Seizures Flashcards
Seizures are due to a abnormal or excess synchronous brain activity, due to imbalance of which two neurotransmitter?
Glutamate - excitation
GABA - inhibition
Give examples of what may cause a reactive seizure
Metabolic disorder
Toxicity
(disturb in brain function)
Give examples of what may cause a structural seziure
Inflammation
Neoplasia
Trauma
(Due to intracranial pathology)
What are the 4 seizure stages/phases?
Prodrome - predicting events
Aura - abnormal feeling
Ictus - seizure itself
Post-ictus
How long do most seizures last and when do they typically occur?
60-90 seconds
At rest or whilst sleeping
What is a cluster seizure?
2+ seizures in 24 hours
After how long of seizuring does irreversible neuronal damage occur?
30-60 minutes
Focal seizures may be motor, autonomic or behavioural give an example of a focal seziure
Audiogenic reflex seizures in cats
Where do focal seizures tend to be most obvious? (body part)
Face
Licking, fly-catching
At what age do audiogenic reflex seizures begin to affect cats?
15 years
What is the treatment for audiogenic reflex seizures in cats?
Levetiracetam
Studies found more useful than phenobarbitone
What are generalised seizures?
Seizures involve both cerebral hemispheres
Consciousness impaired
At what age does idiopathic epilepsy typically occur in dogs?
6 months to 6 years
What breeds are predisposed to idiopathic epilepsy due to genetic inheritance?
Belgian Shepherd
Boerboels
Lagotto Romagnolo
What are the 3 tiers of confidence of epilepsy diagnosis?
Tier 1: clinical signs
Tier 2: clinical signs + unremarkable pre/post prandial bile acids, MRI and CSF
Tier 3: clinical signs, diagnostic tests AND ictal or interictal abnormalities on EEG
When may you consider sending a dog with seizures for an MRI?
If < 6months, >6 years
Interictal neuro abnormalities
Status epilepticus or cluster seizures
Drug resistance following IE diagnosis
When should you start treatment for idiopathic epilepsy?
If status epilepticus or cluster seizures
Inter-ictal period <6 month
Severe post-ictal signs
1st seizure within 1 month of a traumatic event
Increasing frequency or severity of seizures
What treatment is the drug of choice for epilepsy in cats?
Phenobarbitone
Which anti-epileptic drugs are licensed in dogs?
Phenobarbitone
Bromide (not as monotherapy)
Imepitoin (not for cluster seizures, structural epilepsy or as combinational therapy)
When is phenobarbitone contraindicated in cats and dogs?
Liver problems - hepatotoxic
When should you monitor serum after changing the dose of phenobarbitone?
2 weeks after dose change
When should you monitor bloods and bile acid stimulation tests after starting phenobarbitone?
3 + 6 months after starting treatment
monitor serum 2 weeks after dose change
What phenobarbitone levels should you aim for in the blood?
25-30g/L
Which 3 anti-epileptic drugs should not be used in cats and why?
Bromide - causes eosinophilic bronchitis
Propofol - Heinz bodies anaemia
Diazepam - hepatic necrosis if administered orally
