Diagnostik der Epilepsie – Möglichkeiten der Magnetresonanztomografie

Zusammenfassung

Epilepsie ist eine neurologische Erkrankung, die dem Kleintierpraktiker im klinischen Alltag häufig begegnet. Die Erkrankung umfasst eine Vielzahl klinischer Ausprägungen und Ätiologien und die klinische Aufarbeitung bedarf in vielen Fällen einer kostenaufwendigen und umfangreichen Diagnostik. Diese ist notwendig, um eine metabolische Ursache für die Krampfanfälle festzustellen oder auszuschließen bzw. zwischen idiopathischer und struktureller Epilepsie unterscheiden zu können. Für die Klassifikation der Epilepsie ist die Untersuchung mittels Magnetresonanztomografie (MRT) ein zentraler Bestandteil der Diagnosefindung, die sich entscheidend auf Therapie und Prognose auswirkt. Die Standardisierung von MRT-Protokollen hat große Bedeutung, um eine einheitliche Untersuchung und vergleichbare Ergebnisse zu erzielen. Dies kann die Kommunikation und Interaktion zwischen klinischen Einrichtungen erleichtern und die Möglichkeit bieten, noch unerkannte strukturelle Veränderungen im MRT zu erfassen. Dieser Übersichtsartikel beschäftigt sich im Zentralen mit der Definition und Klassifikation der Epilepsie sowie der bildgebenden Diagnostik der Epilepsie beim Hund und nimmt Bezug auf Statistiken und Empfehlungen von Spezialisten zur klinischen Fallaufarbeitung.

Abstract

Epilepsy is a common neurologic disease frequently encountered by small animal practitioners. The disease comprises a multiplicity of clinical presentations and etiologies and often necessitates a comprehensive as well as cost-intensive diagnostic workup. This is mandatory in order to be able to diagnose or exclude a metabolic cause of the seizures and to distinguish between idiopathic and structural epilepsy. The examination by means of magnetic resonance imaging (MRI) represents a central component of the diagnostic workup, which in turn has essential effects on treatment and prognosis. In order to achieve standardized examination and comparable results, it is of utmost importance to use defined MRI protocols. Accordingly, communication and interaction between clinical institutions may be facilitated and as of yet undetected structural changes might be recorded in future MRI techniques. This review article sets particularly emphasis on the definition and classification of epilepsy as well as its diagnostic imaging procedures and refers to statistics and specialists’ recommendations for the diagnostic workup in dogs.

Schlüsselwörter

Strukturelle Epilepsie - idiopathische Epilepsie - Krampfanfälle - Bildgebung - Kleintiere

Key words

Structural epilepsy - idiopathic epilepsy - epileptic seizures - diagnostic imaging - small animals

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