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Neurology
Neuropathies
92
Veterinary Medicine
Professional
06/06/2012

Additional Veterinary Medicine Flashcards

 


 

Cards

Term
Optic neuritis
Definition
Inflammation of CN II
Term
Trigeminal neuritis
Definition

Bilateral inflammation of motor branches of CN-V

demylinantion

Term
Trigeminal neuritis
Definition

acute onset inability to close the jaw

facial sensation generally normal

Term
Trigeminal neuritis
Definition

Improvement will be seen within 2-3 weeks

If no improvement seen, may have missed lymphoma

Term
Masticatory myositis
Definition

inflammatory muscles of mastication

Pain in muscles

Difficulty opening the mouth

Term
Trigeminal nerve sheath tumors
Definition
Unilateral chronic progressive atrophy of masticatory muscles, decreased facial sensation
Term
Idiopathic facial n paralysis
Definition

Unilateral

droppy face, no palpebral reflex, manace reflex only with 3rd eyelid 

Term
Cavernous Sinus Syndrome
Definition
CN III, IV, V, VI defects
Term
Cavernous sinus
Definition

Blood filled space on either side of pituitary gland

Motor innervation to extraocular muscles

Term
Central blindness
Definition
No manace, no PLR
Term
Peripheral blindness
Definition

no manance

PLR present

Term
Peripheral Vestibular disease
Definition
DDx: Otitis media/interna, idopathic vestibular disease, ototoxic drugs cats- nasopharyngeal polyps
Term
Acute Canine Polyradiculoneuritis
Definition
Production of Ab against axons and myelin
Term
Acute Canine Polyradiculoneuritis
Definition

Ventral nerve roots develop most severe pathology

Dorsal nerve roots essentially spared

=

Severe paresis or plegia with preservation of pain sensation; hyperesthesia

Term
Acute Canine Polyradiculoneuritis
Definition

Initial stiff, stilted short strided gait

LMN tetraparesis/plegia, dysphonia

NO smooth muscle/autonomic involvement; CN normal

Fecal and urinary incontinence uncommon

No megaesophagus

Term
Acute Canine Polyradiculoneuritis
Definition
Lumbar CSF analysis: normal cell count but increased protein
Term
Acute Canine Polyradiculoneuritis
Definition

Tx: intensive physical therapy

NO STEROIDS

Term
Botulism
Definition
Cleaves SNAP-25, VAMP, and Syntaxin
Term
Botulism
Definition
Mild weakness-tetraplegia, dysphonia, megaesophagus, dysphagia, mydriasis, decreased PLR
Term
Tick Paralysis
Definition
Salivary neurotoxin causes disease
Term
Tick Paralysis
Definition
Interferes with the function of Ca2+ in the release of Ach from the axon terminal
Term
Tick Paralysis
Definition

Rapid onset

LMN paresis starting in pelvic limbs → recumbant in 24-72 hours

No cranial nerve involvement or megaesophagus

 

Term
Tick Paralysis
Definition

Response to Frontline

Recovers 24-72 hrs 

Do NOT use doxycyline

Term
Acquired myasthenia gravis
Definition

Muscular weakness and fatigability

Auto-antibody mediated destruction of Ach receptors at the NMJ

Term
Generalized MG
Definition

After activity-paresis in pelvic limbs

Regurgiation, drooling, eyelid and lip paresis

Megaesophagus

Spinal reflexes are generally normal

Term
Focal MG
Definition
Dysphagia, megaesophagus
Term
Fulminating MG
Definition

Suddent onset of megaesophagus and severe regurgitation

Rapidly progressive tetraparesis, loss of spinal reflexes

Term
Acquired MG
Definition

Tensilon response test

AchR autoantibody test

Term
Acquired MG
Definition

Tx: Anticholinesterase agents - Pyridostigmine, neostigmine

Immunosuppressive medications: corticosteroids, mycophenolate, cyclosporine, azathioprine

Broad spectrum antibiotics for aspiration pneumonia

Proton pump inhibitors for esophagitis

Term
Congenital MG
Definition
Defect in AchR- no autoimmune component
Term
Granulomatous meningoencephalomyelitis
Definition

Young/middle aged purebreed dogs

Acute

3 forms: focal, disseminated, ocular

Term
Granulomatous meningoencephalomyelitis
Definition
CSF: mononuclear pleocytosis, protein >100 mg/dL
Term
Granulomatous meningoencephalomyelitis
Definition
Angiocentric, white matter predilection, meningeal inflammation, swirling of WBCs around blood vessel
Term
Granulomatous meningoencephalomyelitis - focal
Definition
Chronic progression, focal mass/focal signs, mimics neoplasia (but it's NOT a tumor)
Term
Granulomatous meningoencephalomyelitis- disseminated
Definition

Most common form

acute

white matter predilection: cerebral, cerebellum, caudal brain stem, cervical cord

Term
Granulomatous meningoencephalomyelitis-ocular
Definition
acute blindness, mydriasis, papilledema, retinal hemorrhage, optic neuritis
Term
Necrotizing meningoencephalomyelitis
Definition
Young pugs, primarily forebrain, lymphocytic pleocytosis
Term
Necrotizing meningoencephalomyelitis
Definition
necrotizing gray and white matter, wide-spread meningeal infiltrates, malacia, necrosis, cavitation
Term
Necrotizing leukoencephalitis
Definition

Multifocal, necrotizing, nonsuppurative encephalitis

Yorkies- 4.5 years

Lesions in cerebrum and brainstem

Chronic, progressive, relapsing, remitting

Term
Necrotizing leukoencephalitis
Definition
Minimal meningeal invovlement
Term
Necrotizing leukoencephalitis
Definition

Deep white matter of the cerebrum, thalamus, and brainstem

Cavitation, necrotic axons, gliosis, gitter cells

 

Term
Necrotizing leukoencephalitis
Definition
Term
Central Vestibular Disease
Definition
DDx: Neoplasia,vascular events/"strokes", infectious/immune mediated disease
Term
Peripheral Vestibular Disease
Definition
Cranial nerve VII may be involved
Term
Peripheral Vestibular Disease
Definition
Horner's syndrome may be seen
Term
Peripheral Vestibular Disease
Definition
No postural reaction deficits
Term
Peripheral Vestibular Disease
Definition
Alert, may appear disoriented
Term
Central Vestibular Disease
Definition
Multiple nerves affected: V-XII
Term
Central Vestibular Disease
Definition
Do not see Horner's; often see postural reaction deficits
Term
Central Vestibular Disease 
Definition
May be depressed, surporous, or comatose
Term
Paradoxical vestibular syndrome
Definition
Head tilt is away from the lesion. postural deficits and other cranial nerve deficits ipsilateral to the lesion
Term
Paradoxical vestibular syndrome
Definition
Central lesion (ALWAYS) in caudal cerebellar peduncle or flocculonodular lobe of the cerebellum
Term
Otitis media/interna
Definition

Usually subacute/chronic. 

Peripheral vestibular dz

Term
Otitis media/interna
Definition
50% of peripheral vestibular disease
Term
Otitis media/interna
Definition
Tx: antibiotic therapy for 6-8 weeks
Term
idiopathic geriatric vestibular disease
Definition

Dogs > 8 years, cats (bilateral) of any age

acute/peracute onset of unilateral nonprogressive peripheral vestibular signs

No Horner's/facial n. deficits present

Term
idiopathic geriatric vestibular disease
Definition
associated with hypothyroidism in dogs 
Term
idiopathic geriatric vestibular disease
Definition

Tx: anti-emetics, seadtives, IV fluid support

Steroids do NOT improve recovery

Term
Bilateral peripheral vestibular disease
Definition

Cats >> dogs

No head tilts, no nystagmus, lack of normal physiologic nystagmus

Crouching posture, reluctance to walk

 

Term
Ototoxins
Definition
Aminoglycoside antibiotics
Term
Ototoxins
Definition
Furosemide
Term
Ototoxins
Definition
Ear cleansing compounds applied when tympanic membrane is ruptured
Term
Neoplasia
Definition

Chronic, progressive history (can be acute)

Often other cranial nerve signals

central vestibular disease

Term
Metronidazole toxicity
Definition

Antagonism of GABA in the CNS (Valium - speeds recovery)

Acute onset central vestibular sight +/- seizures (more common in cats) and other forebrain signs

 

Term
Ischemic stroke
Definition

occlusions of vessel

Thrombus/thromboembolism

Deprives tissue of oxygen and glucose

50% may be related to unrelated medical condition

Term
Hemorrhagic strokes
Definition

Rupture of vessel → bleeding into surrounding brain tissue → hematoma → compression of adjacent tissues leads to clinical signs (brainstem = vestibular signs)

rare in dogs

Term
Vascular event
Definition

acute onset, nonprogressive clinical signs

geriatric patients

clinical signs usually begin to improve in 24-72 hours

Term
Ischemic stroke
Definition
Dx: serial blood pressure monitoring, CBC/Chemistry, Urinalysis, UP/UC ratio if indicated, Endocrine testing for Cushing's, thyroid disease, echocardiogram
Term
Hemorrhagic Stroke
Definition
Dx: serial blood pressure monitoring, coagulation profile, buccal mucosal bleeding time, thoracic radiographs/abdominal ultrasounds 
Term
Ischemic stroke 
Definition
Tx: aspirin/Plavix
Term
Feline cerebellar hypoplasia
Definition

Perinatal infection causes destruction of external germinal layer prevents formation of granular layer

Nonprogressive

 

Term
Feline infectious peritonitis
Definition
Inflammation of choroid plexus and ependymal cells of the fourth ventricle produces cerebellar neurolgoical signs 
Term
Equine cerebellar abiotrophy
Definition
Autosomal recessive inherited disorder resulting in head and neck tremors followed by other cerebellar diseases
Term
Dandy-Walker syndrome
Definition

Congenital malformation 

Absence/hypoplasia of cerebellar vermis → concurrent hydrocephalus

cerebellar ataxia, tremors, absent menace at 3-4 months of age

nonprogressive

 

Term
Choroid plexus tumors
Definition
metastasize by "drop mets", nests of neoplastic cells drop in the CSF and circulate to other areas, primarily the spinal cord
Term
Medulloblastoma
Definition
Primitive neuroectodermal tumors. Arise from cells present during embryonic developement of the cerebellum
Term
Medulloblastoma
Definition

Affects younger animals

Cause compression of 4th ventricle and obstructive hydrocephalus

Term
Epidermoid/dermoid cysts
Definition
Embryological invaginations of neruoectoderm
Term
Epidermoid/dermoid cysts
Definition
Portions of neuroectoderm destined to become skin become trapped in the closing neural tube
Term
Epidermoid/dermoid cysts
Definition
Present at brith, but signs generally develop later in life (4.5 years old = mean)
Term
White Shakers
Definition
Idiopathic cerebellitis-immune mediated
Term
Chiari-like malformation and syringomyelia
Definition

Caudal occipital malformation syndrome

Congenital hypoplasia of the supraocipital bone→caudal fossa small compared to entire cranial cavity→cerebellar identation and heirniation→kinking of medulla→loss of dorsal subarachnoid space at the craniocervical jxn→dural/fibrous band and the craniocervical jxn→alterations in CSF flow out the foramen magnum

 

Term
Syringomyelia
Definition
developent of fluid containing cavities in the spinal cord parenchyma - accumulation of ECF from the microcirculation of CSF
Term
Chiari-like malformation and syringomyelia
Definition
Hyperesthesia/paresthesia, phantom scratching, scoliosis, tetraparesis, proprioceptive ataxia, cerebellar signs, cranial nerve deficits
Term
Chiari-like malformation and syringomyelia
Definition
Tx: suboccipital craniectomy, pain management, altertion in CSF production
Term
Congenital Hydrocephalus
Definition

Toy breed and brachycephalics predisposed

Clinical signs 3-12 mo of age

severe cases may be incidental finding 

sunset strabismus, seizures, abnormal behavior, mentation change

Often symmetrical: circling, central blindness, postural reactions deficits 

Term
Hydrocephalus
Definition

Tx: diuretics, mannitol in emergencies, proton pump inhibitors, corticosteroids

Insert a shunt surgically

Term
Quadrigeminal cistern cyst
Definition

Toy breed dogs

may progressively enlarge (signs develop in older animals) or be static - usually incidental

Generalized seizures-occipital cortex

Term
Hypoglycemic encephalopathy
Definition

sepsis, liver failure, insulin overdose, xylitol toxicity

weakness/lethargy and seizures

Term
Hepatic encephalopathy
Definition

<3 years old at diagnosis

low albumin, glucose, cholesterol and BUN

microcytic anemia; bile acids >100 post prandial

Term
Hepatic encephalopathy
Definition
obtunded mentation, visual deficits, head pressing, circling, siezure activity
Term
Hepatic encephalopathy
Definition

Elimination of gut derived toxins

Lactulose: lowers colon pH to prevent ammonia absorption

Antibiotics to redcuce colonic bacterial flora

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