Although the immature brain reportedly is more prone to seizure activity than the mature brain, there are no previous reports on well-defined juvenile epilepsy syndromes in dogs. This study describes a novel juvenile epilepsy syndrome in Lagotto Romagnolo (LR) dogs, namely benign familial juvenile epilepsy (BFJE).
We studied the clinical characteristics of this novel syndrome in 25 affected dogs, while healthy littermates of the affected dogs served as controls. The mean age at onset of focal seizures is 6 weeks, and spontaneous remission of seizures usually occurs by the age of 4 months. Between the seizure episodes, most of the affected puppies are neurologically normal, but puppies with the most severe seizure episodes exhibit some neurological deficits interictally. These deficits also resolve with remission of seizures. Interictal electroencephalography (EEG) shows focal abnormalities, including sharp waves and spikes, in most (88%) of the affected dogs.
Conventional imaging examinations, including magnetic resonance imaging (MRI), show no remarkable focal abnormalities in dogs with BFJE. Positron emission tomography (PET) is a nuclear neuroimaging modality that is able to detect abnormal metabolism in the epileptic focus of the brain. We investigated glucose metabolism of the brain in 6 affected and 5 control dogs using radiolabeled glucose, namely 2-[18F]fluoro-2-deoxy-D-glucose (FDG), as a tracer. In dogs with BFJE, FDG-PET shows areas of hypometabolism with good correspondence to focal EEG findings, thus supporting the area of abnormal metabolism being the epileptic zone. Furthermore, we performed a follow-up study by utilizing two previously validated questionnaires on impulsivity and activity levels in dogs, and additionally, we telephone-interviewed the owners of the affected dogs. We evaluated the results based on the data collected for 25 dogs with a history of BFJE and 91 control dogs. We utilized principal component analysis to explore the factorial structure of the questionnaire. Although the life span of affected dogs seems to be comparable with that of healthy control dogs and recurrence of seizures after remission is rare, the dogs with a history of BFJE exhibit abnormalities in behavior reminiscent of attention deficit hyperactivity disorder (ADHD) in humans.
This study also reveals the mode of inheritance and the genetic defect behind BFJE. Based on pedigree analysis, we found that BFJE is inherited in a recessive Mendelian form. We further found that a mutation in the gene encoding for protein LGI2 is responsible for BFJE. LGI2, as well as LGI1, interacts with neuronal membrane proteins, namely ADAM22 and ADAM23, in synaptic transmission. LGI1, ADAM22, and ADAM23 have previously been shown to be important in the development of epilepsy, and this study reveals the importance of LGI2 in epileptogenesis of BFJE.