15 - PNS I

Question 1

Idiopathic Facial Paralysis

Answer 1

Acute mononeuropathy of one (usually) or both facial nerves
-dogs > cats
Pathogen unk –> similar condition in people

Question 2

Idiopathic Facial Paralysis Who?

Answer 2

Middle-aged to older (>5)

Cocker spaniels

Question 3

Idiopathic Facial Paralysis CS

Answer 3

Reflect acute dysfunction of one or both facial N
–drooping of ears/lips
–deviation of the nasal philtrum toward N side
–Decreased to absent PLR/MR
–Excessive salivation on the affected side
Other signs:
–difficulty keeping food from dropping out of lips on affected sides
–Corneal ulc –> inadeq blinking, interrupt of PS I to lacrimal gland
–Peripheral vestibular syndrome

Question 4

Idiopathic Facial Paralysis Dx

Answer 4

Characteristic hx, clinical findings

R/O other causes of acute facial N dysfunction (otitis media/interna, hypoT - both of which Cockers are predisposed to)

Question 5

Idiopathic Facial Paralysis Prog

Answer 5

Guarded for complete return to function of the facial N
Full recovery may occur in weeks to months
–many cases, some degree of paralysis permanent

Question 6

Idiopathic Facial Paralysis Tx

Answer 6

Symptomatic
–Tears to prevent corneal drying
CS use controversial

Question 7

Which other cancer type is most commonly associated with paraneoplastic malignant neural sheath tumors?

Answer 7

Pancreatic insulinoma

Question 8

Trigeminal neuritis

Answer 8

Idiopathic, usually bilat dysfunction of CN 5
–Acute OS
Typical clinical course = older dog, presents for sudden onset of dropped jaw

Question 9

Trigeminal neuritis Tx

Answer 9

Self-limiting dz
Usually resolves on own within several weeks
Remember that dropped jaw can be a CS of Rabies so verify vax hx and wear gloves

Question 10

Idiopathic Polyradiculoneuritis

Answer 10

AKA coonhound paralysis
Similar to Guillain-Barre syndrome in people
Relatively common in dogs
Hx of raccoon exposure common but not always present or even possible –> suggests that raccoon saliva one of several triggers for develop of DO

Question 11

Idiopathic Polyradiculoneuritis CS

Answer 11

Rapidly progressing LMN dysfunction over 3-10d starting in the pelvic limbs then advanced to the FL
Loss of voice (dysphonia) = common
+/- resp paralysis
+/- facial weakness
Can typically still urinate and defecate normally
Will often eat if the head is supported
Not always overtly painful but often display hyperesthesia upon limb extension and paraspinal palp

Question 12

Idiopathic Polyradiculoneuritis Tx

Answer 12

Supportive

Some req ventilator to survive