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Abordagem terapêutica em estado epilético canino
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O estado epilético canino é uma emergência médica neurológica em clínica veterinária, com uma taxa de mortalidade superior a 25%. É caracterizada por atividade convulsiva contínua e necessita de tratamento urgente e agressivo, de modo a minimizar complicações sistémicas e neurológicas.
Convulsão é um distúrbio caracterizado por contrações musculares involuntárias de todo o corpo ou parte dele, normalmente bilaterais, provocadas por um excesso de atividade elétrica em determinadas áreas cerebrais.
O ataque epilético típico divide-se em quatro fases: pródromo (fase que antecede a atividade convulsiva), aura (manifestação inicial do ictus), ictus (manifestação convulsiva propriamente dita) e pós-ictus.
Nesta dissertação, será abordada a etiologia de estado epilético e a abordagem diagnóstica, que inclui: a anamnese, o exame físico e neurológico, e exames complementares (análise de sangue e urina, diagnóstico imagiológico, análise do líquido cefalorraquidiano e eletroencefalografia).Existem diversos fármacos anticonvulsivantes para tratar estado epilético: benzodiazepinas, fenobarbital, brometo de potássio e levetiracetam. Contudo, muitos cães são refratários ao tratamento com estes fármacos. Nestes casos refratários, a indução de anestesia geral com propofol, cetamina e pentobarbital ou anestesia volátil, são opções terapêuticas.
A estimulação vagal, a terapia dietética, a acupuntura, a cirurgia e a medicina regenerativa estão indicadas em pacientes refratários à terapêutica convencional.
Esta dissertação também descreve o tratamento de emergência do estado epilético no hospital e em casa.
Canine status epilepticus is a neurological medical emergency in veterinary clinic, with a death-rate of more than 25%. Is characterized by continuous seizures and needs urgent and aggressive treatment, in order to minimize systemic and neurological complications. Seizure is a disorder characterized by involuntary muscle contractions of the whole body or part of it, usually bilaterally caused by an excess of electrical activity in certain brain areas. The typical epileptic seizure is divided into four phases: prodrome (pre-seizure phase), aura (initial manifestation of ictus), ictus (seizure itself) and post-ictus. In this dissertation, the etiology of status epilepticus and the diagnostic protocol approach, which includes: anamnesis, physical and neurological examination, and complementary exams (blood and urine analysis, diagnostic imaging, cerebrospinal fluid analysis and electroencephalography).There are many anticonvulsant drugs to treat status epilepticus: benzodiazepines, phenobarbital, potassium bromide and levetiracetam. However, many dogs are refractory to treatment with these drugs. In these refractory cases, the induction of general anesthesia with propofol, ketamine and pentobarbital or inhalant anesthesia, are therapeutic options. Vagal stimulation, acupuncture, dietary therapie, surgery and regenerative medicine are indicated in patients refractory to conventional therapy. This dissertation also describes the emergency treatment of status epilepticus in the hospital and at home.
Canine status epilepticus is a neurological medical emergency in veterinary clinic, with a death-rate of more than 25%. Is characterized by continuous seizures and needs urgent and aggressive treatment, in order to minimize systemic and neurological complications. Seizure is a disorder characterized by involuntary muscle contractions of the whole body or part of it, usually bilaterally caused by an excess of electrical activity in certain brain areas. The typical epileptic seizure is divided into four phases: prodrome (pre-seizure phase), aura (initial manifestation of ictus), ictus (seizure itself) and post-ictus. In this dissertation, the etiology of status epilepticus and the diagnostic protocol approach, which includes: anamnesis, physical and neurological examination, and complementary exams (blood and urine analysis, diagnostic imaging, cerebrospinal fluid analysis and electroencephalography).There are many anticonvulsant drugs to treat status epilepticus: benzodiazepines, phenobarbital, potassium bromide and levetiracetam. However, many dogs are refractory to treatment with these drugs. In these refractory cases, the induction of general anesthesia with propofol, ketamine and pentobarbital or inhalant anesthesia, are therapeutic options. Vagal stimulation, acupuncture, dietary therapie, surgery and regenerative medicine are indicated in patients refractory to conventional therapy. This dissertation also describes the emergency treatment of status epilepticus in the hospital and at home.
Description
Keywords
Estado epilético canino Emergência neurológica Convulsão Fármacos anticonvulsivantes Casos refratários Opção terapêutica Canine status epilepticus Neurological emergency Seizure Anticonvulsant drugs Refractory cases Therapeutic option