Berendt M, Gram L
Small Animal Hospital, Department of Clinical Studies, Royal Veterinary and Agricultural University of Copenhagen, Denmark.
J Vet Intern Med. 1999 Jan-Feb;13(1):14-20.
The human definitions of epilepsy and seizure classification were applied rigidly to epileptic dogs to investigate whether the distribution of the seizure types and epilepsies of dogs is comparable to that of human beings. Sixty-three dogs were referred because of recurrent (> 2) epileptic seizures. Only dogs without previous or ongoing antiepileptic treatment were included. All dogs had a physical and neurologic examination and blood work that included a CBC and a biochemical profile. All owners were asked to complete a questionnaire, focusing on seizure development. In addition, video recordings of suspected seizure episodes were analyzed if available. In the majority of dogs where an intracranial lesion was suspected, a computerized tomography scan was performed. Sixty-five percent of the dogs experienced partial seizures with or without secondary generalization and 32% exhibited primary generalized seizures; in 3% of the dogs the seizures could not be classified. Twenty-five percent of these cases were classified as idiopathic, 16% as symptomatic, and 45% as cryptogenic epilepsy; in 14% of these a classification was not possible. Applying human definitions, the distribution of seizure types and epilepsy classifications in these dogs differed widely from those in previous reports of canine epilepsy, where generalized seizures and idiopathic epilepsy were most frequently reported. However, our findings are consistent with the results of several large studies of human epilepsy patients. In dogs with epilepsy, closer attention must be given to the detection of a partial onset of seizures. In this study, detailed questioning of the owners and when possible analysis of video recorded seizures, proved to be sufficient for diagnosing seizures with a partial onset in a significant number of dogs. Partial onset of seizures may be an indication of underlying cerebral pathology. Some adjustments of veterinary epilepsy terminology are suggested.
将人类对癫痫的定义和发作分类严格应用于患有癫痫的犬只,以研究犬只发作类型和癫痫的分布是否与人类相当。63只犬只因反复发作(>2次)癫痫发作而被转诊。仅纳入未接受过抗癫痫治疗或正在接受抗癫痫治疗的犬只。所有犬只均进行了体格检查、神经学检查以及包括全血细胞计数和生化指标的血液检查。所有犬主均被要求填写一份问卷,重点关注癫痫发作的发展情况。此外,如有疑似癫痫发作的视频记录,也会进行分析。在大多数疑似颅内病变的犬只中,进行了计算机断层扫描。65%的犬只经历了伴有或不伴有继发性全身性发作的部分性发作,32%表现为原发性全身性发作;3%的犬只发作无法分类。这些病例中,25%被归类为特发性,16%为症状性,45%为隐源性癫痫;14%无法进行分类。应用人类的定义,这些犬只的发作类型和癫痫分类分布与先前犬类癫痫报告中的情况有很大差异,先前报告中最常报道的是全身性发作和特发性癫痫。然而,我们的研究结果与几项针对人类癫痫患者的大型研究结果一致。对于患有癫痫的犬只,必须更加关注部分性发作的检测。在本研究中,对犬主进行详细询问,并在可能的情况下分析视频记录的发作情况,被证明足以诊断大量犬只的部分性发作。部分性发作可能提示潜在的脑部病变。建议对兽医癫痫术语进行一些调整。