Department of Clinical Science and Services, Royal Veterinary College, Hertfordshire, UK
Department of Clinical Science and Services, Royal Veterinary College, Hertfordshire, UK.
Vet Rec. 2020 Oct 17;187(8):e63. doi: 10.1136/vr.105708. Epub 2020 Jun 25.
Structural epilepsy in dogs is often treated medically with a combination of antiseizure drugs (ASDs) and other concurrent therapies for the primary condition. Unlike idiopathic epilepsy, there have been few studies on the efficacy of medical management in structural epilepsy. This study investigated factors affecting treatment outcomes in dogs medically managed for structural epilepsy.
Cases of 71 dogs diagnosed with structural epilepsy were identified from a referral hospital database and data were analysed retrospectively. Efficacy of treatment was assessed by survival time, seizure-free period after diagnosis and overall seizure control.
Results showed that the most significant prognostic indicator was the occurrence of status epilepticus (SE) before diagnosis, with these dogs having reduced survival times, shorter seizure-free periods after diagnosis and overall worse seizure control. Cluster seizure history showed similar, although not statistically significant, trends in treatment efficacy. Treatment outcomes were not significantly impacted by ASD therapy used or by specific diagnosis, with the exception of meningoencephalitis of unknown aetiology cases surviving longer.
Overall, medical management of canine structural epilepsy achieves the best treatment outcomes when the patient has no history of SE. This study may provide a basis for future investigations into the treatment of canine structural epilepsies.
犬结构性癫痫通常采用抗癫痫药物(ASD)联合其他针对原发性疾病的联合治疗。与特发性癫痫不同,针对结构性癫痫的药物治疗效果的研究较少。本研究调查了影响结构性癫痫犬药物治疗效果的因素。
从一家转诊医院的数据库中确定了 71 例诊断为结构性癫痫的犬病例,并进行了回顾性数据分析。通过生存时间、诊断后无癫痫发作期和总体癫痫控制来评估治疗效果。
结果表明,最显著的预后指标是诊断前癫痫持续状态(SE)的发生,这些犬的生存时间缩短,诊断后无癫痫发作期缩短,总体癫痫控制较差。簇发性癫痫史在治疗效果上表现出相似的趋势,但无统计学意义。ASD 治疗的使用或特定诊断对治疗效果没有显著影响,但病因不明的脑膜脑炎病例的存活时间更长。
总体而言,当患者无 SE 病史时,犬结构性癫痫的药物治疗效果最佳。本研究可为犬结构性癫痫的治疗提供未来研究的基础。