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不明原因的脑膜脑炎致犬后脑炎后癫痫:临床特征、风险因素和长期预后。

Postencephalitic epilepsy in dogs with meningoencephalitis of unknown origin: Clinical features, risk factors, and long-term outcome.

机构信息

Small Animal Hospital, School of Veterinary Medicine, University of Glasgow, Glasgow, United Kingdom.

Laboratory of Veterinary Epidemiology and Economics, Faculty of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Warsaw, Poland.

出版信息

J Vet Intern Med. 2020 Mar;34(2):808-820. doi: 10.1111/jvim.15687. Epub 2020 Jan 28.

Abstract

BACKGROUND

Although the presence of seizures in dogs with meningoencephalitis of unknown origin (MUO) has been associated with shorter survival times, data regarding the prevalence and risk factors for postencephalitic epilepsy (PEE) is lacking.

OBJECTIVES

To describe the clinical features, prevalence, risk factors, and long-term outcome of PEE in dogs with MUO.

ANIMALS

Sixty-one dogs with presumptive diagnosis of MUO based on the clinicopathological and diagnostic imaging findings.

METHODS

Retrospective study. Cases were identified by search of hospital medical records for dogs with suspected or confirmed MUO. Medical records of dogs meeting inclusion criteria were reviewed. Signalment, seizure history, clinicopathologic, and magnetic resonance imaging (MRI) findings were recorded.

RESULTS

Among 61 dogs at risk of PEE, 14 (23%) dogs developed PEE. Three of 14 dogs with PEE (21%) developed drug-resistant epilepsy. Dogs with PEE were younger (P = .03; OR = 0.75; 95% confidence interval [CI], 0.58-0.98) and had significantly shorter survival times (log-rank test P = .04) when compared to dogs that did not develop epilepsy. The risk factors associated with the development of PEE were the presence of acute symptomatic seizures (ASS; P = .04; OR = 4.76; 95% CI, 1.11-20.4) and MRI lesions in the hippocampus (P = .04; OR = 4.75; 95% CI, 1.07-21.0).

CONCLUSIONS AND CLINICAL IMPORTANCE

Dogs with MUO and seizures at the early stage of the disease (ASS) seem to be at a higher risk of developing PEE.

摘要

背景

尽管在不明原因脑膜脑炎(MUO)的犬中出现癫痫与存活时间缩短有关,但有关脑炎后癫痫(PEE)的患病率和危险因素的数据尚不清楚。

目的

描述 MUO 犬 PEE 的临床特征、患病率、危险因素和长期预后。

动物

61 只根据临床病理和诊断性影像学发现疑似 MUO 的犬。

方法

回顾性研究。通过搜索疑似或确诊 MUO 犬的医院病历来确定病例。回顾符合纳入标准的犬的病历。记录品种、癫痫发作史、临床病理和磁共振成像(MRI)发现。

结果

在有 PEE 风险的 61 只犬中,有 14 只(23%)犬发生了 PEE。14 只 PEE 犬中有 3 只(21%)患有耐药性癫痫。发生 PEE 的犬比未发生癫痫的犬更年轻(P=0.03;OR=0.75;95%CI,0.58-0.98),存活时间明显缩短(对数秩检验 P=0.04)。与发生 PEE 相关的危险因素是存在急性症状性癫痫(ASS;P=0.04;OR=4.76;95%CI,1.11-20.4)和海马 MRI 病变(P=0.04;OR=4.75;95%CI,1.07-21.0)。

结论和临床意义

MUO 犬早期(ASS)出现癫痫似乎有更高的发生 PEE 的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94bf/7096646/35927463f43f/JVIM-34-808-g001.jpg

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