Effect of prior general anesthesia or sedation and antiseizure drugs on the diagnostic utility of wireless video electroencephalography in dogs

Abstract

Background: Ambulatory wireless video electroencephalography (AEEG) is the method of choice to discriminate epileptic seizures from other nonepileptic episodes. However, the influence of prior general anesthesia (GA), sedation, or antiseizure drug (ASD) on the diagnostic ability of AEEG is unknown. Hypothesis/Objectives: The use of sedation/GA or ASD treatment before AEEG recording may affect the diagnostic ability of AEEG and the time to first abnormality on AEEG. Animals: A total of 108 client-owned dogs undergoing ambulatory AEEG for paroxysmal episodes. Methods: Retrospective cohort study. Proportions of diagnostic AEEG and time to first abnormality were compared between dogs that received sedation/GA or neither for instrumentation as well as dogs receiving at least 1 ASD and untreated dogs. Results: Ambulatory EEG was diagnostic in 60.2% of all dogs including 49% of the sedation/GA dogs and 68% of dogs that received neither (odds ratio [OR], 2.25; 95% confidence interval [CI], 1.02-5.00; P = .05). The AEEG was diagnostic in 51% of dogs receiving at least 1 ASD and 66% of untreated dogs (OR, 1.95; 95% CI, 0.9-4.3; P = .11). No difference was found in time to first abnormality between sedation/GA or neither or ASD-treated or untreated dogs (P = .1 and P = .3 respectively). Ninetyfive percent of dogs had at least 1 abnormality within 277 minutes. Conclusion and Clinical Importance: Sedation/GA and concurrent ASD administration were not identified as confounding factors for decreasing AEEG diagnostic capability nor did they delay the time to first abnormality. A 4-hour minimal recording period is recommended.

ACADM Frameshift Variant in Cavalier King Charles Spaniels with Medium-Chain Acyl-CoA Dehydrogenase Deficiency

“…Clinical signs due to Chiari-like malformation and/or syringomyelia and MCAD deficiency are partially overlapping and may be very difficult to disentangle in a clinical setting. The most objective way of differentiating epileptiform seizures would be by recording the electrical activity of the brain using electroencephalography, but this is technically impractical for several reasons in veterinary settings [ 25 ]. Further prospective studies are needed to better differentiate between those diseases in CKCS and to evaluate the clinical impact of the observed enzyme deficiency in some dogs of this breed.…”

Novel subscalp and intracranial devices to wirelessly record and analyze continuous EEG in unsedated, behaving dogs in their natural environments: A new paradigm in canine epilepsy research

“…In addition, there was a significant positive correlation between the duration of EEG monitoring and seizure frequency in the 16 dogs ( Figure 4 ), again demonstrating that—because of the periodicity of spontaneous seizures—the chance of detecting seizures increases with the duration of EEG monitoring. This is substantiated by the low seizure detection rates of ambulatory EEG monitoring previously used in dogs ( 21 , 75 ), underlining the usefulness of long-term EEG monitoring in the diagnosis of canine epilepsy.…”

“…Mobile or ambulatory scalp EEG systems can be used in people for continuous EEG monitoring over several days ( 88 , 89 ), but—as discussed above—scalp EEG-based systems are not usable in dogs. In epileptic dogs, subcutaneous needle electrodes placed under sedation or anesthesia were used for recording wireless ambulatory EEG with synchronized video ( 75 ), but the duration of EEG recording was restricted to a few hours.…”

Seizure frequency discrepancy between subjective and objective ictal electroencephalography data in dogs

“…A subset of AEEG data and medical records of these dogs was documented in previous studies, of which 5 Rhodesian Ridgebacks also were included in the present study. 18 , 23 , 24 , 25 However, the correlation between reported seizure frequency and ictal PD frequency was not evaluated.…”