Lafora Disease (LD) is a rare, fatal, late-onset, progressive form of myoclonic epilepsy, occurring in humans and dogs. Clinical manifestations of LD usually include seizures, spontaneous and reflex myoclonus with contractions of the neck and limb muscles. We studied the electroencephalogram (EEG) patterns of two beagles in whom LD was subsequently confirmed by genetic testing. In both cases, the EEG recordings, accompanied by electromyography (EMG), have shown similar uncommon patterns. The hypovoltaged background rhythm was interrupted by waxing "crescendo" polyspikes-slow wave complexes appearing 80-250 ms after the start of intermittent photic stimulation, followed by myoclonic jerks after 80-150 ms. This study highlights the value of EEG in establishing a presumptive diagnosis of LD in dogs.

subtle motor phenomena in critically ill patients can raise the suspicion of NCSE. Nevertheless, EEG is needed to confirm the diagnosis, since none of the semiological features are specific.

Case summary A 9-month-old male neutered domestic shorthair cat presented 2 weeks after castration with a 48 h history of acute-onset lateral recumbency and severe hindlimb rigidity. Physical examination findings included hyperthermia, tachypnoea, hindlimb rigidity and a healed orchidectomy site. Neurological examination of the head and forelimbs was normal; however, there was a spastic, non-ambulatory paraparesis of the hindlimbs, which was more severe on the left. Abnormal findings included mildly elevated serum creatine kinase levels and on electromyography there was bilateral pathological spontaneous activity of the biceps femoris muscles. A tentative diagnosis of tetanus was made based on clinical presentation. Treatment was initiated with tetanus antitoxin, diazepam, metronidazole, buprenorphine and physiotherapy of the hindlimbs. There was an improvement over the following 20 days. Twenty-five days later the cat presented with acute, painful, non-weightbearing lameness of the left hindlimb. Physical examination was suggestive of craniodorsal coxofemoral joint luxation, which was confirmed radiographically. This was treated with analgesia and rest. A marked clinical improvement was observed at the 3-month follow-up. Relevance and novel information To our knowledge, there have been no previously published reports of spontaneous coxofemoral joint luxation as a complication of hindlimb localised tetanus infection in cats. This report suggests that coxofemoral luxation should be considered as a possible complication in young cats with hindlimb localised tetanus.

Highlights We measured EEG spectral changes during hemodialysis. We found slowing of the EEG background activity during hemodialysis. These changes were correlated with risk factors of dialysis disequilibrium syndrome.