Microsoft word - clinical neurology.doc

Area of Research: Clinical Neurology
Mentor: Dominik Faissler
Add on therapy of levetiracetam in idiopathic epileptic dogs: Idiopathic
epilepsy is one of the most common neurological problems in dogs. The cause is
unknown but an imbalance between excitatory and inhibitory neurotransmitters is
suspected. Some breeds are more affected. A recessive most likely polygenic
mode of transmission is suspected. The course of the disorder is often slowly
progressive which results in increasing seizure frequency and duration as well as
worsening of the postictal phase. Therapy is limited to medical treatment. Initially,
anticonvulsive medications like phenobarbital or potassium bromide used as
monotherapy reduce seizure frequency and duration significantly in 65% to 85%
of treated dogs. On a long term basis 10% to 50% percent of the dogs suffering
from idiopathic epilepsy treated with a single drug start to be refractory
(Farnbach, 1984; Derkx-Overduin, 1994; Podell, 1995). The combination of
phenobarbital and bromide was shown to be successful in 65% to 72% of the
dogs with a chronic seizure history. Adding on potassium bromide to the
phenobarbital reduced seizure frequency more than 50% compared to the initial
monotherapy. There are still 20% to 30% of the idiopathic seizing dogs who are not
satisfactorily controlled, with the combination therapy of bromide and phenobarbital. The
lack of alternative treatments in dogs or the limited long-term use of phenobarbital
because of its side effect on the liver warrants a third medication or the replacement of
phenobarbital. A newer drug levetiracetam was prescribed in several dogs and some of
them showed improved seizure control.
Goal: The goal of this project is to evaluate seizure frequency, duration, the
occurrence of cluster seizures, and the quality of the postictal period before and
after the additional therapy of levetiracetam to the previous medication schedule.
Data basis: Neuro data basis, so far 11 cases.
Area of Research: Clinical Neurology
Mentor: Dominik Faissler
Incidence of encephalitis in dogs: The terms encephalitis or
meningoencephalitis refer to inflammation of the brain parenchyma and its
meningeal linings. The most common reasons mentioned in the literature are
distemper virus, other viral infections, protozoal and bacterial
meningoencephalitis (Tipold, 1995, Heim et al, 1998). The second important
group of disorders causing meningoencephalitis is the idiopathic inflammatory
brain disease like granulomatous meningoencephalitis (GME), necrotizing
encephalitis and eosinophilic meningoencephalitis. The diagnosis of these
idiopathic inflammatory brain diseases in living dogs is based on CSF analysis,
MRI imaging and exclusion of infectious disorders. For a definitive confirmation
histopathology or brain biopsy is needed. The treatment is difficult and often
related to corticoids. Newer options are immune modulating medication like
procarbazine or cytosine arabinoside. In contrast to other researchers the most
common cause in dogs for meningoencephalitis here at Tufts University seem to
be to the idiopathic inflammatory brain disorders. More data about incidence,
clinical presentation, diagnostic possibilities and treatment options are needed to
improve the approach to this group of brain disorders.
Goal: The primary goal of this study is to establish a data basis of the different
causes for encephalitis or meningoencephalitis in dogs, and calculate the
incidence of the different diseases. Our working hypothesis is that idiopathic
inflammatory disorders of the brain are the most common cause for encephalitis
or meningoencephalitis presented at Tufts University.
- CSF results clinical laboratory Tufts University - Necropsy results Tufts University - MRI reports Tufts University - Case log neurology 2002


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