犬顽固性癫痫持续状态的诊治  

Diagnosis and Treatment of Refractory Status Epilepticus in a Dog

作　　者：李莹莹[1] 倪浩然 周雪影 LI Yingying;NI Haoran;ZHOU Xueying(College of Veterinary Medicine,China Agricultural University,Beijing 100193,China)

机构地区：[1]中国农业大学动物医学院,北京海淀100193

出　　处：《中国兽医杂志》2024年第4期133-137,共5页Chinese Journal of Veterinary Medicine

摘　　要：顽固性癫痫是一种涉及获得性和遗传性的多因素疾病。本院接诊了1例有3~4年癫痫病史的5岁雄性贵宾犬,经他院治疗无效后,来本院治疗。该患犬来院时呈癫痫持续状态,初步检查后,静脉注射咪达唑仑治疗效果不明显,继而静脉注射丙泊酚以控制癫痫发作。经实验室检查,提示患犬肝细胞受损、胆汁淤积、肾前性氮质血症、呼吸性酸中毒、消化道出血和慢性胰腺炎。治疗以调整苯巴比妥用药方案,控制癫痫发作和维持血药浓度为主,纠正癫痫持续状态导致的机体电解质紊乱;同时兼顾治疗患犬慢性胰腺炎、腹膜炎和异物导致的肠炎,调整其体况,避免再次诱发癫痫。住院治疗8 d后,患犬明显好转,期间癫痫未发作。1个月后复查,该犬状态良好。本文通过对该病例的病史、诊断和治疗过程进行总结、分析,以期为国内兽医诊治该类疾病提供参考。Refractory epilepsy is a multifactorial disease involving both acquired and genetic factors.This report presents the case of a 5-year-old male Poodle with a 3-to 4-year history of epilepsy.After ineffective treatment at another clinic,the dog was brought to our clinic while in status epilepticus.Initial examination revealed little response to intravenous administration of midazolam,and subsequently,propofol was administered intravenously to control the seizures.Laboratory investigations revealed hepatocellular damage,bile stasis,prerenal azotemia,respiratory acidosis,gastrointestinal bleeding,and chronic pancreatitis in the affected dog.The treatment focused on adjusting the phenobarbital regimen to control seizures and maintain therapeutic blood levels,correcting electrolyte imbalances resulting from status epilepticus,and simultaneously addressing chronic pancreatitis,peritonitis,and enteritis caused by foreign bodies.After 8 days of hospitalization,the dog showed significant improvement with no seizures during that period.One month later,a follow-up examination indicated the dog was in good condition.This case report summarizes and analyzes the history,diagnosis,and treatment process,aiming to provide insights for the diagnosis and treatment of similar conditions in veterinary medicine.

关 键 词：犬 顽固性癫痫 癫痫持续状态 临床诊断 治疗 

分 类 号：S858.292[农业科学—临床兽医学]