Epilepsy is a non progressive brain disorder that induces recurrent seizures. It is very important to understand that there are numerous disorders that can cause seizures, and in order to make a diagnosis of true epilepsy, many of these other causes must be ruled out.
What is a Seizure?
A seizure is the clinical manifestation of a cerebral disorder that can appear suddenly out of a background of normality, and then disappear with equal abruptness. The term fit is often used colloquially when referring to a seizure.
In humans, an epileptic seizure is a definable event that can be classified according to categories set by the International League Against Epilepsy. A formal classification system specifically for dogs and cats does not exist, but seizures can nevertheless be classified as either partial or generalized episodes.
Partial Seizures
These are seizures in which a localized onset may be determined. They usually have a congenital (present at birth) or an acquired (cancer, encephalitis) cause, and can sometimes evolve into a secondary generalized seizure.
Generalized Seizures
Generalized seizures are the most common type of seizures in dogs and cats. There are several variations of these seizures:
1. Absence seizures (petit mal): sudden brief loss of consciousness, rare in animals
2. Myoclonic seizures: muscle jerk of one or more muscles
3. Clonic seizures: rhythmic muscle contractions
4. Tonic seizures: increase in muscle tone in all skeletal muscles
5. Tonic Clonic seizures (grand mal): the most common form of seizure in pets
Tonic Clonic Seizures
Tonic Clonic (grand mal) seizures account for 60% of seizures in cats and 80% of seizures in dogs. They are usually accompanied by a loss of consciousness, and consist of a tonic phase, where the increased muscle tone causes the animal to fall on its side with its limbs extended, and a clonic phase, consisting of intense muscle jerking or paddling movements.
Causes of Seizures
In order to diagnose true epilepsy, other causes of seizures must be first ruled out. The questions a veterinarian must answer are:
Is the cause inside the brain or outside the brain?
If inside the brain, is the cause progressive (e.g. cancer, infection) or non progressive (epilepsy)?
If outside the brain, does the cause originate inside the body (e.g. low blood glucose, kidney failure, a liver problem) or outside the body (e.g. lead poisoning, organophosphate toxicity)?
Making a Diagnosis
If an animal has a solitary seizure, most veterinarians will advise against expensive and time consuming tests for something that may never happen again. If an animal has more than one seizure though, tests are indicated.
A veterinarian will start by taking a detailed case history, focusing on the description of the animals seizures, their frequency and duration, and the animals behavior between seizures. Ideally the seizure should be videotaped by the owner, and then shown to the veterinarian. It is important to differentiate a proper seizure from other causes of collapse such as an episode of syncope (where the heart misses several beats), narcolepsy or weakness due to another neurological problem (e.g. myasthenia gravis). Features of the description which indicate a seizure are:
1. Tonic (increased muscle tone) and clonic (jerky) muscle movements
2. Loss of consciousness (though not always)
3. Increased salivation
4. Spontaneous urination or defaecation
The veterinarian will then conduct a full clinical examination, followed by a more specific neurological examination. Blood will then be taken for full hematology and biochemistry profiles. A fasting blood glucose is useful to rule out hypoglycaemia, which is a frequent cause of seizures in dogs less than 6 months old and dogs with an insulinoma, an insulin secreting pancreatic tumor. If liver enzymes are raised, a further liver function test (bile acid stimulation) may be done. Blood lead levels should be measured in animals that may have had access to lead containing materials.
Xrays of the chest and abdomen are sometimes performed to check for any other significant disease, and fecal analysis is recommended in puppies with seizures as heavy parasite burdens have been implicated.
If all of the above tests are normal, and no disease outside the brain has been detected, many animals will be diagnosed with epilepsy as further tests are of the expensive variety. If further tests for intracranial (within the brain) disease are to be performed, cerebrospinal fluid (CSF) analysis is the first step. CSF is tested for the presence of viral (e.g. Canine Distemper, Rabies), bacterial, fungal (e.g. Cryptococcus) and protozoal (e.g. Toxoplasmosis) infections. Electroencephalography (EEG) is useful for diagnosing malformations present since birth, such as hydrocephalus. Brain tumors are often only able to be diagnosed by advanced imaging techniques such as Computed Tomography (CT) Scanning or Magnetic Resonance Imaging (MRI). These must be done under general anesthesia as the animal must be completely motionless during the scan.
Treatment of Epilepsy
Once a tentative diagnosis of epilepsy has been made (by excluding all the other known causes of seizures), the animal can be prescribed anticonvulsant drugs. These drugs are not appropriate for animals with seizures caused by a problem outside the brain. The overall goal of anticonvulsant therapy is to eradicate all seizure activity, but this is rarely achieved. Most pets benefit from anticonvulsant drugs by reducing the frequency, severity and duration of their seizures. A more realistic goal is to reduce the frequency of the seizures to a level that is acceptable for the owner, without having negative side effects for the animal. A minority of animals require such high doses of anticonvulsant drugs to suppress their seizures that the adverse effects caused by it outweigh the benefits.
Since epilepsy is not curable, the owner must be prepared to give the medication for the rest of the animals life. However, if after being on anticonvulsant medication for over a year no seizures have occurred, a cautious slow reduction in dose can be attempted.
The three most commonly used drugs in the treatment of epilepsy in cats and dogs are:
1. Diazepam
Known to many by its trade name Valium, diazepam is used in emergency short term situations to treat animals in status epilepticus, i.e. during a seizure. It is best administered intravenously so that it is delivered to the brain quickly, though finding a vein or placing a catheter in a fitting animal can be a challenge. In those situations, it is sometimes given rectally, where it is fairly rapidly absorbed across the rectal wall. If status epilepticus continues despite the repeated administration of diazepam, phenobarbitone can be given intravenously.
2. Phenobarbitone
Phenobarbitone is the most commonly prescribed anticonvulsant drug for both canine and feline epilepsy, owing to its efficacy and its low cost. Over three quarters of epileptic dogs have their seizures controlled by phenobarbitone alone. Sometimes it can take several weeks for the level of phenobarbitone in the blood stream to reach a high enough level to work properly, so many vets favor using a higher loading dose initially, reducing it for the maintenance phase. However, care must be taken as high doses of phenobarbitone can cause liver damage, and liver enzymes should be periodically checked in animals on long term therapy. Annual blood tests are also advised to check serum concentration levels of the drug, to calibrate the dose effectively. High doses can also cause sedation.
3. Potassium Bromide
A proportion of dogs are resistant to phenobarbitone. In such dogs, the addition of potassium bromide, i.e. a second drug, can be tried. The potassium bromide may also be tried alone as an alternative to phenobarbitone, but generally only after phenobarbitone has been thoroughly investigated at various doses and found to be inadequate. Phenobarbitone is also deemed unsuitable if the dog has liver dysfunction of any kind, in these cases potassium bromide (often referred to simply as bromide as that is the therapeutic part) can be used. Potassium bromide is not used in cats, only diazepam and phenobarbitone are recommended in this species.
I grew out of epilepsy, but recently after having 4 vodka cruisers and 2 shots of baileys, which caused me to have 3 seizures in the morning.
On other occasions i’ve managed to have over 20 different types of drinks in one night, and had no seizures.
Anyone know what the hell is going on?
Dr. Nicholas Wetjen, a neurosurgeon at Mayo Clinic, talks about when surgery might be an option for pediatric patients with Epilepsy. To read more on Epilepsy and it’s treatments, click here: www.mayoclinic.org
Epilepsy is a form of brain disorder that is characterized by seizures, often recurrent. It is a condition that affects only about 1 person in every 200. It has a tendency to appear in families, although the genes that are supposed to cause epilepsy are still undetermined.
On its own, epilepsy can cause memory loss, specifically about the events that occurred during the time period involving the seizure. There is no clear cause to this condition.
Epileptic amnesia
Memory loss is always present in epileptic seizures, although the extent to which amnesia is experienced can vary from one person to another. Some may have violent seizures during an attack and then report absolutely no memory of the events. Others may experience what is called anterograde amnesia : the kind of memory loss where the brain finds it difficult to process new information. This is a temporary form of memory loss, however a person might soon recover after a period of time.
There is also another form of memory loss related to epilepsy wherein a person might still be able to interact with the environment normally during a seizure. This is called ictal amnesia or pure amnesic seizure. Although the person will appear ‘normal’ during the seizure, even participate in conversations and other activities, they will not remember the events during the episode.
How epilepsy leads to memory loss
Epilepsy as a brain activity occurs on a specific region or site of the brain, particularly the medial temporal lobe. The problem with this condition is that repeated attacks can damage brain tissues in some of the most important areas of the brain, such as the hippocampus. The hippocampus is essential to the processing of information and memory.
Should damage occur, it can cause problems in the storage of information and ultimately, in remembering them. If damage occurs on the left side of the brain, this can lead to the loss of verbal memory. As a result, the person will find it difficult to remember words, whether they are spoken or written. If damage occurs on the right side of the brain, visual memory is affected. The person will find it difficult to remember what he saw and will have problems processing objects and directions. If damage is found on the frontal lobes, this can lead to short-term memory loss. When this happens, the person will find it difficult to keep their attention for long.
Avoiding memory loss in epilepsy
There is no cure for epilepsy, although there are of course several methods used to treat it. These include diet, therapy and medication. The main objective here is to treat the symptoms : that is, the seizures : and prevent them from occurring. Medications such as anticonvulsants may sometimes be prescribed in order to manage and eliminate seizures. The end result here is to ensure that damage to the brain is prevented and thus, avoid memory loss altogether.
People with epilepsy can also take the time to improve their memory with the use of memory aids. These can be extremely beneficial not just as sources of information but also as sources of visual and auditory memory. As a result, the individual still has access to information that they may be in danger of losing should epilepsy cause damage in the brain.
Epilepsy is a brain disorder that causes people to have recurring seizures. The seizures happen when clusters of nerve cells, or neurons, in the brain send out the wrong signals. People may have strange sensations and emotions or behave strangely. They may have violent muscle spasms or lose consciousness.
It can be scary watching someone have an epileptic seizure. The person may lose consciousness or seem unaware of what’s going on, make involuntary motions (movements the person has no control over, such as jerking or thrashing one or more parts of the body), or experience unusual feelings or sensations (such as unexplained fear). After a seizure, he or she may feel tired, weak, or confused.
Signs and Symptoms of Epilepsy
Generalized seizures: All areas of the brain (the cortex) are involved in a generalized seizure. Sometimes these are referred to as grand mal seizures. To the observer, the person experiencing such a seizure may cry out or make some sound, stiffen for some seconds, then have rhythmic movements of the arms and legs. Often the rhythmic movements slow before stopping.
Loss of consciousness distinguishes complex partial seizures from simple partial seizures. While unconscious, the patient may have “vacant” or “frightened” look and may have signs and symptoms of a simple partial seizure. Automatisms may occur during unconsciousness.
Complex partial seizures. These seizures alter consciousness, causing you to lose awareness for a period of time. Complex partial seizures often result in staring and nonpurposeful movements â such as hand rubbing, lip smacking, arm positioning, vocalization or swallowing.
Simple partial seizures are further subdivided into four categories according to the nature of their symptoms: motor, autonomic, sensory or psychological. Motor symptoms include movements such as jerking and stiffening. Sensory symptoms caused by seizures involve unusual sensations affecting any of the five senses (vision, hearing, smell, taste or touch). When simple partial seizures cause sensory symptoms only (and not motor symptoms), they are called “auras.”
Treatment for Epilepsy
Medications â In many cases, seizures can be successfully prevented with medications. The type of medication your child will receive depends on many factors. Your child’s neurologist will explain how the medication should be taken and the side effects that may occur. Over time, your child’s medication regimen may be changed. It is very important that your child take their medication exactly as directed. Call your neurologist if you have any questions about the medications or if your child is experiencing unexpected side effects.
Surgery is most commonly done when tests show that your seizures originate in a small, well-defined area in the temporal lobes or the frontal lobes of your brain. Surgery is rarely an option if you have seizures that start in several areas of the brain or if you have seizures originating from a region of the brain that contains vital brain functions.
Do not try to force the mouth open with any hard implement or with fingers. It is not true that a person having a seizure can swallow his/her tongue, and efforts to hold the tongue down can injure his/her teeth or jaw. A person in the middle of a seizure may bite down with enough force to bite off fingers.
Ketogenic diet: Some children with epilepsy have been helped by adopting a rigid diet that’s high in fat and protein and low in carbohydrates. The goal of the diet is to get the body to produce ketones, which cause the body to use fat instead of glucose for energy. The exact way in which the ketogenic diet works is unclear.
Medical tourism has become a common form of vacationing, and covers a broad spectrum of medical services like epilepsy surgery in India. It mixes leisure, fun and relaxation together with wellness and healthcare. A combination of many factors has lead to the recent increase in popularity of medical tourism. Exorbitant cost of healthcare and medical facilities in advanced countries, ease and affordability of international travel, favorable currency exchange rates in the global economy, rapidly improving technology and high standards of medical care in the developing countries has all contributed their share to this rapid development of medical tourism. This process is being facilitated by the corporate sector involved in medical care as well as the tourism industry – both private and public. Medical tourism can be broadly defined as the provision of ‘cost effective’ private medical care in collaboration with the tourism industry for patients needing surgical and other forms of specialized treatment like epilepsy surgery in India.
Epilepsy surgery can be especially beneficial to patients who have seizures associated with structural brain abnormalities, such as benign brain tumors, malformations of blood vessels (including disorders known as arteriovenous malformations, venous angiomas, and cavernous angiomas), and strokes. Epilepsy treatment has evolved to include consideration of the patient’s quality of life, not just the number of seizures. Both continued seizures and high doses of medication impose costs on all areas of a person’s life-intellectual, psychological, social, educational, and employment. The individualized approach that should be used when prescribing seizure medicines is carried over to the surgical treatment of epilepsy. State-of-the-art technology is applied to perform the safest and least-invasive procedure that will help the patient to achieve the highest possible quality of life. Epilepsy surgery can be especially beneficial to patients who have seizures associated with structural brain abnormalities, such as benign brain tumors, malformations of blood vessels (including disorders known as arteriovenous malformations, venous angiomas, and cavernous angiomas), and strokes. Epilepsy treatment has evolved to include consideration of the patient’s quality of life, not just the number of seizures. Both continued seizures and high doses of medication impose costs on all areas of a person’s life-intellectual, psychological, social, educational, and employment. The individualized approach that should be used when prescribing seizure medicines is carried over to the surgical treatment of epilepsy. State-of-the-art technology is applied to perform the safest and least-invasive procedure that will help the patient to achieve the highest possible quality of life.
For neurosurgery, patients must find surgeons who are appropriately trained. Another factor to consider is cost and reimbursement. Typical cost for epilepsy surgery can vary, and many insurance companies will only provide partial coverage, or even no coverage, since they still consider the surgery experimental. And finally, patients need to be aware that like any new medical technology, this surgery carries with it a certain level of unknown technical risks. Since epilepsy surgery it is still a relatively new procedure in India with a certain level of risks.
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Epilepsy in a dog is not that uncommon. However, it is not the only thing that will cause seizures or episodes. Several other conditions can make your pet convulse, including ingestion of poisons, kidney & liver disease, infections and meningitis to name a few. All other sources of seizures have to be ruled out before a diagnosis of epilepsy can be arrived at. There are many tests that may be necessary to rule out other conditions. MRI scanning has become available to help speed up the process of diagnosing epilepsy in dogs.
There are certain breeds that seem to have a predisposition towards epilepsy. Some of the breeds that seem to have a higher risk are Collies, Poodles and German Shepherds. However, it can occur in any breed and mixed breeds as well. The first seizure can happen at any age, but it is usually young to middle aged dogs who acquire this condition.
An epileptic seizure or fit is commonly described as an uncontrolled release of electrical discharge in the brain. It causes the animal to shake, tremble and salivate. Sometimes uncontrolled urination and defecation occurs. After a few episodes an owner will begin to understand and learn certain trigger factors that apply to their pet.
In most cases the episode doesn’t last very long, usually it is over before you can take action. There are a variety of medications on the market today which can help to make the seizures less frequent and less severe.
Here are some suggestions on things a person can do for their dog if they have canine epilepsy.
Educate Yourself
A person should learn all they can about canine epilepsy. There are many good and helpful books on this subject. You can search the internet for sites relating to this condition in dogs. There are web support groups and there may be local support groups in your area. These things will help a pet owner to understand the disease and also to give them a support system to lean on.
Record Everything
Keep a journal or diary on your dog’s seizures or any episode that you thought was a seizure. Make sure to record the date, time started and ended. Write down the symptoms and any factors that you think may have triggered the episode. These factors could include change in the dog’s diet, any loud noises and if the canine seemed stressed. If the dog had been ill or had a recent injury be sure to include that in your journal as well. Try to include as many details as possible because your records may hold clues to enable you to be prepared next time.
Pay particular attention to the dog’s behaviour prior to the seizure. Write down things like if the animal started pacing, was sleeping excessively or seemed to be more needy than usual. If you have other animals in the household make sure you pay attention to their reactions to the episode. Pets are often a lot smarter than we give them credit for, and some animals may be able to signal to you when a seizure is about to start.
Be Prepared
Set up a routine to follow when a seizure occurs. A person has to be prepared to have to make an emergency clinic visit in the middle of the night. Make sure there is always fuel in the car and have supplies handy such as towels or blankets. Keep the phone numbers of your vet and emergency animal hospital close at hand at all times. If your pet is having a seizure be sure to keep other pets away and remove any objects that could injure your dog.
Medications
Make sure you keep a supply of daily medication and any emergency medicine the veterinarian supplies. Ensure you have plenty on hand and give the dog its medication at set times every day. It is a good idea to keep on top of the latest research or treatments that become available for dogs with canine epilepsy. Before changing your dog’s medication or trying a new kind of treatment it is wise to discuss this with the vet first.
Establishing a pattern is the key to successful management of canine epilepsy. Discuss with your vet the different options available that pertain to your dog. Medications used for controlling seizures in dogs include Phenobarbitone, Mysoline, Epanutin and Potassium Bromide. Your vet will have you closely monitor your dog and will adjust the amount of medication needed to control seizures in your dog. Once you have started a course of treatment it is imperative that you don’t run out of medication; this is a well known trigger to restarting seizures.
Canine epilepsy can’t be cured but it can be controlled. Even a dog that has its epilepsy under control may have an occasional seizure. This condition can be controlled by medication that is given daily by mouth.
With proper medication a dog with epilepsy can still live a normal life. Dogs with canine epilepsy can live a happy and full life. They can go for walks, play in the park and do almost anything a healthy dog can.
If you are consistent with giving the required daily medication and have your dog seen regularly by your vet you will have many years ahead of you to enjoy your canine companion. You might want to consider getting pet insurance on your dog in case there will be any unforeseen medical expenses in the years to come. This will give your family peace of mind knowing that you will be able to provide medical attention when needed.
The Nebraska Medical Center is home to a Comprehensive Epilepsy Center serving Nebraska and the surrounding region and is providing new hope and opportunities to people with epilepsy.
A neurological disorder that affects the nervous system, epilepsy is also known as ‘the seizure disorder.’ In fact, epilepsy is often diagnosed after a person has had 2-3 seizures that were not brought on by any known medical condition. A seizure refers to sudden high-voltage electrical activity in the brain, and it affects a person’s feelings or actions for a short span of time. Seizures can be so mild as to go unnoticed or be intensely disturbing in their ferocity. The cause of an epileptic seizure is not known. It may be the direct result of a brain injury or a heredity factor.
Anyone can develop epilepsy; it occurs across all ages and all races of people. Epilepsy is quite common, affecting 1 in every 120 adults in the US alone. Whether a person will be epileptic or not depends on his seizure threshold, (an individual’s resistance level to seizures). A low seizure threshold means the person is more prone to having seizures for no reason. Such a person can easily develop a seizure when an apparently mild outside event triggers it. A person with a high seizure threshold is likely to get a seizure due to a serious outside factor, like a head injury. This means that almost ANYONE CAN HAVE A SEIZURE IF THE CIRCUMSTANCES ARE RIGHT. Often, a seizure may not immediately follow an injury. It may take place after 6-10 months, though there is no known cause for this delay.
Causes:
The causes of epilepsy can be classified into three groups. Each group is characterized by a different type of seizure.
Symptomatic epilepsy: In this kind of epilepsy, there is a known cause for the seizure. This may include a head injury, a stroke, or a scar on the brain. Infections like meningitis can also lead to an epileptic seizure. A scan often reveals the cause and treatment is started accordingly.
Idiopathic epilepsy: There is no known reason for this type of epileptic seizure, except a low seizure threshold. This person has no disabilities and leads a normal life. Response to treatment is fairly good among such patients.
Cryptogenic epilepsy: When a doctor rules out the previous two kinds of epilepsy, he or she may deduce that the seizure is cryptogenic. So, it is surmised that underlying physical reasons that need to be investigated are causing the seizures.
Making a diagnosis can be tricky because there are no obvious symptoms in epilepsy. The person having the seizure can remember little of what happens during that time. Therefore, it is helpful to get information from someone who has seen the seizure happening. Blood tests, EEG, CT scans, and MRI scans provide additional information.
New cases of epilepsy are most likely to occur in children during the first year of their lives. This tendency gradually declines until the child reaches 10 years, after which it stabilizes.
The people who are most vulnerable to an epileptic attack include:
-Underweight babies
-Babies with abnormal brain structures
-People who have suffered a bleeding into the brain
-People who have had a serious brain injury
-People with cerebral palsy
-People with mental handicaps
-Children who have had febrile seizures
-People with a family history of seizures
Treatment:
Around 70% of the people with epilepsy are treated with anti-epileptic drugs (AED’s). AED’s only prevent seizures; they do not cure epilepsy. The type of AED and the dosage needed depends on the type of seizure. Some people experience a decrease in the tendency towards seizures as they age. Sadly, there are people who never achieve control over their epilepsy in spite of receiving the most suitable treatment.