Everest Stephen, Gaitero Luis, Dony Robert, Linden Alexander Zur, Cortez Miguel A, James Fiona M K
Department of Clinical Studies, Ontario Veterinary College Health Sciences Centre, University of Guelph, Guelph, ON, Canada.
School of Engineering, College of Engineering and Physical Sciences, University of Guelph, Guelph, ON, Canada.
Front Vet Sci. 2024 Nov 14;11:1402546. doi: 10.3389/fvets.2024.1402546. eCollection 2024.
Electroencephalography (EEG) is the gold standard for confirming epileptic seizures in both human and veterinary patients. Despite idiopathic epilepsy being one of the most common neurological conditions in dogs, our understanding of it in veterinary medicine lags that in human medicine. The relative underuse of EEG in dogs with seizures has potential causes including practical issues, financial concerns, lack of training/equipment, and questions of clinical value. This technological underuse may lead to, or result from, major gaps in our understanding of EEG in veterinary patients. This underutilization of EEG is of significant clinical relevance because the diagnosis of specific epilepsy syndromes in humans guides the treatment, namely pharmacological, dietary, or surgical. These epilepsy syndromes are diagnosed based on several factors, one of which is the characteristic electrical brain activity on EEG. The aim of this narrative literature review was to highlight the study of cortical brain activity to improve our understanding of EEG in veterinary medicine. Specifically, the utility of EEG with focus on the existing proposed electrode arrays and their current supporting evidence. A recent survey study confirmed that a variety of canine EEG protocols are concurrently in use, including diverse electrode arrays. By comparison, in humans there is a standardized 10-20 electrode array, with average localization error of 13-17 mm depending on the number of placed electrodes on the scalp. We offer a review of the factors that would contribute to the ideal canine EEG electrode array highlighting areas for improvement and future validation. This proposed level of understanding will facilitate the identification of cortical seizure foci with a known degree of error, paving the way for non-pharmaceutical interventions like epilepsy surgeries.
脑电图(EEG)是确认人类和兽医患者癫痫发作的金标准。尽管特发性癫痫是犬类最常见的神经系统疾病之一,但我们在兽医学中对其的了解仍落后于人类医学。癫痫发作犬类中脑电图使用相对不足有潜在原因,包括实际问题、经济问题、缺乏培训/设备以及临床价值问题。这种技术使用不足可能导致我们对兽医患者脑电图理解上的重大差距,或者是由这种差距导致 的。脑电图的这种未充分利用具有重要的临床意义,因为人类特定癫痫综合征的诊断指导治疗,即药物治疗、饮食治疗或手术治疗。这些癫痫综合征是基于几个因素诊断的,其中之一是脑电图上特征性的脑电活动。这篇叙述性文献综述的目的是强调对皮质脑活动的研究,以增进我们对兽医学中脑电图的理解。具体而言,关注脑电图的实用性,重点是现有的提议电极阵列及其当前的支持证据。最近的一项调查研究证实,目前同时使用多种犬类脑电图方案,包括不同的电极阵列。相比之下,在人类中,有一个标准化的10 - 20电极阵列,根据头皮上放置电极的数量,平均定位误差为13 - 17毫米。我们综述了有助于理想犬类脑电图电极阵列的因素,突出了改进和未来验证的领域。这种提议的理解水平将有助于在已知误差程度的情况下识别皮质癫痫病灶,为癫痫手术等非药物干预铺平道路。