September 4th, 2023
An insight into Feline Limbic Encephalitis
Content provided from Vetstream's Vetlexicon Felis
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).
Cats with FEPSO will present with CPS consisting of facial twitching and staring, facial twitching; post-ictal signs include behavioral changes and aggression.
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: https://www.rvc.ac.uk/research/feline-encephalitis/testing.
If severe seizures are present, then management for status epilepticus or severe cluster seizures is appropriate.
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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