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      Myoclonus in older Cavalier King Charles Spaniels

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          Abstract

          Background

          Myoclonus is observed in older Cavalier King Charles Spaniels (CKCS) but a full description is lacking.

          Objectives

          The presence, age of onset, characteristics and treatment of myoclonic episodes were retrospectively evaluated in a cohort of CKCS which presented to 1 board‐certified neurologist. Clinical data, imaging studies, presence of seizures and their management, as well as other comorbidities were noted.

          Animals

          Thirty‐nine CKCS that were presented to 2 institutions between 2001 and 2018 with signs consistent with myoclonus. Clinical examination, blood sampling, advanced diagnostic imaging, cerebrospinal fluid analysis, and record keeping of other comorbidities was performed.

          Methods

          This is a retrospective case series, describing the presence of myoclonus in CKCS.

          Results

          Clinical signs reported were spontaneous in onset, lasted a few seconds and consisted of rapid blinking with head nodding and variable extension down the thoracic limbs. Myoclonus occasionally led to stumbling of the thoracic limbs or collapse. Mean age of onset was 8.38 years (SD ±1.96). Thirteen of 39 dogs with myoclonus had paroxysmal events, such as generalized seizures (9/13).

          Conclusions and Clinical Importance

          Myoclonus occurs in middle‐aged to older CKCS and seems to be another epiphenomena of this breed. A link to epilepsy might be present.

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          Most cited references25

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          International veterinary epilepsy task force consensus proposal: diagnostic approach to epilepsy in dogs

          This article outlines the consensus proposal on diagnosis of epilepsy in dogs by the International Veterinary Epilepsy Task Force. The aim of this consensus proposal is to improve consistency in the diagnosis of epilepsy in the clinical and research settings. The diagnostic approach to the patient presenting with a history of suspected epileptic seizures incorporates two fundamental steps: to establish if the events the animal is demonstrating truly represent epileptic seizures and if so, to identify their underlying cause. Differentiation of epileptic seizures from other non-epileptic episodic paroxysmal events can be challenging. Criteria that can be used to make this differentiation are presented in detail and discussed. Criteria for the diagnosis of idiopathic epilepsy (IE) are described in a three-tier system. Tier I confidence level for the diagnosis of IE is based on a history of two or more unprovoked epileptic seizures occurring at least 24 h apart, age at epileptic seizure onset of between six months and six years, unremarkable inter-ictal physical and neurological examination, and no significant abnormalities on minimum data base blood tests and urinalysis. Tier II confidence level for the diagnosis of IE is based on the factors listed in tier I and unremarkable fasting and post-prandial bile acids, magnetic resonance imaging (MRI) of the brain (based on an epilepsy-specific brain MRI protocol) and cerebrospinal fluid (CSF) analysis. Tier III confidence level for the diagnosis of IE is based on the factors listed in tier I and II and identification of electroencephalographic abnormalities characteristic for seizure disorders. The authors recommend performing MRI of the brain and routine CSF analysis, after exclusion of reactive seizures, in dogs with age at epileptic seizure onset 6 years, inter-ictal neurological abnormalities consistent with intracranial neurolocalisation, status epilepticus or cluster seizure at epileptic seizure onset, or a previous presumptive diagnosis of IE and drug-resistance with a single antiepileptic drug titrated to the highest tolerable dose. This consensus article represents the basis for a more standardised diagnostic approach to the seizure patient. These recommendations will evolve over time with advances in neuroimaging, electroencephalography, and molecular genetics of canine epilepsy. Electronic supplementary material The online version of this article (doi:10.1186/s12917-015-0462-1) contains supplementary material, which is available to authorized users.
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            The canine cognitive dysfunction rating scale (CCDR): a data-driven and ecologically relevant assessment tool.

            Canine cognitive dysfunction (CCD) is an age-related neurobehavioural syndrome which, although common, is severely under-diagnosed in community-based dogs. Using data from a large cross-sectional survey of older dogs (n=957), this study aimed to develop a clinical scale for assessing CCD. Data-driven analytical techniques were used to distil 27 significant behavioural items (previously identified as relevant to CCD) into an assessment tool with maximal cognito-behavioural breadth whilst maintaining clinical utility. The resulting CCD rating scale (CCDR) comprised 13 behavioural items, of which three were sensitive to the severity of the disease stage. When tested on an independent survey sample, the CCDR had an overall 98.9% diagnostic accuracy with a 77.8% positive predictive value and a 99.3% negative predictive value. Test-re-test reliability of the CCDR over 2months was also high (r=0.73, P<0.0001). In conjunction with veterinary assessment, the CCDR could be a valuable tool in research and clinical settings for both the assessment and longitudinal tracking of cognitive change. Copyright © 2010 Elsevier Ltd. All rights reserved.
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              International Veterinary Epilepsy Task Force consensus proposal: medical treatment of canine epilepsy in Europe

              In Europe, the number of antiepileptic drugs (AEDs) licensed for dogs has grown considerably over the last years. Nevertheless, the same questions remain, which include, 1) when to start treatment, 2) which drug is best used initially, 3) which adjunctive AED can be advised if treatment with the initial drug is unsatisfactory, and 4) when treatment changes should be considered. In this consensus proposal, an overview is given on the aim of AED treatment, when to start long-term treatment in canine epilepsy and which veterinary AEDs are currently in use for dogs. The consensus proposal for drug treatment protocols, 1) is based on current published evidence-based literature, 2) considers the current legal framework of the cascade regulation for the prescription of veterinary drugs in Europe, and 3) reflects the authors’ experience. With this paper it is aimed to provide a consensus for the management of canine idiopathic epilepsy. Furthermore, for the management of structural epilepsy AEDs are inevitable in addition to treating the underlying cause, if possible.
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                Author and article information

                Contributors
                crotter@fitzpatrickreferrals.co.uk
                Journal
                J Vet Intern Med
                J Vet Intern Med
                10.1111/(ISSN)1939-1676
                JVIM
                Journal of Veterinary Internal Medicine
                John Wiley & Sons, Inc. (Hoboken, USA )
                0891-6640
                1939-1676
                23 March 2022
                May-Jun 2022
                : 36
                : 3 ( doiID: 10.1111/jvim.v36.3 )
                : 1032-1038
                Affiliations
                [ 1 ] Orthopedics and Neurology Fitzpatrick Referrals Ltd Surrey United Kingdom
                [ 2 ] School of Veterinary Medicine University of Surrey Surrey United Kingdom
                Author notes
                [*] [* ] Correspondence

                Carina Rotter, Orthopedics and Neurology, Fitzpatrick Referrals Ltd, Halfway Lane, Eashing, Surrey, GU7 2QQ, United Kingdom.

                Email: crotter@ 123456fitzpatrickreferrals.co.uk

                Author information
                https://orcid.org/0000-0002-9032-3510
                https://orcid.org/0000-0003-0240-8141
                https://orcid.org/0000-0002-3366-2110
                Article
                JVIM16404
                10.1111/jvim.16404
                9151451
                35319117
                d46f1b5c-15c2-461d-a786-d6369df92fa6
                © 2022 Fitzpatrick Referrals Limited. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 28 February 2022
                : 20 July 2021
                : 02 March 2022
                Page count
                Figures: 2, Tables: 0, Pages: 7, Words: 4925
                Categories
                Standard Article
                SMALL ANIMAL
                Standard Articles
                Neurology
                Custom metadata
                2.0
                May/June 2022
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.1.6 mode:remove_FC converted:30.05.2022

                Veterinary medicine
                involuntary movement,levetiracetam,myoclonic epilepsy,nonrhythmic muscle twitching,primary progressive myoclonus of aging

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