance predictor constrained to have the same time in warning for all 3 dogs over a range of total warning times. Seizure clusters were observed in all 3 dogs, and when the effect of seizure clusters was decreased by considering the subset of seizures separated by at least 4 hours, the forecasting performance remained better than chance for a subset of algorithm parameters. These results demonstrate that seizures in canine epilepsy are not randomly occurring events, and highlight the feasibility of long-term seizure forecasting using iEEG monitoring.

Abstract In human medicine, focal seizures can clinically express as autonomic signs, such as gastrointestinal dysfunction, cardiovascular changes, and variation of pupillary size; but little is known about possible presentations of autonomic seizures in veterinary medicine. Three dogs were presented for recurrent episodes characterized by hypersalivation, vomiting, retching, and signs of abdominal discomfort. Neurological examinations were normal between episodes. Electroencephalographic (EEG) recordings identified ictal or interictal epileptiform discharges in all dogs. Based on clinical signs and EEG findings, a diagnosis of focal autonomic seizures was made. There was a notable positive response of clinical signs to antiepileptic treatment. These cases highlight the diverse clinical presentations of focal autonomic seizures in dogs and emphasize the diagnostic value of EEG in these cases.

Abstract Background Diagnosing epilepsy and dyskinesia in dogs relies on seizure semiology, laboratory workup, brain imaging, and electroencephalography. Variability in existing epilepsy surveys complicates comparison and impedes epidemiologic and genetic research. Objective To characterize the semiology of epileptic seizures and dyskinesia episodes using a novel, owner-completed, multi-language online questionnaire. Animals A cohort of 606 dogs from 96 breeds with paroxysmal events, perceived by their owners as epilepsy or dyskinesia. Materials and Methods A comprehensive epilepsy and dyskinesia questionnaire featuring pragmatic seizure categories and video upload was developed in German, Finnish, and English. The reliability of the questionnaire was assessed, and the study cohort analyzed. Results The questionnaire demonstrated strong internal consistency and interrater agreement. Owners correctly classified paroxysmal events in 90.1% of cases (95% CI 88.18–92.11). Video footage was submitted from 23.8% (143/606) and supported the seizure type in the questionnaire in 96.5%. The age of onset ranged from 6 months to 6 years in 80.2% (median 2 years; IQR 1–5 years). Generalized (epileptic) convulsive seizures occurred in 58.6% of dogs, non-generalized paroxysmal motor events without convulsions in 58.1%, sudden falls without movement in 6.1%, episodes of impaired awareness in 15.8%, and other unclassified events in 7.1%. Multiple seizure types were reported in 25.2% of the dogs. Labrador Retrievers exhibited a higher prevalence of non-generalized motor events compared to Border Collies, Siberian Huskies, and other breeds (p < 0.001). Conclusions The questionnaire reliably characterizes epileptic seizures and dyskinesia episodes in dogs, making it a valuable tool for large-scale epidemiological and genetic studies.

Due to variation in study designs the prevalence of idiopathic epilepsy (IE) and structural epilepsy (SE) in dogs is largely unknown. The objective was to provide estimates of the prevalence of IE and SE in a large population of dogs undergoing MRI for epileptic seizures. A retrospective study on 900 dogs undergoing MRI for seizures was performed. MRI scans, summary clinical history and neurological examination from the VetCT database were reviewed and a diagnosis assigned by board-certified radiologists. Structural lesions were identified as a cause of seizures in 45.1 per cent (n=406) of cases. No structural lesions were identified in 54.9 per cent (n=494) of cases with presumed IE diagnosed in 53.8 per cent (n=484) of dogs. Dogs between six months and six years were more often associated with IE (P<0.001), small breeds were overrepresented with suspected inflammatory brain disease (P=0.001) and large entire dogs more often diagnosed with extra-axial neoplasms (P=0.001). Over 31.0 per cent of dogs with suspected IE were six years or older. This study is the largest of its kind in dogs and provides accurate estimates of underlying causes of epilepsy. MRI findings should be considered in the context of a detailed clinical history and neurological examination.

Abstract Background Juvenile idiopathic epilepsy (JIE) is categorized as a generalized epilepsy. Epilepsy classification entails electrocortical characterization and localization of epileptic discharges (ED) using electroencephalography (EEG). Hypothesis/Objectives Characterize epilepsy in Egyptian Arabian foals with JIE using EEG. Animals Sixty-nine foals (JIE, 48; controls, 21). Methods Retrospective study. Inclusion criteria consisted of Egyptian Arabian foals: (1) JIE group diagnosed based on witnessed or recorded seizures, and neurological and EEG findings, and (2) control group of healthy nonepileptic age-matched foals. Clinical data were obtained in 48 foals. Electroencephalography with photic stimulation was performed under standing sedation in 37 JIE foals and 21 controls. Results Abnormalities on EEG were found in 95% of epileptic foals (35 of 37) and in 3 of 21 control asymptomatic foals with affected siblings. Focal ED were detected predominantly in the central vertex with diffusion into the centroparietal or frontocentral regions (n = 35). Generalization of ED occurred in 14 JIE foals. Epileptic discharges commonly were seen during wakefulness (n = 27/37 JIE foals) and sedated sleep (n = 35/37 JIE foals; 3/21 controls). Photic stimulation triggered focal central ED in 15 of 21 JIE foals. Conclusions and Clinical Importance Juvenile idiopathic epilepsy has a focal onset of ED at the central vertex with spread resulting in clinical generalized tonic-clonic seizures with facial motor activity and loss of consciousness. Electroencephalography with photic stimulation contributes to accurate phenotyping of epilepsy. Foals with this benign self-limiting disorder might serve as a naturally occurring animal model for self-limited epilepsy in children.

Background Epilepsy is a common neurological disease in dogs affecting approximately 0.6–0.75% of the canine population. There is much evidence of neuroinflammation presence in epilepsy, creating new possibilities for the treatment of the disease. An increased expression of interleukin-1 beta (IL-1β) was reported in epileptogenic foci. We hypothesized that there is an elevation of IL-1β in serum and CSF of dogs with epilepsy, as well as in serum of dogs with TBI, reflecting involvement of this cytokine in pathophysiology of naturally occurring canine epilepsy in a clinical setting. Results IL-1β levels were evaluated in CSF and serum of six healthy and 51 dogs with epilepsy (structural and idiopathic). In 16 dogs with TBI, only serum was tested. IL-1β concentrations in CSF were not detectable. Serum values were not elevated in dogs with TBI in comparison to healthy controls ( p  > 0.05). However, dogs with epilepsy had increased levels of IL-1β in serum ( p  = 0.003) regardless of the underlying cause of the disease ( p  = 0.0045). There was no significant relationship between the variables and IL-1β levels. Statistically noticeable ( p  = 0.0630) was that approximately 10% of dog with epilepsy (R 2  = 0.105) had increased seizure frequency and IL-1β elevation. Conclusion Increased IL-1β levels were detected in the peripheral blood in dogs with idiopathic and structural epilepsy leading to the assumption that there is an involvement of inflammation in pathophysiology of epilepsy which should be considered in the search for new therapeutic strategies for this disease. However, to better understand the pathogenic role of this cytokine in epilepsy, further evaluation of IL-1β in brain tissue is desired.

Abstract Background Although repetitive transcranial magnetic stimulation (rTMS) has been assessed in epileptic humans, clinical trials in epileptic dogs can provide additional insight. Objectives Evaluate the potential antiepileptic effect of rTMS in dogs. Animals Twelve client-owned dogs with drug-resistant idiopathic epilepsy (IE). Methods Single-blinded randomized sham-controlled clinical trial (dogs allocated to active or sham rTMS) (I) and open-labeled uncontrolled clinical trial (dogs received active rTMS after sham rTMS) (II). Monthly seizure frequency (MSF), monthly seizure day frequency (MSDF), and number of cluster seizures (CS) were evaluated for a 3-month pre-TMS and post-rTMS period and safety was assessed. The lasting effect period of rTMS was assessed in each dog treated by active stimulation using the MSF ratio (proportion of post-TMS to pre-rTMS MSF) and treatment was considered effective if the ratio was <1. Results No adverse effects were reported. In trial I, MSF and MSDF decreased significantly (P = .04) in the active group (n = 7). In the sham group (n = 5), no significant changes were found (P = .84 and .29, respectively). Cluster seizures did not change significantly in either group. No significant differences were detected between the groups. In trial II, previously sham-treated dogs (n = 5) received active rTMS and significant decreases in MSF and MSDF were noted (P = .03 and .008, respectively). The overall effect of rTMS lasted for 4 months; thereafter, the MSF ratio was >1. Conclusions and Clinical Importance Repetitive transcranial magnetic stimulation may be a safe adjunctive treatment option for dogs with drug-resistant IE, but large-scale studies are needed to establish firm conclusions.

Abstract Background Medium-chain triglyceride (MCT) enriched diet has a positive effect on seizure control and behavior in some dogs with idiopathic epilepsy (IE). Objective To evaluate the short-term efficacy of MCTs administered as an add-on dietary supplement (DS) to a variable base diet to assess seizure control and antiseizure drug's (ASD) adverse effect profiles. Animals Twenty-eight dogs with International Veterinary Epilepsy Task Force Tier II (IVETF) level diagnosis of treated IE with 3 or more seizures in the last 3 months were used. Methods A 6-month multicenter, prospective, randomized, double-blinded, placebo-controlled crossover trial was completed, comparing an MCT-DS with a control-DS. A 9% metabolic energy-based amount of MCT or control oil was supplemented to the dogs' diet for 3 months, followed by a control oil or MCT for another 3 months, respectively. Dogs enrolled in this study satisfied most requirements of IE diagnosis stated by the IVETF II level. If they received an oil DS or drugs that could influence the metabolism of the investigated DS or chronic ASD, the chronic ASD medication was adjusted, or other causes of epilepsy were found, the dogs were excluded from the study. Results Seizure frequency (median 2.51/month [0-6.67] versus 2.67/month [0-10.45]; P = .02) and seizure-day frequency were significantly (1.68/month [0-5.60] versus 1.99/month [0-7.42], P = .01) lower when dogs were fed MCT-DS in comparison with the control-DS. Two dogs were free of seizures, 3 had ≥50% and 12 had <50% reductions in seizure frequency, and 11 dogs showed no change or an increase in seizure frequency. Conclusions and Clinical Importance These data show antiseizure properties of an MCT-DS compared to a control oil and support former evidence for the efficacy of MCTs as a nutritive, management option for a subpopulation of drug-resistant dogs with epilepsy.

Abstract Background Post-ictal (PI) clinical signs are a key defining stage of seizure manifestation in dogs. However, this phase remains poorly understood. Objectives To further characterize PI signs and their relation to other parts of a seizure, and understand the owner's perception of how PI signs affect the quality of life (QOL) of the dog. Animals Eight-seven dogs with a diagnosis of idiopathic epilepsy from a single institution. Methods The prospective questionnaire-based study surveying owners of dogs previously and newly diagnosed with idiopathic epilepsy. Results Post-ictal signs were identified in 79/87 dogs, 5/5 of dogs with focal seizures and 74/82 of dogs with generalized seizures. Median duration of PI signs was 30 minutes (range, 5-4320 minutes). The most common PI signs reported were disorientation (50/79) and wobbliness or clumsiness (49/79). Within a year, a change in PI signs was seen in 18/79 dogs. The administration of benzodiazepines was significantly associated with an increase in duration of PI signs (P = .04). Post-ictal signs had more impact on dogs' quality of life compared with ictal signs (P < .01). Groupings of co-existing PI signs identified included disorientation, blindness and deafness. Conclusion Post-ictal signs are a commonly reported aspect of seizures in dogs with idiopathic epilepsy, both in focal as well as generalized seizures. Co-existence of signs could provide some valuable insight into the relevance of this particular phase of a seizure. Owner-reported signs and documentation emphasize the need for a better understanding of PI signs in dogs with idiopathic epilepsy.