Web-Vet TM Neurology Specialists
Vestibular Epilepsy in a Dog
A 7-year-old Dachshund mix presented with episodes of 'rolling' and right-sided head tilt. The episodes would last 2-3 minutes and the dog was normal in between these events. The use of intravenous benzodiazepines seemed to stop the event. The dog was otherwise systemically healthy. Blood work, MRI, and CSF were all normal. The long-term use of levetiracetam was associated with a reduction of the frequency of these events although the owner did not want to stop the medication to see if this was unrelated to drug use.
In human medicine, vestibular epilepsy is described as focal seizures with signs of vestibular disease as the only or main symptoms and these signs can range from mild disequilibrium to dizziness and vertigo. Vestibular seizures have been described to be short duration, of a few seconds, with an abrupt ending - see video below. The events are electrophysiologically detectable at the level of the temporal and parietal lobes of the cerebral cortex but MRI of affected people has not revealed a structural cause. Importantly though these events need to be differentiated from the so-called vestibular paroxysmia which are "episodes of spinning or non‐spinning vertigo, lasting from seconds to minutes, which occur spontaneously or after changes in body position in the absence of other potential underlying differential diagnoses".
The paper in the link below describes 10 dogs with recurrent vestibular episodes, in terms of their clinical features, phenotypical manifestations, and outcome. Advanced imaging was normal in all cases and the CSF evaluated from 4 of the dogs was also considered normal. 5/10 dogs were Pugs!