title: Non-pharmacological treatment options for refractory epilepsy: an overview of human treatment modalities and their potential utility in dogs.
abstract: Refractory epilepsy is a common disorder both in humans and dogs and treatment protocols are difficult to optimise. In humans, different non-pharmacological treatment modalities currently available include surgery, the ketogenic diet and neurostimulation. Surgery leads to freedom from seizures in 50-75% of patients, but requires strict patient selection. The ketogenic diet is indicated in severe childhood epilepsies, but efficacy is limited and long-term compliance can be problematic. In the past decade, various types of neurostimulation have emerged as promising treatment modalities for humans with refractory epilepsy. Currently, none of these treatment options are used in routine daily clinical practice to treat dogs with the condition. Since many dogs with poorly controlled seizures do not survive, the search for alternative treatment options for canine refractory epilepsy should be prioritised. This review provides an overview of non-pharmacological treatment options for human refractory epilepsy. The current knowledge and limitations of these treatments in canine refractory epilepsy is also discussed.
authors.affiliation: Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Merelbeke 9820, Belgium. Electronic address: Valentine.Martle@UGent.be.
authors.forename: Valentine
authors.initials: V
authors.lastname: Martlé
authors.affiliation: Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Merelbeke 9820, Belgium.
authors.forename: Luc
authors.initials: L
authors.lastname: Van Ham
authors.affiliation: Laboratory for Clinical and Experimental Neurophysiology, Department of Neurology, Ghent University Hospital, Ghent 9000, Belgium.
authors.forename: Robrecht
authors.initials: R
authors.lastname: Raedt
authors.affiliation: Laboratory for Clinical and Experimental Neurophysiology, Department of Neurology, Ghent University Hospital, Ghent 9000, Belgium.
authors.forename: Kristl
authors.initials: K
authors.lastname: Vonck
authors.affiliation: Laboratory for Clinical and Experimental Neurophysiology, Department of Neurology, Ghent University Hospital, Ghent 9000, Belgium.
authors.forename: Paul
authors.initials: P
authors.lastname: Boon
authors.affiliation: Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Merelbeke 9820, Belgium.
authors.forename: Sofie
authors.initials: S
authors.lastname: Bhatti
mesh_terms: D000818:Animals; D055423:Diet, Ketogenic / Q000662:veterinary; D004283:Dog Diseases / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D004285:Dogs; D004827:Epilepsy / Q000178:diet therapy / Q000601:surgery / Q000628:therapy* / Q000662:veterinary*; D006801:Humans
keywords: Diet; Dog; Epilepsy surgery; Neurostimulation; Refractory epilepsy