Feline limbic encephalitis or feline complex partial cluster seizure with orofacial involvement (FEPSO) is a suspected immune-mediated condition of geriatric cats.
In people, limbic encephalitis is associated with the production of serum antibodies against voltage-gated potassium channel complexes (VGKC-complexes) resulting in an acute epileptic condition.
In a study of 14 cats suffering distinctive complex partial cluster seizures (CPS), consisting of facial twitching and staring, 5/14 cats had VGKC-complex antibodies and 4/14 cats had leucine-rich glioma-inactivated 1 (LGI1)-antibodies (Pakozdy et al., 2013).
Clinical signs
Cats with FEPSO will present with CPS consisting of facial twitching and staring, facial twitching; post-ictal signs include behavioral changes and aggression.
Diagnosis
MRI may reveal hyperintensities within the hippocampus and serology can reveal increased antibody concentrations to voltage-gated potassium channel (VGKC)-complexes. A test is available via the Royal Veterinary College International Feline Encephalitis Study Group Laboratory.
Treatment
If severe seizures are present, then management for status epilepticus or severe cluster seizures is appropriate.
Prognosis
The long-term outcome for LGI1-antibody positive cats is highly variable. Many respond well to treatment and have a good long-term outcome, but resistant cases also occur in which seizure activity persists despite medication. If a positive response to treatment is seen in the first month following diagnosis, the long-term outcome is typically good and seizure freedom can frequently be achieved.
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