Electroencephalography: electrode arrays in dogs

Electroencephalography (EEG) is the gold standard for confirming epileptic seizures in both human and veterinary patients. Despite idiopathic epilepsy being one of the most common neurological conditions in dogs, our understanding of it in veterinary medicine lags that in human medicine. The relative underuse of EEG in dogs with seizures has potential causes including practical issues, financial concerns, lack of training/equipment, and questions of clinical value. This technological underuse may lead to, or result from, major gaps in our understanding of EEG in veterinary patients. This underutilization of EEG is of significant clinical relevance because the diagnosis of specific epilepsy syndromes in humans guides the treatment, namely pharmacological, dietary, or surgical. These epilepsy syndromes are diagnosed based on several factors, one of which is the characteristic electrical brain activity on EEG. The aim of this narrative literature review was to highlight the study of cortical brain activity to improve our understanding of EEG in veterinary medicine. Specifically, the utility of EEG with focus on the existing proposed electrode arrays and their current supporting evidence. A recent survey study confirmed that a variety of canine EEG protocols are concurrently in use, including diverse electrode arrays. By comparison, in humans there is a standardized 10-20 electrode array, with average localization error of 13-17 mm depending on the number of placed electrodes on the scalp. We offer a review of the factors that would contribute to the ideal canine EEG electrode array highlighting areas for improvement and future validation. This proposed level of understanding will facilitate the identification of cortical seizure foci with a known degree of error, paving the way for non-pharmaceutical interventions like epilepsy surgeries.