Estimation of the prevalence of idiopathic epilepsy and structural epilepsy in a general population of 900 dogs undergoing MRI for epileptic seizures

2020 ◽  
Vol 187 (10) ◽  
pp. e89-e89 ◽  
Author(s):  
Rachel Hall ◽  
Julien Labruyere ◽  
Holger Volk ◽  
Thomas James Cardy
Keyword(s):  
Neurological Examination ◽  
Large Population ◽  
Epileptic Seizures ◽  
Clinical History ◽  
Idiopathic Epilepsy ◽  
Mri Findings ◽  
Detailed Clinical History ◽  
Mri Scans ◽  
Structural Epilepsy ◽  
Study Designs

Due to variation in study designs the prevalence of idiopathic epilepsy (IE) and structural epilepsy (SE) in dogs is largely unknown. The objective was to provide estimates of the prevalence of IE and SE in a large population of dogs undergoing MRI for epileptic seizures. A retrospective study on 900 dogs undergoing MRI for seizures was performed. MRI scans, summary clinical history and neurological examination from the VetCT database were reviewed and a diagnosis assigned by board-certified radiologists. Structural lesions were identified as a cause of seizures in 45.1 per cent (n=406) of cases. No structural lesions were identified in 54.9 per cent (n=494) of cases with presumed IE diagnosed in 53.8 per cent (n=484) of dogs. Dogs between six months and six years were more often associated with IE (P<0.001), small breeds were overrepresented with suspected inflammatory brain disease (P=0.001) and large entire dogs more often diagnosed with extra-axial neoplasms (P=0.001). Over 31.0 per cent of dogs with suspected IE were six years or older. This study is the largest of its kind in dogs and provides accurate estimates of underlying causes of epilepsy. MRI findings should be considered in the context of a detailed clinical history and neurological examination.

scholarly journals (Doctor…My child keeps falling over) unexpected MRI findings in children with history of frequent falls and dizziness: a case series

2019 ◽  
Vol 12 (7) ◽  
pp. e229849 ◽  
Author(s):  
Ashraf Nabeel Mahmood ◽  
Osama Abulaban ◽  
Arshad Janjua
Keyword(s):  
Physical Examination ◽  
Case Series ◽  
Clinical History ◽  
Brain Stem Glioma ◽  
Mri Findings ◽  
Group Management ◽  
Wide Range ◽  
Detailed Clinical History ◽  
History Of ◽  
Low Threshold

Frequent falls and dizziness are common complaints in children. These symptoms can be caused by wide range of underlying pathologies including peripheral vestibular deficits, cardiac disease, central lesions, motor skills delay and psychogenic disorders. We report three paediatric cases who presented with complaints of repeated falls and imbalance. MRI scan revealed underlying brain lesions (frontal lobe arteriovenous malformation, exophytic brain stem glioma and cerebellomedullary angle arachnoid cyst with cerebellar tonsillar ectopia). By reporting these cases, we would like to emphasise the importance of a thorough assessment of children with similar symptoms by detailed clinical history, physical examination and maintaining low threshold for investigations, including radiological imaging. Taking in consideration, the wide range of differential diagnosis, the challenge of obtaining detailed history and difficulty of performing reliable physical examination in this age group. Management of underlying disorders can be medical, surgical or just observational.

scholarly journals Feline Epilepsy: An update

2020 ◽  
Vol 70 (4) ◽  
pp. 1749
Author(s):  
RD BAKA ◽  
ZS POLIZOPOULOU
Keyword(s):  
Epileptic Seizures ◽  
Final Diagnosis ◽  
Idiopathic Epilepsy ◽  
Vascular Events ◽  
Inflammatory Conditions ◽  
Csf Analysis ◽  
Degenerative Disorders ◽  
Life Threatening ◽  
Cluster Seizures ◽  
Structural Epilepsy

Epileptic seizures are the most common neurological disorder in the clinical setting. Their etiology is multifactorial and is mainly divided into structural, reactive and idiopathic epilepsy. Structural epilepsy can be caused by vascular events, inflammatory conditions (encephalitis), traumatic injuries, neoplasia, congenital and inherited (degenerative) disorders. Reactive epilepsy is caused by exposure in toxins or metabolic derangements. Although idiopathic epilepsy was thought to be rare in cats, it is now established as a common cause. Epileptic seizures in cats appear with various clinical presentations including generalized, focal with or without secondary generalization epileptic seizures. Diagnostic investigation is crucial in order to establish final diagnosis and to determine the therapeutic plan. Diagnostics include physical and neurological examination with detailed history (drug or toxin exposure), routine hematology (CBC, biochemistry, urinalysis), specific laboratory tests if concurrent or metabolic disease are suspected, advanced diagnostic imaging (CT/MRI) whether intracranial disease is suspected and cerebrospinal fluid (CSF) analysis. Most commonly used antiepileptic drugs (AED) in cats are phenobarbital and levetiracetam. Bromide is contraindicated in cats due to severe respiratory disease caused as an adverse life-threatening reaction. Diazepam is an emergency AED used to eliminate cluster seizures or status epilepticus but it should be avoided as a long-term medication because it has been associated with fatal hepatotoxicity. Gabapentin in another potential antiepileptic drug however its longterm efficacy has to be evaluated. Prognosis depends on the underlying etiology and treatment response. In most cats quality of life is improved and (>50% reduction of epileptic seizures) regardless of etiology. The complete remission of epileptic seizures in cats is rare and most cats should be maintained on anti-epileptic therapy.

Diagnostic value of cerebrospinal fluid analysis in a population of dogs with suspected idiopathic epilepsy

2019 ◽  
Vol 185 (17) ◽  
pp. 539-539 ◽  
Author(s):  
Ana Maria Coelho ◽  
Thomas W Maddox ◽  
Daniel Sanchez-Masian ◽  
Rita Gonçalves
Keyword(s):  
Cerebrospinal Fluid ◽  
Neurological Examination ◽  
Complete Blood Count ◽  
Epileptic Seizures ◽  
Diagnostic Value ◽  
Idiopathic Epilepsy ◽  
Time Interval ◽  
Diagnostic Investigation ◽  
Fluid Analysis ◽  
Csf Analysis

Cerebrospinal fluid (CSF) analysis is commonly used in the diagnostic investigation of seizure disorders in order to exclude possible inflammatory underlying aetiology. The medical records were searched for dogs presenting with epileptic seizures (ES) that had normal interictal neurological examination, normal complete blood count and biochemistry analysis, unremarkable MRI of the brain and had CSF analysis performed as part of the diagnostic investigation. A total of 200 dogs met the inclusion criteria. The CSF was abnormal in 30 dogs with a median total nucleated cell count of two cells/µl (IQR 1.5–6) and median protein concentration of 0.37 g/l (IQR 0.31–0.41). Pleocytosis was recorded in 14/30 dogs and the CSF protein was increased in 22/30. There was no correlation between abnormal CSF and the type or number of seizures or the time interval between the last seizure and CSF collection. A significant correlation was found between the number of red blood cells on CSF and having an abnormal CSF. The prevalence of having a diagnosis other than suspected idiopathic epilepsy (IE) was 0.5 per cent (1/200). These results suggest that performing CSF analysis in dogs with recurrent ES that have normal interictal neurological examination and unremarkable MRI has a low diagnostic value.

Delayed post-hypoxic leukoencephalopathy: Case report

2017 ◽  
Vol 41 (S1) ◽  
pp. s839-s839 ◽  
Author(s):  
M. Solerdelcoll Arimany ◽  
M. Garriga ◽  
E. Parellada
Keyword(s):  
Neuropsychiatric Symptoms ◽  
Brain Mri ◽  
Clinical History ◽  
Good Prognosis ◽  
Mri Findings ◽  
The Mean ◽  
Competing Interest ◽  
Weighted Sequences ◽  
Direct Toxicity ◽  
Progressive Cognitive Impairment

IntroductionDelayed post-hypoxic leukoencephalopathy (DPHL) is an underrecognized syndrome of delayed demyelination, where patients manifest neuropsychiatric symptoms after a period of 2–40 days of apparent recovery from a cerebral hypo-oxygenation episode.ObjectivesWe report a case of a patient who successfully recovered from an overdose of heroin, but then suffered a delayed abrupt neurological deterioration.AimsTo improve assessment and recognition of DPHL.MethodsAn adequate retrospective collection of clinical data and nonsystematic review of the literature was performed.ResultsA 43-year-old male with schizoaffective disorder who attempted suicide with an overdose of heroin, was successfully revived and return to his previously mental status, but 3 weeks after, he abruptly developed progressive cognitive impairment with akinetic mutism and ataxia. He was admitted to our acute psychiatric unit after brain CT and chemistry analyses were unremarkable. Brain MRI showed diffusely symmetric hyperintensity in the white matter (WM), pronominally the periventricular WM, on FLAIR and T2 weighted sequences. At 16 weeks postoverdose, he presented improvement both cognitive and motor symptoms, lasting deficits in frontal-executive functions.DiscussionDPHL is characterized by similar clinical and neuroimaging features regardless of the initial insult. The mean lucid interval coincides with the replacement half-life for myelin related lipids and proteins. Prolonged mild-to-moderate hypo-oxygenation of WM is thought to disrupt myelin turnover. It appears probable that these were responsible for DPHL in our patient rather than a direct toxicity.ConclusionDPHL can be diagnosed when clinical history, laboratory assessments and MRI findings are concordant. DPHL requires extensive support care and carries a relatively good prognosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Clinical features of psychogenic non-epileptic seizures in prepubertal and pubertal patients with idiopathic epilepsy

2009 ◽  
Vol 30 (4) ◽  
pp. 319-323 ◽  
Author(s):  
Alberto Verrotti ◽  
Sergio Agostinelli ◽  
Angelika Mohn ◽  
Rossella Manco ◽  
Giangennaro Coppola ◽  
...  
Keyword(s):  
Clinical Features ◽  
Epileptic Seizures ◽  
Idiopathic Epilepsy

scholarly journals Etiology of epilepsy a prospective study of 210 cases

1991 ◽  
Vol 49 (3) ◽  
pp. 251-254 ◽  
Author(s):  
Walter Oleschko Arruda
Keyword(s):  
Ct Scan ◽  
Neurological Examination ◽  
Epileptic Seizures ◽  
Partial Seizures ◽  
Complex Partial Seizures ◽  
Blood Tests ◽  
Generalized Seizures ◽  
A Prospective Study ◽  
Csf Examination

The objective of this study was to establish the etiology of epilepsy in 210 chronic epileptics (110 female, 100 male), aged 14-82 years (34.2±13.3). Patients less than 10 years-old and alcoholism were excluded. All underwent neurological examination, routine blood tests, EEG and CT-scan. Twenty patients (10.5%) were submitted to spinal tap for CSF examination. Neurological examination was abnormal in 26 (12.4%), the EEG in 68 (45.5%), and CT-scan in 93 (44.3%). According to the International Classification of Epileptic Seizures (1981), 101 (48.1%) have generalized seizures, 66 (31.4%) partial seizures secondarily generalized, 25 (11.8%) simple partial and complex partial seizures, and 14 (6.6%) generalized and partial seizures. Four patients (2.0%) could not be classified. In 125 (59.5%) patients the etiology was unknown. Neurocysticercosis accounted for 57 (27.1%) of cases, followed by cerebrovascular disease 8 (3.8%), perinatal damage 5 (2.4%), familial epilepsy 4 (1.9%), head injury 4 (1.9%), infective 1 (0.5%), and miscelanea 6 (2.8%).

scholarly journals Comparison of symptomatic spondylolysis in young soccer and baseball players

2020 ◽  
Author(s):  
Takuji Yokoe ◽  
Takuya Tajima ◽  
Hiroshi Sugimura ◽  
Shinichirou Kubo ◽  
Shotarou Nozaki ◽  
...  
Keyword(s):  
Contralateral Side ◽  
Soccer Players ◽  
Clinical Factors ◽  
Young Athletes ◽  
Mri Findings ◽  
Sports Activity ◽  
Baseball Players ◽  
Lumbar Level ◽  
Mri Scans ◽  
Dominant Side

Abstract Background: Spondylolysis is a main cause of low back pain (LBP) in young athletes. There are few studies analyzing the difference of spondylolysis among young athletes with different sports activity. The purpose of this study was to compare the clinical factors and distribution of the lesions of spondylolysis on magnetic resonance imaging (MRI) scans in young soccer and baseball players with symptomatic spondylolysis.Methods: The medical records of 267 young athletes aged 7 to 18 years old who underwent MRI to evaluate the cause of LBP between 2017 to 2020 were retrospectively reviewed to identify patients with spondylolysis. Of the young athletes with symptomatic spondylolysis, clinical factors and MRI findings in soccer and baseball players were retrospectively evaluated. The clinical factors were age, sex, interval from onset of LBP to MRI, and side of the dominant leg in the sports field. MRI findings included number, lumbar level, and side of the lesions. Results: A total of 33 soccer players (mean age, 15.4 ± 1.4 years) and 49 baseball players (mean age, 15.4 ± 1.6 years) with symptomatic spondylolysis were enrolled. All patients were male. No significant differences were noted in age and the interval from onset of LBP to MRI between the groups. Soccer players had greater numbers of multiple (p < 0.001) and bilateral (p < 0.001) lesions than baseball players. The dominant side of the hand for pitching or batting was correlated with the contralateral-side lesions in baseball players (p = 0.001).Conclusions: The distribution of the lesions of spondylolysis differed in young soccer and baseball players. Pitching or batting with the dominant-side hand would be associated with contralateral-side lesions in baseball players. Sports-specific movements and the side of the dominant leg should be considered when treating young athletes with symptomatic spondylolysis.

scholarly journals Comparison of Symptomatic Spondylolysis in Young Soccer and Baseball Players

2020 ◽  
Author(s):  
Takuji Yokoe ◽  
Takuya Tajima ◽  
Hiroshi Sugimura ◽  
Shinichirou Kubo ◽  
Shotarou Nozaki ◽  
...  
Keyword(s):  
Contralateral Side ◽  
Soccer Players ◽  
Clinical Factors ◽  
Young Athletes ◽  
Mri Findings ◽  
Sports Activity ◽  
Baseball Players ◽  
Lumbar Level ◽  
Mri Scans ◽  
Dominant Side

Abstract Background: Spondylolysis is a main cause of low back pain (LBP) in young athletes. There are few studies analyzing the difference of spondylolysis among young athletes with different sports activity. The purpose of this study was to compare the clinical factors and distribution of the lesions of spondylolysis on magnetic resonance imaging (MRI) scans in young soccer and baseball players with symptomatic spondylolysis.Methods: The medical records of 178 young athletes aged 7 to 18 years old who underwent MRI to evaluate the cause of LBP between 2017 to 2019 were retrospectively reviewed to identify patients with spondylolysis. Of the young athletes with symptomatic spondylolysis, clinical factors and MRI findings in soccer and baseball players were retrospectively evaluated. The clinical factors were age, sex, interval from onset of LBP to MRI, and side of the dominant leg in the sports field. MRI findings included number, lumbar level, and side of the lesions. Results: A total of 21 soccer players (mean age, 15.2 ± 1.4 years) and 38 baseball players (mean age, 15.1 ± 1.7 years) with symptomatic spondylolysis were enrolled. All patients were male. No significant differences were noted in age and the interval from onset of LBP to MRI between the groups. Soccer players had greater numbers of multiple (p = 0.005) and bilateral (p = 0.004) lesions than baseball players. The dominant side of the hand for pitching or batting was correlated with the contralateral-side lesions in baseball players (p = 0.01).Conclusions: The distribution of the lesions of spondylolysis differed in young soccer and baseball players. Pitching or batting with the dominant-side hand would be associated with contralateral-side lesions in baseball players. Sports-specific movements and the side of the dominant leg should be considered when treating young athletes with symptomatic spondylolysis.

scholarly journals Study of etiological factors in unilateral maxillary chronic sinusitis

2016 ◽  
Vol 3 (1) ◽  
pp. 88
Author(s):  
D. Chandrika ◽  
Anantharaju G. S.
Keyword(s):  
Maxillary Sinusitis ◽  
Clinical History ◽  
Causative Factor ◽  
Successful Outcome ◽  
Dental Infection ◽  
Deviated Nasal Septum ◽  
Detailed Clinical History ◽  
Chronic Maxillary Sinusitis ◽  
Symptoms And Signs

<p class="abstract"><strong>Background:</strong> Chronic rhinosinusitis is an extremely prevalent disorder which has significant effect on quality of life of affected individual. Varied symptomatology and varied etiology of unilateral chronic maxillary rhinosinusitis requires a comprehensive approach by otorhinolaryngologist. The objectives of the study were to evaluate the causative factor of unilateral chronic maxillary sinusitis and to study clinical presentation of unilateral chronic maxillary sinusitis<span lang="EN-IN">. </span></p><p class="abstract"><strong>Methods:</strong> 50 patients with symptoms and signs suggestive of unilateral chronic maxillary sinusitis were evaluated. All were subjected to detailed clinical history, ENT examination including complete orodental examination, diagnostic nasal endoscopy, intra oral peri apical radiographs, CT scan of para nasal sinuses<span lang="EN-IN">.  </span></p><p class="abstract"><strong>Results:</strong> Of total of 50 patients studied, gross deviated nasal septum (DNS) is commonest cause of chronic unilateral maxillary sinusitis followed by dental infection of upper premolars<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> This study was carried out with an effort to find out etiology of unilateral chronic maxillary sinusitis as identification of etiology will help in successful outcome of the treatment<span lang="EN-IN">.</span></p>

scholarly journals CLINICAL STUDY OF PAIN IN RIGHT ILIAC FOSSA

2020 ◽  
Vol 4 (8) ◽  
Author(s):  
Saurabh Kothari ◽  
Manjula Kothari ◽  
Shree Mohan Joshi ◽  
Kalp Shandilya
Keyword(s):  
Iliac Fossa ◽  
Signs And Symptoms ◽  
Clinical History ◽  
X Ray ◽  
Pain Abdomen ◽  
Detailed Clinical History ◽  
Right Iliac Fossa Pain ◽  
Chest X Ray ◽  
The Right ◽  
Appendicular Mass

Background: A mass in the right iliac fossa is a common diagnostic problem encountered in clinical practice, requiring skill in diagnosis. Methods: 100 patients with signs and symptoms of right iliac fossa mass admitted in Hospital were identified and were studied by taking detailed clinical history, physical examination and were subjected to various investigations like x ray erect abdomen, chest x-ray, contrast x-ray . Result: In this study of out of 100 cases, 65.00% of cases were related to appendicular pathology either in the form of appendicular mass or appendicular abscess. There were 12.00% cases of ileocaecal tuberculosis. Conclusion: Appendicular lump remains the most common cause for right iliac fossa pain. Ileocaecal tuberculosis is one of the most important differential diagnoses for pain abdomen. Keywords: Appendicular Mass, Ileocaecal Tuberculosis, Carcinoma Caecum, Right Iliac Fossa Mass.

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