A large multicenter European group recently published data regarding a new survey designed to help more closely evaluate seizure semiology (appearance) to help us better classify seizures vs dyskinesias (abnormal movements that aren’t seizures). Over 600 dogs were included in the initial survey. You can view the survey here: https://dogepilepsyresearch.org/us/. The owners were instructed to proceed through 7 steps during episode description.
Step 1: report the seizure appearance in their own words
Step 2: Read a description of one of 4 episodes and see which one best fits their pet. These included 1) generalized seizures 2) non-generalized motor events 3) sudden falls without movement and 4) episodic impaired awareness (stare into space with behavioral arrest). The survey provides verbal descriptions of the categories as well as videos.
Step 3: Owners answer specific questions about the seizures include pre/post ictal signs, signs at first onset, description of the position, muscle tone, responsiveness during the event, age at onset, triggers and a few other questions.
Step 4: Historical questions about familial history, a history of head trauma or puppyhood diseases are asked.
Step 5: Veterinary exam results
Step 6: Medications and medication history
Step 7: Interictal changes in behavior
Results
The most common breeds were Labrador retrievers, Siberian Huskies and Border collies. Median age at onset was 2 years (IQR 1-5 yrs) with 80% experiencing their first episode between 6 months and 6 years old. Only about 50% of the dogs has neurologic examinations (what??!). Interestingly, owners described generalized seizures in about 58% of dogs, non-generalized motor activity in 58% of dogs, sudden falls in 6% and episodic impaired awareness in 15% of dogs. Over 25% had multiple types reported. Overall, reviewers agreed with owner classification about 90% of the time. Similarly, for dogs with multiple different types of seizures, reviewers agreed with classification about 86% of the time. The questionnaire was considered usable and/or easy to complete by about 70% of owners.
Interestingly, Labrador retrievers were more likely to have one classification, and it was the non-generalized motor event. This was compared to Huskies and Border Collies who were more likely to have generalized type seizures. Within the Labrador group, the majority of cases were consistent with dyskinesias NOT seizures (70%) and focal motor seizures in 24%. The remainder were undefined in classification.
Key Points
This questionnaire is a great tool for those researching seizures (um…me) but might be worthwhile for all of us to look at to make sure we are asking the right questions. While they did not set out to differentiate between dyskinesias and seizures, they state that this questionnaire might be the right tool to do so. My goal in showing you this article was to make you aware of the existence of this seizure questionnaire. Your clients can contribute to the ongoing data collection (by completing the form), and you can become familiar with the types of questions that might be helpful when faced with a dog with a possible seizure disorder.
If you’d like to watch the videos linked to the survey please see the article: https://doi.org/10.1111/jvim.70077
Thanks for reading! I hope you are finding time to enjoy this wonderful fall weather!