1
|
Glantschnigg-Eisl U, Klang A, Kneissl S, Lang B, Waters P, Irani SR, Binks SNM, Pakozdy A. A feline model of spontaneously occurring autoimmune limbic encephalitis. Vet J 2023; 296-297:105974. [PMID: 36958405 DOI: 10.1016/j.tvjl.2023.105974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/08/2023] [Accepted: 03/20/2023] [Indexed: 03/25/2023]
Abstract
Autoimmune encephalitis (AE) is an important cause of encephalitis in humans and occurs at a similar rate to infectious encephalitis. It is frequently associated with antibodies against the extracellular domain of neuronal proteins. Among human AE, that with antibodies against leucine-rich glioma-inactivated 1 (LGI1) is one of the most prevalent forms, and was recently described in cats with limbic encephalitis (LE). In this study, we describe a large cohort (n = 32) of cats with AE, tested positive for voltage gated potassium channel (VGKC)-antibodies, of which 26 (81%) harboured LGI1-antibodies. We delineate their clinical and paraclinical features as well as long-term outcomes up to 5 years. Similar to human cases, most cats with LGI1-antibodies had a history of focal seizures (83%), clustering in the majority (88%), with interictal behavioural changes (73%). Among feline AE patients, there was no seizure type or other clinical characteristic that could distinguish LGI1-antibody positive from negative cats, unlike the pathognomic faciobrachial dystonic seizures seen in humans. Although six cats were euthanased in the first year for epilepsy-associated reasons, those attaining at least 1-year survival had good seizure control and quality of life with appropriate veterinary care and medication. Acute-phase immunotherapy (prednisolone) was given to the most severely unwell cases and its effect is retrospectively evaluated in 10 cats. Our data show LGI1-antibodies are an important cause of feline encephalitis, sharing many features with human AE. Further research should examine optimal therapeutic management strategies and the cause of LE in seronegative cats, building on paradigms established in the counterpart human disease.
Collapse
Affiliation(s)
- U Glantschnigg-Eisl
- Clinic for Small Animals, Internal Medicine, University of Veterinary Medicine Vienna, Austria.
| | - A Klang
- Institute for Pathology and Forensic Veterinary Medicine, Universitiy of Veterinary Medicine Vienna, Austria
| | - S Kneissl
- Diagnostic Imaging, University of Veterinary Medicine Vienna, Austria
| | - B Lang
- Oxford Autoimmune Neurology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, OX3 9DU, UK
| | - P Waters
- Oxford Autoimmune Neurology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, OX3 9DU, UK
| | - S R Irani
- Oxford Autoimmune Neurology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, OX3 9DU, UK; Department of Neurology, John Radcliffe Hospital, Oxford University Hospitals Foundation Trust, Oxford OX3 9DU, UK
| | - S N M Binks
- Oxford Autoimmune Neurology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, OX3 9DU, UK; Department of Neurology, John Radcliffe Hospital, Oxford University Hospitals Foundation Trust, Oxford OX3 9DU, UK
| | - A Pakozdy
- Clinic for Small Animals, Internal Medicine, University of Veterinary Medicine Vienna, Austria
| |
Collapse
|
2
|
Kitz S, Thalhammer JG, Glantschnigg U, Wrzosek M, Klang A, Halasz P, Shouse MN, Pakozdy A. Feline Temporal Lobe Epilepsy: Review of the Experimental Literature. J Vet Intern Med 2017; 31:633-640. [PMID: 28382749 PMCID: PMC5435036 DOI: 10.1111/jvim.14699] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 01/12/2017] [Accepted: 02/23/2017] [Indexed: 12/01/2022] Open
Abstract
Accumulating evidence suggests that epileptic seizures originating from the temporal lobe (TL) occur in cats. Typically, affected animals have clinically focal seizures with orofacial automatisms including salivation, facial twitching, lip smacking, chewing, licking, and swallowing. Motor arrest and autonomic and behavioral signs also may occur. Many affected cats have magnetic resonance imaging (MRI) changes within the hippocampus or histopathologically confirmed hippocampal sclerosis or necrosis. From the 1950s to the 1980s, cats frequently were used as animal models for neurophysiological experiments and electrophysiological studies, from which important basic knowledge about epilepsy originated, but which has been rarely cited in clinical veterinary studies. These studies were reviewed. Experimental research on cats showed the widespread anatomical connections among TL structures. The ictal clinical signs originating from the hippocampus, amygdala, or lateral temporal cortex are similar, because of their dense interconnections. The ictal signs can be divided into autonomic, somatic, and behavioral. For research purposes, a 6‐stage system was established, reflecting the usual sequential progression from focal to generalized seizure: attention response (1), arrest (2), salivation, licking (3), facial twitching (4), head turning or nodding (5), and generalized clonic convulsions (6). Knowledge of this data may help in recognizing low‐stage (stage 1 or stage 2) epileptic seizures in clinical practice. Early experimental research data are in accordance with recent clinical observations regarding ictal clinical signs of TL epileptic seizures in cats. Furthermore, the research data supports the idea that TL epilepsy represents a unique clinical entity with a specific seizure type and origin in cats.
Collapse
Affiliation(s)
- S Kitz
- Clinical Department for Companion Animals and Horses, Clinic for Small Animals Internal Medicine, University of Veterinary Medicine, Vienna, Austria
| | - J G Thalhammer
- Clinical Department for Companion Animals and Horses, Clinic for Small Animals Internal Medicine, University of Veterinary Medicine, Vienna, Austria
| | - U Glantschnigg
- Clinical Department for Companion Animals and Horses, Clinic for Small Animals Internal Medicine, University of Veterinary Medicine, Vienna, Austria
| | - M Wrzosek
- Department of Internal Disease with Clinic of Horses, Dogs and Cats, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - A Klang
- Pathology and Forensic Veterinary Medicine, University of Veterinary Medicine, Vienna, Austria
| | - P Halasz
- Institute of Experimental Medicine, Budapest, Hungary
| | - M N Shouse
- Department of Neurobiology, Center for Health Sciences, UCLA, Los Angeles, CA
| | - A Pakozdy
- Clinical Department for Companion Animals and Horses, Clinic for Small Animals Internal Medicine, University of Veterinary Medicine, Vienna, Austria
| |
Collapse
|
3
|
Klang A, Thaller D, Schmidt P, Kovacs GG, Halasz P, Pakozdy A. Bilateral Dentate Gyrus Structural Alterations in a Cat Associated With Hippocampal Sclerosis and Intraventricular Meningioma. Vet Pathol 2015; 52:1183-6. [PMID: 25572262 DOI: 10.1177/0300985814564979] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A 13-year-old cat had a history of seizures for 3 years that resembled temporal lobe epilepsy. Histologic examination of the brain revealed bilateral hippocampal alterations, including hypergyration and broadening of the dentate gyrus associated with hippocampal sclerosis and an intraventricular meningioma near the hippocampal region. The findings in the dentate gyrus were interpreted as a congenital malformation; however, it could not be ruled out that the alterations were induced by the seizures. Similar changes of the dentate gyrus have not been previously described in cats.
Collapse
Affiliation(s)
- A Klang
- Institute of Pathology and Forensic Veterinary Medicine, Department for Pathobiology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - D Thaller
- Institute of Pathology and Forensic Veterinary Medicine, Department for Pathobiology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - P Schmidt
- Institute of Pathology and Forensic Veterinary Medicine, Department for Pathobiology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - G G Kovacs
- Institute of Neurology, Medical University of Vienna, Vienna, Austria
| | - P Halasz
- National Institute of Neuroscience, Budapest, Hungary
| | - A Pakozdy
- University Clinic for Small Animals, Department for Companion Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
| |
Collapse
|
4
|
Pakozdy A, Angerer C, Klang A, König EH, Probst A. Gyration of the Feline Brain: Localization, Terminology and Variability. Anat Histol Embryol 2014; 44:422-7. [DOI: 10.1111/ahe.12153] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 08/11/2014] [Accepted: 09/14/2014] [Indexed: 11/30/2022]
Affiliation(s)
- A. Pakozdy
- University Clinic of Small Animals; University of Veterinary Medicine Vienna; Austria
| | - C. Angerer
- University Clinic of Small Animals; University of Veterinary Medicine Vienna; Austria
| | - A. Klang
- Institute of Pathology and Forensic Veterinary Medicine; University of Veterinary Medicine Vienna; Austria
| | - E. H. König
- Institute of Anatomy Histology and Embryology; University of Veterinary Medicine Vienna; Austria
| | - A. Probst
- Institute of Anatomy Histology and Embryology; University of Veterinary Medicine Vienna; Austria
| |
Collapse
|
5
|
Abstract
The veterinary literature on epilepsy in cats is less extensive than that for dogs. The present review summarizes the most important human definitions related to epilepsy and discusses the difficulties in applying them in daily veterinary practice. Epileptic seizures can have a wide range of clinical signs and are not necessarily typical in all cases. Whether a seizure event is epileptic can only be suspected based on clinical, laboratory, and neuroimaging findings as electroencephalography diagnostic techniques have not yet been developed to a sufficiently accurate level in veterinary medicine. In addition, the present review aims to describe other diagnoses and nonepileptic conditions that might be mistaken for epileptic seizures. Seizures associated with hippocampal lesions are described and discussed extensively, as they seem to be a special entity only recognized in the past few years. Furthermore, we focus on clinical work‐up and on treatment that can be recommended based on the literature and summarize the limited data available relating to the outcome. Critical commentary is provided as most studies are based on very weak evidence.
Collapse
Affiliation(s)
- A Pakozdy
- University Clinic for Small Animals, Clinical Department for Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | | | | |
Collapse
|
6
|
Klang A, Kneissl S, Glaenzel R, Fuchs-Baumgartinger A. Fibrodysplasia Ossificans Progressiva in a Cat. J Comp Pathol 2014. [DOI: 10.1016/j.jcpa.2013.11.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
7
|
Shibly S, Klang A, Galler A, Schwendenwein I, Christian M, Guija A, Tichy A, Hirt RA. Architecture and inflammatory cell composition of the feline lung with special consideration of eosinophil counts. J Comp Pathol 2013; 150:408-15. [PMID: 24529513 DOI: 10.1016/j.jcpa.2013.12.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2013] [Revised: 10/10/2013] [Accepted: 12/16/2013] [Indexed: 01/21/2023]
Abstract
An increase in the number of eosinophils in bronchoalveolar lavage fluid (BALF) is a hallmark of feline asthma; however, a wide range in the percentage of eosinophils in BALF has been documented in healthy cats. In this study, BALF and lung tissue were collected from 15 cats without respiratory disease, BALF was taken from 15 cats with asthma and lung tissue was collected from six different asthmatic cats. Total nucleated cell count (TNCC) and inflammatory cell percentages were measured in BALF and lung tissue was evaluated microscopically. Asthmatic cats had a significantly higher eosinophil count in lung tissue, but BALF TNCC did not differ significantly between groups. Cats without respiratory signs had significantly more numerous macrophages and lymphocytes in BALF than asthmatics, but significantly lower percentages of eosinophils (4.2 ± 7.8% versus 49.4 ± 20.6%, P <0.001). In healthy feline airways a BALF eosinophil percentage of <5% can be expected. Dominant microscopical findings in feline asthma include high eosinophil counts, airway remodelling and inflammation. There is good correlation between the findings in BALF and tissue in feline asthma.
Collapse
Affiliation(s)
- S Shibly
- Department for Small Animals and Horses, Clinic of Internal Medicine and Infectious Diseases, University of Veterinary Medicine Vienna, A-1210 Vienna, Austria.
| | - A Klang
- Department for Pathobiology, Institute of Pathology and Forensic Veterinary Medicine, University of Veterinary Medicine Vienna, A-1210 Vienna, Austria
| | - A Galler
- Department for Small Animals and Horses, Clinic of Internal Medicine and Infectious Diseases, University of Veterinary Medicine Vienna, A-1210 Vienna, Austria
| | - I Schwendenwein
- Department for Pathobiology, Central Diagnostic Unit, University of Veterinary Medicine Vienna, A-1210 Vienna, Austria
| | - M Christian
- Department for Pathobiology, Central Diagnostic Unit, University of Veterinary Medicine Vienna, A-1210 Vienna, Austria
| | - A Guija
- Department for Pathobiology, Central Diagnostic Unit, University of Veterinary Medicine Vienna, A-1210 Vienna, Austria
| | - A Tichy
- Department of Biomedical Sciences, Platform of Biostatistics, University of Veterinary Medicine Vienna, A-1210 Vienna, Austria
| | - R A Hirt
- Department for Small Animals and Horses, Clinic of Internal Medicine and Infectious Diseases, University of Veterinary Medicine Vienna, A-1210 Vienna, Austria
| |
Collapse
|
8
|
Pakozdy A, Thaller D, Gumpenberger M, Leschnik M, Galler A, Shibly S, Klang A. Concurrent bilateral temporal lobe pathology and unilateral oligodendroglioma in a dog with status epilepticus. J Small Anim Pract 2013; 54:112-3. [PMID: 23298327 DOI: 10.1111/jsap.12006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
9
|
Klang A, Högler S, Osuchowski M, Weixelbaumer K, Tichy A, Schmidt P. Pathohistological and Immunohistochemical Examinations of Brains in Dying and Surviving Septic Mice. J Comp Pathol 2013. [DOI: 10.1016/j.jcpa.2012.11.202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
10
|
Pakozdy A, Halasz P, Klang A, Bauer J, Leschnik M, Tichy A, Thalhammer J, Lang B, Vincent A. Suspected Limbic Encephalitis and Seizure in Cats Associated with Voltage-Gated Potassium Channel (VGKC) Complex Antibody. J Vet Intern Med 2012; 27:212-4. [DOI: 10.1111/jvim.12026] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Revised: 09/26/2012] [Accepted: 10/24/2012] [Indexed: 01/17/2023] Open
Affiliation(s)
- A. Pakozdy
- Clinical Department for Companion Animals and Horses; Clinic for Small Animals Internal Medicine; University of Veterinary Medicine; Vienna Austria
| | - P. Halasz
- Institute of Experimental Medicine; Budapest Hungary
| | - A. Klang
- Institute of Pathology and Forensic Veterinary Medicine; University of Veterinary Medicine; Vienna Austria
| | - J. Bauer
- Department of Neuroimmunology; Center for Brain Research; Medical University of Vienna; Vienna Austria
| | - M. Leschnik
- Clinical Department for Companion Animals and Horses; Clinic for Small Animals Internal Medicine; University of Veterinary Medicine; Vienna Austria
| | - A. Tichy
- Plattform Bioinformatic and Biostatistics; University of Veterinary Medicine; Vienna Austria
| | - J.G. Thalhammer
- Clinical Department for Companion Animals and Horses; Clinic for Small Animals Internal Medicine; University of Veterinary Medicine; Vienna Austria
| | - B. Lang
- Department of Clinical Neurology; Weatherall Institute of Molecular Medicine; John Radcliffe Hospital; Oxford England
| | - A. Vincent
- Department of Clinical Neurology; Weatherall Institute of Molecular Medicine; John Radcliffe Hospital; Oxford England
| |
Collapse
|
11
|
Hassan J, Katic N, Klang A, Schwendenwein I, Böhler A, Künzel F. Treatment of nephroblastoma with polycythaemia by nephrectomy in a rabbit. Vet Rec 2012; 170:465. [DOI: 10.1136/vr.100614] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- J. Hassan
- Clinic for Diagnostic Imaging; Clinical Department for Small Animals and Horses
| | - N. Katic
- Clinic of Surgery and Ophthalmology; Clinical Department for Small Animals and Horses
| | - A. Klang
- Institute of Pathology and Forensic Medicine; Department of Pathobiology; University of Veterinary Medicine Vienna; Veterinärplatz 1 1210 Vienna Austria
| | - I. Schwendenwein
- Institute of Immunology: Laboratory medicine; Clinical Department for Small Animals and Horses
| | - A. Böhler
- Clinic for Diagnostic Imaging; Clinical Department for Small Animals and Horses
| | - F. Künzel
- Clinic of Internal Medicine and Infectious Diseases; Clinical Department for Small Animals and Horses
| |
Collapse
|