Kontinuierliche EEG Überwachung für die Therapie von Hunden und Katzen im Status epilepticus

Goal of this case series was to describe the management of Status
epilepticus in dogs and cats with the aid of continuous
electroencephalographic (EEG) monitoring. Ten patients (7 dogs, 3
cats) with SE of differing etiology (idiopathic epilepsy, n=3;
toxicity, n=4; meningoencephalitis, n=2; undefined, n=1) were
included in the study. The EEG was recorded continuously from five
stainless steel needle-electrodes inserted subcutaneously. Animals
were treated with diazepam and phenobarbital followed by either
propofol (n=3) or pentobarbital (n=7) at a continuous rate of
infusion. Clinical seizures stopped after induction of anesthesia
in each animal. The EEG, however, still showed distinct
epileptiform patterns (spikes, polyspikes) in all animals.
Paroxysms were suppressed by increasing the infusion rate of either
pentobarbital or propofol. A burst-suppression pattern was achieved
in 5 animals. Electroencephalographic epileptiform activity
reappeared in 4 animals when attempting to taper the dose after
> 6 hours of anesthesia. This was interpreted as ongoing EEG
seizure activity and an increased risk for clinical seizures, and
the anesthetic dosage was adjusted accordingly. We conclude that
continuous EEG monitoring appears to be a useful tool for
therapeutic monitoring of SE in dogs and cats. It allows the
detection of EEG seizures without the appearance of clinical
seizures. Further investigations with blinded investigators and
homogeneous animal groups to define therapeutic endpoints are
warranted.