Epileptic Seizures and their Imitators: Differential Diagnoses of Paroxysmal Syndromes (Case Presentations)

Abstract

Paroxysmal syndromes describe a variety of symptoms and signs that appear suddenly, involuntarily, and usually repetitively (episodic) through time. General practitioner confronts paroxysmal episodes (either epileptic seizures or not) in daily practice, that are usually overdiagnosed as epileptic seizures. Thus, it is important for the general practitioner to be able to create a differential diagnoses list in a case with paroxysmal disorder, to choose the appropriate treatment, to define the prognosis and consequently to provide high quality service to the owner. Paroxysmal syndromes include: (a) epileptic seizures (generalized or focal), (b) syncope, (c) episodic vestibular syndrome, (d) myotonia/neuromyotonia, (e) myokymia, (f) episodic hypertonicity of Cavalier King Charles Spaniels (former episodic falling syndrome), (g) paroxysmal dyskinesia, (h) paroxysmal dyskinesia due to gluten hypersensitivity, (i) hyperekplexia syndrome of Irish Woolfhounds, (j) Lafora disease, (k) Dancing Doberman Syndrome, (l) exercise-induced collapse, (m) generalized muscular stiffness of Labradors, (n) idiopathic head tremor, (o) narcolepsy/katalepsy, (p) REM sleep disorder, and (q) behavioural disorders. New syndromes or diseases are continuously being added in the abovementioned list. In the current lecture, clinical cases of dogs and cats are mainly presented, highlighting differences between epileptic and non-epileptic paroxysmal episodes. Features of differentiation are also discussed, based on history (incl. recorded video), clinical findings, diagnostic procedures and progression of the case.