Behavioral and autonomic manifestations of suspected focal impaired awareness seizures supported by interictal electroencephalographic findings in three dogs: a case series

Abstract

Focal epileptic seizures with sensory impairment can be difficult to recognize and are often mistaken for behavioral disorders. Electroencephalography (EEG) can provide important supportive evidence for their epileptic origin when interpreted in conjunction with clinical presentation. This article describes three cases of canine patients: a 2-year-old Border Terrier, a 1-year-old Poodle mix, and a 4-year-old mixed-breed dog. All three were presented with a history of recurrent episodes characterized by fear, restlessness, hyperactivity, hiding, staring into space or at the sky, lip licking, and hypersalivation. In two dogs, there were also signs of impaired consciousness. The frequency of the episodes varied, ranging from multiple episodes per day to one episode every 1–2 weeks. No pre-ictal or post-ictal signs were reported. Clinical and neurological examinations were unremarkable in all three cases. The diagnostic workup included EEG using a Natus Xltek system and magnetic resonance imaging (MRI) of the brain with a Siemens 1.5 T scanner. EEG monitoring lasting 1.5–4 h revealed epileptiform discharges predominantly in the parietal and temporal regions. This case series highlights the occurrence of behavioral and autonomic symptoms without typical motor manifestations as a presentation of presumed idiopathic epilepsy in dogs, supported by EEG findings in conjunction with the clinical presentation. All three dogs were treated with antiseizure medication, which resulted in a decrease in both the frequency and intensity of episodes, with complete seizure freedom achieved in two dogs.