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Topic:Retrospective Study

Retrospective studies in horses involve the analysis of pre-existing data to identify patterns, outcomes, and associations related to health and disease within equine populations. These studies utilize historical records, such as veterinary medical histories, treatment outcomes, and diagnostic results, to explore various aspects of equine health and management. Retrospective studies can provide insights into the prevalence of diseases, the effectiveness of treatments, and risk factors associated with certain conditions. This page aggregates peer-reviewed research studies and scholarly articles that focus on the methodologies, findings, and implications of retrospective analyses in equine veterinary science.
Hair cortisol level as a retrospective marker of hypothalamic-pituitary-adrenal axis activity in horse foals.
Veterinary journal (London, England : 1997)    May 23, 2012   Volume 194, Issue 1 131-132 doi: 10.1016/j.tvjl.2012.04.006
Comin A, Veronesi MC, Montillo M, Faustini M, Valentini S, Cairoli F, Prandi A.Stimulation of the hypothalamic-pituitary-adrenal (HPA) axis and elevated cortisol concentrations in fetal plasma are associated with foal maturity, viability and adaptation to independent life. However, non-invasive measurement of cortisol in hair samples has not yet been validated in horses. The current study developed a radioimmunoassay to analyse cortisol in horse hair and was used to measure cortisol hair concentration at birth and at 30 and 60 days of age as a retrospective study of HPA axis activity. Cortisol was detectable in the hair of foals from birth until 2 months, but decreased w...
Results of computed tomography in horses with ethmoid hematoma: 16 cases (1993-2005).
Journal of the American Veterinary Medical Association    May 23, 2012   Volume 240, Issue 11 1338-1344 doi: 10.2460/javma.240.11.1338
Textor JA, Puchalski SM, Affolter VK, MacDonald MH, Galuppo LD, Wisner ER.To determine whether CT provides unique information about the treatment or prognosis for horses with ethmoid hematoma (EH). Methods: Retrospective case series. Methods: 16 horses with EH. Methods: Horses with a diagnosis of EH that had undergone a diagnostic CT study were included. Clinical features, treatment, outcome, radiographic and CT images, and histologic specimens were reviewed. Results: CT provided new diagnostic information that affected treatment in 10 of 16 horses. Bilateral disease occurred in 8 of 16 horses and was undetected in 5 horses prior to CT. Paranasal sinus involvement o...
Parturition, dystocia and foal survival: a retrospective study of 1047 births.
Equine veterinary journal. Supplement    May 19, 2012   Issue 41 22-25 doi: 10.1111/j.2042-3306.2011.00476.x
McCue PM, Ferris RA.An understanding of the normal events of foaling, causes of dystocia and clinical outcomes is important for equine practitioners. Objective: The goals of the present study were to: 1) evaluate factors that influence gestation length; 2) report duration of Stage II labour; 3) determine the frequency of dystocia and premature placental separation; and 4) determine the relationship between problems at foaling and foal survival. Methods: Foaling records of 1047 mare births were evaluated. Results: The average gestation length was 342.7 days [corrected] +/- 0.4 days, with no effect of mare age or b...
The impact of birthweight on mare health and reproductive efficiency, and foal health and subsequent racing performance.
Equine veterinary journal. Supplement    May 19, 2012   Issue 41 26-29 doi: 10.1111/j.2042-3306.2011.00479.x
Whittaker S, Sullivan S, Auen S, Parkin TD, Marr CM.Although low birthweight is a risk factor for neonatal illness, the impact of high birthweight on the health of foals and mares, and on the foals' long-term athletic capability, is unknown. Objective: To investigate whether: 1) foals that are excessively heavy are associated with an increased prevalence of maternal illness in the first month post partum and reproductive dysfunction in the following season; 2) excessively light or heavy foals are at an increased risk of illness in the first month of life; and 3) birthweight is associated with racing success. Methods: Veterinary records from 230...
Equine subepithelial keratomycosis.
Veterinary ophthalmology    May 14, 2012   Volume 16, Issue 2 93-96 doi: 10.1111/j.1463-5224.2012.01031.x
Brooks DE, Plummer CE, Mangan BG, Ben-Shlomo G.To describe clinical findings in equine subepithelial keratomycosis (SEK). Methods: Retrospective medical records study. Methods: Medical records of horses that had subepithelial keratomycosis (SEK) at the University of Florida Veterinary Medical Center from 2007 to 2011 were reviewed. Methods: Data collected from the medical records included signalment, clinical descriptions of ocular lesions, diagnostic techniques, and therapeutic outcomes. Results: Twenty-one horses, consisting of three Quarter horse geldings, two Morgan geldings, one Morgan mare, two Arabian mares, three Arabian geldings, ...
Osmotic shock induces structural damage on equine spermatozoa plasmalemma and mitochondria.
Theriogenology    May 11, 2012   Volume 78, Issue 2 415-422 doi: 10.1016/j.theriogenology.2012.02.021
González-Fernández L, Morrell JM, Peña FJ, Macías-García B.The present study aimed to elucidate the effects that osmotic shock exerts on equine spermatozoa. To achieve this goal, a retrospective study of the cellular volume of 40 equine ejaculates subjected to osmolarities ranging from 75 to 900 mOsm in Biggers-Whitten-Whittingham (BWW) media was performed using a Multisizer3 Coulter Counter®. The 300 mOsm BWW solution was used as control. The sperm volume ranged between 37.93±0.6 (mean±Standard Error of the Mean (SEM)) in 75 mOsm BWW to 21.61±0.27 (mean±SEM) for 900 mOsm BWW. Thus the spermatozoa behaved as linear osmometers when adjusted to the...
Use of serial measurements of peritoneal fluid lactate concentration to identify strangulating intestinal lesions in referred horses with signs of colic.
Journal of the American Veterinary Medical Association    May 9, 2012   Volume 240, Issue 10 1208-1217 doi: 10.2460/javma.240.10.1208
Peloso JG, Cohen ND.To determine the value of serial measurements of peritoneal fluid lactate concentration (PFL) for detecting strangulating intestinal lesions (SLs) in referred horses with signs of colic. Methods: Retrospective cohort study. Methods: 94 horses with signs of colic. Methods: Medical records of horses evaluated between September 2006 and February 2010 because of signs of colic were reviewed. All included horses had ≥ 2 peritoneal fluid samples collected, including one at admission and another within 1 to 6 hours after admission. Of the 94 horses, 26 were assigned to the SL group on the basis of ...
Palatal sclerotherapy for the treatment of intermittent dorsal displacement of the soft palate in 51 standardbred racehorses.
The Canadian veterinary journal = La revue veterinaire canadienne    May 2, 2012   Volume 52, Issue 11 1203-1208 
Jean D, Picandet V, Céleste C, Macieira S, Cesarini C, Morisset S, Rossier Y, Marcoux M.This retrospective study evaluated the efficacy and side effects of palatal sclerotherapy in standardbred racehorses suspected to have intermittent dorsal displacement of the soft palate (IDDSP). Fifty-one horses were treated with multiple endoscopically guided injections of 3% sodium tetradecyl sulfate in the soft palate. Two groups were identified: those that had respiratory noises during exercise (n = 27) and those that did not (n = 24). Treatment was well-tolerated. Furthermore, horses significantly reduced their racing times for the last 400 m compared with their times before treatment an...
Rib fracture in a horse during an endurance race.
The Canadian veterinary journal = La revue veterinaire canadienne    May 2, 2012   Volume 52, Issue 11 1226-1227 
Trigo P, Muñoz A, Castejón F, Riber C, Hassel DM.We describe a fatal case, in which a horse suffered a fall and as a consequence, rib fractures. Diagnosis was made postmortem and the horse died without showing clear signs of respiratory dysfunction. The retrospective reports of injuries can be important to reduce these traumatic events and to avoid fatalities. Nous décrivons un cas mortel, chez un cheval ayant subi une chute qui a causé des fractures des côtes. Un diagnostic a été posé à l’autopsie et le cheval est mort sans avoir montré de symptômes évidents de troubles respiratoires. Les rapports rétrospectifs de blessures pe...
Arthroscopic approach to the subextensorius recess of the lateral femorotibial joint of the foal.
Veterinary surgery : VS    April 30, 2012   Volume 41, Issue 4 529-535 doi: 10.1111/j.1532-950X.2012.00963.x
Hennessy SE, Cudmore L, Jackson LP, Vasey JR, Russell T.To (1) develop an arthroscopic approach to the subextensorius recess of the lateral femorotibial (LFT) joint in foals and (2) report its use in foals with LFT joint sepsis. Methods: (1) Anatomic study and (2) retrospective case series. Methods: (1) Cadaveric hind limbs (n = 32 foals) to delineate the anatomy of the subextensorius recess; 13 foal limbs for cadaver surgery to assess the approach to the subextensorius recess; and (2) foals (n = 8) with LFT joint sepsis. Methods: (1) The LFT joint was distended and examined ultrasonographically. Dissection was used to document periarticular landma...
Interovulatory intervals in mares receiving deslorelin implants in Ireland (2009 to 2010).
The Veterinary record    April 25, 2012   Volume 170, Issue 21 541 doi: 10.1136/vr.100386
Henderson IS, Brama P, Osborne M, Beltman ME.Deslorelin acetate implants, recently licensed in Ireland and the UK for ovulation induction in mares, have been associated with prolonged interovulatory intervals in USA studies, leading to the practice of removing implants postovulation. Trial data in Australia indicate a less pronounced effect on interovulatory intervals, suggesting possible geographical variation. Objectives of the current study were to assess the effect of deslorelin implants, with and without removal on oestrous cycle length in Irish- and UK-based Thoroughbred broodmares. Data were collected retrospectively from 88 oestr...
[Diagnostic assessment of peritoneal fluid cytology in horses with abdominal neoplasia].
Tierarztliche Praxis. Ausgabe G, Grosstiere/Nutztiere    April 25, 2012   Volume 40, Issue 2 85-93 
Recknagel S, Nicke M, Schusser GF.To evaluate the diagnostic value of peritoneal fluid (PF) cytology for clinical diagnosis of abdominal neoplasia in horses. Methods: Ten horses with histopathologically confirmed abdominal neoplasia, in which a PF analysis was performed, were included in this retrospective study. PF was analyzed for total protein concentration and a nucleated cell count was performed. Using cytological criteria of malignancy, the PF samples were evaluated regarding their probability of malignancy. Results: Cytologic classification of cells according to criteria of malignancy allowed a positive cytologic diagno...
Diagnostic frequency, response to therapy, and long-term prognosis among horses and ponies with pituitary par intermedia dysfunction, 1993-2004.
Journal of veterinary internal medicine    April 24, 2012   Volume 26, Issue 4 1027-1034 doi: 10.1111/j.1939-1676.2012.00932.x
Rohrbach BW, Stafford JR, Clermont RS, Reed SM, Schott HC, Andrews FM.Pituitary pars intermedia dysfunction (PPID) is common in older horses. Objective: To determine diagnosis frequency, prognostic factors, long-term survival, and owner satisfaction with treatment. Methods: Medical records from horses diagnosed with PPID, 1993-2004. Methods: A retrospective cohort design with data collected from the Veterinary Medical Data Base (VMDB) and a cohort of 3 VTHs. Proportional accessions, annual incidence, and demographics were compared for all accessions. During the same period, a subset of medical records (n = 44) was extracted and owners (n = 34) contacted to obtai...
Comparison of radiography, nuclear scintigraphy, and magnetic resonance imaging for detection of specific conditions of the distal tarsal bones of horses: 20 cases (2006-2010).
Journal of the American Veterinary Medical Association    April 21, 2012   Volume 240, Issue 9 1109-1114 doi: 10.2460/javma.240.9.1109
Daniel AJ, Judy CE, Rick MC, Saveraid TC, Herthel DJ.To describe pathological findings identified with MRI in the distal tarsal bones of horses with unilateral hind limb lameness attributable to tarsal pain and to compare the usefulness of MRI with that of radiography and nuclear scintigraphy in evaluation of this region. Methods: Retrospective case series. Methods: 20 lame horses. Methods: In all horses, MRI, radiography (4 standard projections), and nuclear scintigraphy of the tarsus had been performed. Horses were excluded if the results of all 3 imaging modalities were not available or if lameness was detected in more than 1 limb. Pathologic...
Retrospective study of 103 presumed cases of tick (Ixodes holocyclus) envenomation in the horse.
Australian veterinary journal    April 19, 2012   Volume 90, Issue 5 175-180 doi: 10.1111/j.1751-0813.2012.00916.x
Ruppin M, Sullivan S, Condon F, Perkins N, Lee L, Jeffcott LB, Dart AJ.  Review 103 cases of presumed tick envenomation in horses. Methods:   Retrospective study. Methods:   Variables, including date of presentation, age, breed, weight, presence of ticks, gait and respiration scores, duration of recumbency, treatment, outcome and complications were recorded. A series of univariable screening tests were performed and used in a multivariable logistic regression model. Results:   There were a total of 103 cases affecting 10 breeds, aged between 1 week and 18 years of age. Horses >6 months old and weighing >100 kg had a higher odds of death than those...
Extraocular lymphoma in the horse.
Veterinary ophthalmology    April 13, 2012   Volume 16, Issue 1 35-42 doi: 10.1111/j.1463-5224.2012.01016.x
Schnoke AT, Brooks DE, Wilkie DA, Dwyer AE, Matthews AG, Gilger BC, Hendrix DV, Pickett P, Grauwels M, Monroe C, Plummer CE.To describe the clinical findings and prognosis for extraocular lymphoma in the horse. Methods:   Retrospective medical records study of horses diagnosed with third eyelid, corneoscleral, conjunctival, and/or eyelid lymphoma from multiple academic and private veterinary institutions. Data collected from the medical records included signalment, clinical descriptions of the extraocular lesions, treatment, and treatment outcomes. Nonparametric statistical analysis was performed with Fischer's exact tests. Results:   Extraocular lymphoma involving the eyelid, third eyelid, cornea, sclera, and/...
Local anesthesia and hydro-distension to facilitate cystic calculus removal in horses.
Veterinary surgery : VS    March 29, 2012   Volume 41, Issue 5 638-642 doi: 10.1111/j.1532-950X.2012.00986.x
Russell T, Pollock PJ.To report a technique for improving surgical access to the bladder for removal of cystic calculi in male horses. Methods: Retrospective case series. Methods: Geldings (8) with cystic calculi. Methods: After catheterization of the bladder through the penis, 100 mL 2% lidocaine hydrochloride solution was instilled. After 10 minutes, the bladder was distended with sterile, warmed Hartmann's solution to a pressure of ≈ 40 cm H(2) O, using gravity feed. This was left in place until abdominal access was gained at surgery, then the fluid siphoned off via the catheter. Results: Calculi were 3-11 cm ...
Frequency distributions of 174 fractures of the distal condyles of the third metacarpal and metatarsal bones in 167 Thoroughbred racehorses (1999-2009).
Equine veterinary journal    March 12, 2012   Volume 44, Issue 6 707-713 doi: 10.1111/j.2042-3306.2012.00558.x
Jacklin BD, Wright IM.Although fractures of the metacarpal and metatarsal condyles are the most common long-bone fractures of Thoroughbred horses in training, limited data on variations in morphology and incidence have been published. Additionally, grouped analyses of previous studies from the UK and USA would permit comparison between study groups and the creation of a substantial pool of international data. Methods: Retrospective analysis of case records of horses with fractures of the distal condyles of third metacarpal/metatarsal bones seen over the last 10 years at Newmarket Equine Hospital. The current series...
Salmonella enterica shedding in hospitalized horses and associations with diarrhea occurrence among their stablemates and gastrointestinal-related illness or death following discharge.
Journal of the American Veterinary Medical Association    March 3, 2012   Volume 240, Issue 6 726-733 doi: 10.2460/javma.240.6.726
Hartnack AK, Van Metre DC, Morley PS.To evaluate the potential association between Salmonella enterica shedding in hospitalized horses and the risk of diarrhea among stablemates, and to characterize gastrointestinal-related illness and death following discharge among horses that shed S. enterica while hospitalized. Methods: Retrospective cohort study [corrected]. Methods: 221 horses (59 that shed S. enterica during hospitalization and 162 that tested negative for S. enterica shedding ≥ 3 times during hospitalization). Methods: Information from medical records (signalment, results of microbial culture of fecal samples, clinical ...
Association of clinical signs with endoscopic findings in horses with nasopharyngeal cicatrix syndrome: 118 cases (2003-2008).
Journal of the American Veterinary Medical Association    March 3, 2012   Volume 240, Issue 6 734-739 doi: 10.2460/javma.240.6.734
Norman TE, Chaffin MK, Bisset WT, Thompson JA.To characterize the associations between clinical signs of nasopharyngeal cicatrix syndrome (NCS) and endoscopic findings in horses. Methods: Retrospective, case-control study. Methods: 239 horses (118 case horses and 121 control horses). Methods: Medical records of horses that had an endoscopic evaluation of the upper airway performed between January 2003 and December 2008 were reviewed. Clinical signs and the appearance and anatomic locations of lesions identified during endoscopic evaluation were reviewed and recorded for each horse. The associations between clinical signs and endoscopic fi...
Exostoses on the palmar or plantar aspect of the diaphysis of the third metacarpal or metatarsal bone in horses: 16 cases (2001-2010).
Journal of the American Veterinary Medical Association    March 3, 2012   Volume 240, Issue 6 740-747 doi: 10.2460/javma.240.6.740
Bertoni L, Forresu D, Coudry V, Audigie F, Denoix JM.To characterize the clinical features, diagnostic procedures, treatment, and outcome for horses with an exostosis on the palmar or plantar cortex of the third metacarpal bone (MC3) or third metatarsal bone (MT3). Methods: Retrospective case series. Methods: 16 horses. Methods: Records from 2001 through 2010 were evaluated to identify horses with radiographic and ultrasonographic evidence of an exostosis on an MC3 or MT3. Signalment, history, lameness examination results, diagnostic imaging results, surgical and histopathologic findings, treatment, and outcome were evaluated. Results: 9 horses ...
Beta-hemolytic Streptococcus spp. from horses: a retrospective study (2000-2010). Erol E, Locke SJ, Donahoe JK, Mackin MA, Carter CN.The goal of this retrospective study was to have a comprehensive picture of the β-hemolytic streptococci of horses including tissue/organ distributions and susceptibility patterns against specific antimicrobials between January 1, 2000 and December 31, 2010. A total of 2,497 β-hemolytic streptococci were isolated from 2,391 cases, of which Streptococcus equi subsp. zooepidemicus was the most frequent isolate (72.0%). Other species isolated were Streptococcus dysgalactia subsp. equisimilis (21.3%), Streptococcus equi subsp. equi (5.8%), and unidentified β-hemolytic streptococci (0.9%). As ex...
Equine keratomycosis in Japan.
Veterinary ophthalmology    February 28, 2012   Volume 16, Issue 1 1-9 doi: 10.1111/j.1463-5224.2012.01004.x
Wada S, Hobo S, Ode H, Niwa H, Moriyama H.To describe the incidence, clinical progress, visual outcome, and laboratory findings of equine keratomycosis in Japan. Methods:  Retrospective study of the medical records of horses clinically and mycologically diagnosed with keratomycosis at the Equine Hospitals of the Japan Racing Association from 2005 to 2011. Results: The diagnosis of keratomycosis was confirmed in eight horses (40.0% of the 20 horses with infectious keratitis from which fungi and/or bacteria were isolated). Fungi recovered from corneal swabs were identified as Aspergillus flavus (4), Aspergillus niger (1), Fusarium sol...
Risk factors for superficial digital flexor tendinopathy in Thoroughbred racehorses in hurdle starts in the UK (2001-2009).
Equine veterinary journal    February 28, 2012   Volume 44, Issue 5 564-569 doi: 10.1111/j.2042-3306.2012.00552.x
Reardon RJ, Boden LA, Mellor DJ, Love S, Newton JR, Stirk AJ, Parkin TD.Superficial digital flexor (SDF) tendinopathy is a common injury in Thoroughbred horses racing over hurdles. Identification of risk factors may allow the introduction of measures to minimise the incidence of this injury. Objective: To identify risk factors for SDF tendinopathy in Thoroughbred horses in hurdle races in the UK. Methods: Potential risk factors for SDF tendinopathy were studied between 1 January 2001 and 31 December 2009 using a retrospective cohort study design with 1031 case starts and 168,637 control starts. Potential risk factors were screened using univariable logistic regres...
Meningitis and meningoencephalomyelitis in horses: 28 cases (1985-2010).
Journal of the American Veterinary Medical Association    February 16, 2012   Volume 240, Issue 5 580-587 doi: 10.2460/javma.240.5.580
Toth B, Aleman M, Nogradi N, Madigan JE.To describe clinical and clinicopathologic findings and outcome of horses with meningitis and meningoencephalomyelitis. Methods: Retrospective case series. Methods: 28 horses. Methods: Medical records of horses admitted to the hospital during a 25-year period were reviewed. Horses with a definitive diagnosis of meningitis or meningoencephalomyelitis were included in this study. Information extracted from the medical records included signalment, history, reason for admission, clinical signs, results of clinicopathologic testing and diagnostic procedures, treatment, outcome, and necropsy finding...
The association of 2-year-old training milestones with career length and racing success in a sample of Thoroughbred horses in New Zealand.
Equine veterinary journal    February 10, 2012   Volume 45, Issue 1 20-24 doi: 10.1111/j.2042-3306.2011.00534.x
Tanner JC, Rogers CW, Firth EC.There is increasing evidence that exercise early in life has a positive effect on musculoskeletal health. At present, there is little whole population research investigating the effect of racing as 2-year-olds on future racing career. Objective: To investigate the association between attaining training milestones as 2-year-olds with length of career and racing success in Thoroughbred horses in New Zealand. Methods: Retrospective data were obtained of the 2001/02-born Thoroughbred foal crop. The 3 training milestones were: registered with a trainer, trialled and raced. The association of the tr...
The first nosocomial outbreak of methicillin-resistant Staphylococcus aureus in horses in Sweden.
Acta veterinaria Scandinavica    February 8, 2012   Volume 54, Issue 1 11 doi: 10.1186/1751-0147-54-11
Bergström K, Aspan A, Landén A, Johnston C, Grönlund-Andersson U.Methicillin-resistant Staphylococcus aureus (MRSA) in animals is a rare finding in Sweden. In horses, MRSA was first detected in a screening survey in 2007. In 2008, six clinical cases occurred in an equine hospital, indicating an outbreak. Methods: All MRSA isolates detected, 11 spa-type t011 and one t064 (n = 12), in infected horses (n = 10) and screening of horses (n = 2) in Sweden from December 2007 to March 2010 were retrospectively analysed with pulsed-field gel electrophoresis (PFGE) using Cfr9I and ApaI restriction enzymes, to study relationship between the isolates. Medical records of...
Transection of the lateral and long digital extensor tendons in racehorses.
Australian veterinary journal    January 20, 2012   Volume 90, Issue 1-2 20-23 doi: 10.1111/j.1751-0813.2011.00871.x
Elliott CR, Vasey JR, Russell TM.To report on the outcome of wounds to the hindlimb of racehorses, and horses with the intended use of racing, where both the long digital extensor (LoDE) and lateral digital extensor (LaDE) tendons had been completely transected. Methods: Retrospective case series. Methods: Records of all horses admitted with hindlimb lacerations between 2002 and 2009 were examined for cases where both the LoDE and LaDE tendons in the hindlimb had been severed, and specifically in horses intended to be used for racing. Outcome was assessed via retrieval of race records and via telephone questioning of the owne...
Osteomyelitis of the patella in eight foals.
Veterinary surgery : VS    January 6, 2012   Volume 41, Issue 2 307-315 doi: 10.1111/j.1532-950X.2011.00937.x
Kay AT, Hunt RJ, Rodgerson DH, Spirito MA, Santschi EM, Payne RJ.To describe the characteristics of osteomyelitis lesions of the patella and to report short- and long-term outcome after treatment in 8 foals. Methods: Retrospective case series. Methods: Foals (n = 8). Methods: Medical records (2003-2007) and radiographs of foals that had osteomyelitis of the patella were reviewed. Inclusion criteria included clinical, radiographic, and surgical findings consistent with osteomyelitis of the patella, and a long-term follow-up of >15 months. Information acquired included signalment, hematologic and serum biochemical profile results, clinical and radiographic si...
Epilepsy in horses: aetiological classification and predictive factors.
Equine veterinary journal    December 14, 2011   Volume 44, Issue 6 646-651 doi: 10.1111/j.2042-3306.2011.00527.x
Lacombe VA, Mayes M, Mosseri S, Reed SM, Fenner WR, Ou HT.In contrast with reports in man and small animals, a systematic classification of seizures in horses is lacking. Objective: The purpose of this study was to classify seizures based on their aetiology and to characterise epilepsy in 104 horses presented for seizures at the Ohio State University Veterinary Medical Center between 1988 and 2009. Methods: In a retrospective observational study, seizures were classified by aetiology based on history, clinical observations, diagnostic investigations (e.g. electroencephalograms, cerebrospinal fluid and computed tomography imaging of the head) and post...
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