Cave Veterinary Specialists, Wellington, UK.
Aust Vet J. 2021 Jan;99(1-2):1-5. doi: 10.1111/avj.13018. Epub 2020 Sep 7.
Idiopathic epilepsy (IE) is the most common cause of repeated seizures in dogs. The International Veterinary Epilepsy Task Force consensus guidelines recommend performing magnetic resonance imaging (MRI) of the brain and cerebrospinal fluid (CSF) analysis as part of a tier II diagnosis of IE, and these procedures have documented risks. The aim of this retrospective study was to identify how often dogs with suspected IE have abnormalities on CSF analysis.
Dogs aged between 6 months and 6 years that were presented with a history of two or more seizures with at least 24 h between seizure episodes, a normal neurologic examination, no evidence of toxic or metabolic causes, a normal MRI scan (including contrast administration) and CSF analysis were included.
Eighty-two dogs were included. Of these, nine dogs (10.9%) had abnormalities on CSF analysis: five of nine dogs (55.5%) had albuminocytologic dissociation, three of nine dogs (33.3%) had mild increases in total nucleated cell count (TNCC), and one of nine dogs (11.1%) had mild increase in both total protein and TNCC. Cytology in dogs with elevated TNCC revealed a mononuclear pleocytosis. One of the nine dogs with abnormal CSF had a seizure within the 24 h before investigations, and six of nine dogs had a seizure within 1 month before investigation.
CSF analysis can play an important role in the diagnostic investigation of the underlying causes of repeated seizures. However, in dogs with a normal inter-ictal neurological examination and MRI scan, it rarely reveals significant abnormalities, and the risk of performing a CSF tap may outweigh the potential diagnostic gain.
特发性癫痫(IE)是犬反复癫痫发作最常见的原因。国际兽医癫痫工作组共识指南建议对疑似 IE 进行脑磁共振成像(MRI)和脑脊液(CSF)分析作为二级诊断的一部分,这些程序有记录的风险。本回顾性研究的目的是确定有多少疑似 IE 的犬在 CSF 分析中存在异常。
纳入年龄在 6 个月至 6 岁之间、有两次或两次以上癫痫发作史且两次发作之间至少间隔 24 小时、神经检查正常、无中毒或代谢原因、MRI 扫描(包括对比剂给药)和 CSF 分析正常的犬。
共纳入 82 只犬。其中 9 只犬(10.9%) CSF 分析异常:9 只犬中有 5 只(55.5%)存在白蛋白细胞分离,9 只犬中有 3 只(33.3%)总核细胞计数(TNCC)轻度升高,9 只犬中有 1 只(11.1%)总蛋白和 TNCC 均轻度升高。升高的 TNCC 犬的细胞学检查显示单核细胞增多。9 只 CSF 异常犬中有 1 只在检查前 24 小时内有癫痫发作,6 只犬在检查前 1 个月内有癫痫发作。
CSF 分析在反复癫痫发作的潜在病因的诊断性检查中起着重要作用。然而,在具有正常发作间神经检查和 MRI 扫描的犬中,它很少显示出显著异常,并且进行 CSF 穿刺的风险可能超过潜在的诊断收益。