Complex Partial Cluster Seizures in Cats with Orofacial Involvement

Abstract

Seventeen cats were presented with acute onset of complex partial seizures with orofacial involvement (salivation, facial twitching, lip smacking, chewing, licking or swallowing), motor arrest (motionless starring) and behavioural changes. In 11 cats hippocampal necrosis (HN) was confirmed by histopathology. In a further six cats hippocampal changes were suggested by magnetic resonance imaging. The mean monitoring time of eight cats which were not euthanased in the acute phase of the disease, was 408 days (60-908): four cats are still alive. In all surviving cases, the owners reported a good quality of life. We conclude that an acute cluster of complex partial seizures with orofacial involvement are often associated with HN and that HN is not necessarily a fatal condition. Supportive and antiepileptic therapy can result in remission. The long-term outcome can be good to excellent; therefore, euthanasia should be avoided in the acute phase of the signs.

Hippocampal Necrosis in a Cat from Australia

“…Hippocampal necrosis is reported to have a poor prognosis with high rates of death and euthanasia [1][2][3][4][5][6]. The outcome of this case is disappointing, but the management of this case was similar to the four reported surviving cases which were all managed with an anticonvulsant and supportive care [5].…”

“…Whilst exposure to a cholinesterase-inhibiting compound causes similar presenting signs, in a previous case series cholinesterase activity was unremarkable in all cats with hippocampal necrosis in which the test was performed [5].…”

“…Hippocampal necrosis is an infrequently reported MRI and postmortem finding in cats [1][2][3][4][5][6]. It has been predominantly associated with clinical signs of behavioral change and seizure activity and, to date, has been reported in cats from the UK, Switzerland, Italy, USA, and Austria [1][2][3][4][5][6].…”

“…It has been predominantly associated with clinical signs of behavioral change and seizure activity and, to date, has been reported in cats from the UK, Switzerland, Italy, USA, and Austria [1][2][3][4][5][6]. Cats with this disease have been reported to show a myriad of symptoms including salivation, behavioural change, complex focal seizures, facial twitching, lip smacking, chewing, retching, vomiting, diarrhoea, circling, excessive swallowing, and postural deficits or weakness [1][2][3][4][5][6]. The reported prognosis for this disease is very poor with one case series reporting 4 survivors out of 17 cases (23%) over a four-month period [4].…”

Autoimmune Epilepsies

“…Publications show that domestic cats can suffer from epilepsy with orofacial seizures that show some similarities to the dystonic faciobrachial seizures in patients with LGI1 antibodies [14]. Interestingly, cats with such seizures can also be found to present with LGI1 antibodies [73,74]. Neuropathological investigation of these cats shows a severe hippocampal degeneration in the presence of complement C9neo deposition on the surface of neurons.…”