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href="#ulink_5034e2ce-98f4-50b8-bd85-8e1181fc8d5a">Chapter 5.

Table 3.3. Veterinary classification of seizures and epilepsies based on underlying aetiology, parallelism with the ILAE 2010 proposed new terminology, and terminology used in this book.

Current veterinary terminology	ILAE 2010 proposed new terminology	Terminology used in this book
Reactive seizures	Metabolic	Reactive seizures
Symptomatic or secondary epilepsy	Structural epilepsy	Structural epilepsy
Probable symptomatic or cryptogenic epilepsy	Epilepsy of unknown aetiology	Cryptogenic epilepsy
Idiopathic or primary epilepsy	Genetic	Idiopathic epilepsy

Box 3.1. Aetiologies of reactive seizures.

      Metabolic

      Hepatic disease

      congenital and acquired portosystemic shunt, microvascular dysplasia, hepatic lipidosis, neoplasia, inflammation

      Renal disease

      acute renal failure, end-stage chronic renal failure

      Electrolyte imbalance

      hypo- or hypernatraemia, hypocalcemia

      Hypoglycaemia

      insulin-secreting tumour, severe sepsis, iatrogenic insulin overdose

      Hypoxia

      Hypertension

      Polycythaemia

      Nutritional

      Thiamine deficiency

      Toxicity

      Pyrethrins/ Pyrethroids, organophosphates, chlorinated hydrocarbons carbamate

      Metaldehyde

      Strychnine, bromathalin

      Sodium monofluoroacetate (compound 1080)

      Ethylene glycol

      Detergents and disinfectants

      Lead and other heavy metals

      Poisonous plants

      Mycotoxins (penitrem A, roquefortine)

      Animal-related poisoning (toad, spider, bee and wasp venom)

      Metronidazole (cats)

      5-hydroxytryptophan

      Caffeine and other methylxanthines

      Amphetamine and amphetamine-like compounds

      Selective serotonin reuptake inhibitors

      Classification of certain disorders may be open to debate. For example, organic acidurias such as L-2-hydroxyglutaric aciduria in Staffordshire bull terriers may be classified as structural epilepsy as they result in MRI and histological changes in the brain as well as metabolic disorders as they are caused by an error of cellular metabolism, or genetic epilepsy, as the underlying genetic mutation is known (Abramson et al., 2003; Penderis et al., 2007).

Box 3.2. Aetiologies of structural epilepsy.

      Vascular

      Cerebrovascular disease (ischaemic, haemorrhagic)

      Inflammatory/ infectious

      Viral

      Bacterial

      Rickettsial

      Protozoal

      Mycotic

      Parasitic

      Mycoplasmosis

      Algal

      Granulomatous meningoencephalomyelitis

      Necrotizing meningoencephalitis

      Necrotizing leukoencephalitis

      Other feline and canine meningoencephalitis or meningoencephalomyelitis of unknown aetiology Traumatic brain injury Anomalous and developmental

      Hydrocephalus

      Hydranencephaly

      Porencephaly

      Meningoencephalocele

      Meningoencele

      Exencephaly

      Holoprosencephaly

      Agenesis of the corpus callosum

      Lissencephaly

      Polymicrogyria

      Cerebral neuronal heterotopias or dysplasias

      Neoplastic

      Primary

      Meningioma

      Astrocytoma (glioblastoma multiforme)

      Oligodendroglioma

      Gliomatosis cerebri

      Ependymoma

      Choroid plexus tumours

      Primitive neuroectodermal tumours (neuroblastomas, medulloblastoma, gangliocytomas)

      Primary CNS lymphomas

      Primary CNS histiocytic sarcoma (malignant histiocytosis)

      Secondary

      Haemangiosarcoma

      Lymphoma

      Pituitary Tumours

      Carcinomas/ Adenocarcinomas (mammary, prostatic, pancreatic, pulmonary)

      Nasal tumours (e.g. adenocarcinoma, squamous cell carcinoma, chondrosarcoma, neuroesthesioblastoma)

      Histiocytic sarcoma

      Calvarial osteosarcoma and multilobulated tumour of bone (multilobulated osteochondrosarcoma)

      Malignant melanoma

      Others

      Degenerative

      Lysosomal storage diseases

      Organic acidurias

      Mitochondrial encephalopathies and encephalomyelopathies

      Leukodystrophies

      Spongy degenerations

      Multisystem neuronal degeneration/abiotrophy

       Probable symptomatic or cryptogenic epilepsy

      Probable symptomatic or cryptogenic epilepsy refers to recurrent seizures caused by an underlying brain disease that is strongly suspected but cannot be identified despite extensive investigations (e.g. undetected hypoxic or vascular events, post-encephalitic changes and post-traumatic lesions that do not cause any detectable changes on brain imaging). Animals with cryptogenic epilepsy may or may not have behavioural and/or neurological abnormalities (other than seizures) interictally. The term ‘epilepsy of unknown aetiology’ has been proposed to replace the term cryptogenic epilepsy in humans (Berg et al., 2010) and although not widely accepted by expert epileptologists (Panayiotopoulos, 2012), it may be of value in veterinary medicine due to its more immediate meaning. However, in veterinary medicine, it would be important to specify when the cause of the seizures is unknown despite extensive diagnostic investigations to rule out toxic, metabolic, nutritional and structural brain disorders (see Chapter 10) rather than unknown because of minimal or no investigations.

       Idiopathic or primary epilepsy

      Idiopathic or primary epilepsy refers to recurrent seizures with no underlying cause other than a strongly suspected or confirmed genetic or familial basis. In this context, the term ‘idiopathic’ refers

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