5: Vestibular Patient Flashcards
Physiologic functions of the vestibulocochlear system:
Maintains posture & balance
detects acceleration & deceleration
Coordinates eye movement
Clinical signs of vestibular disease:
Abnormal posture
Vestibular ataxia
Strabismus
Nystagmus
Peripheral Vestibular Signs:
Alert-Disoriented
Head tilt ipsilateral to lesion
Vestibular ataxia
No postural reaction deficits
If any CN deficits it is CN VII or Horner’s syndrome
Horizontal or rotary nystagmus
Central vestibular signs:
Normal or abnormal mentation
Head tilt usually ipsilateral but sometimes contralateral to lesion
Vestibular ataxia +/- paresis
Postural deficits ipsilateral to lesion
Any CN deficits
Vertical nystagmus
Causes of peripheral vestibular disease:
Otitis media/interna
Inflammatory polyps
Aural neoplasia
Idiopathic vestibular disease
Toxicities
Causes of otitis media/interna:
P. aeruginosa, S. pseud, E. coli
PSOM, glue ear
Tx of otitis media/interna
Oral Abx
Myringotomy/TECA BO
Tx of inflammatory polyps:
Traction or bulla ostomy
Signalment for idiopathic vestibular disease
Adult cats, geriatric dogs, acute onset
Tx of Idiopathic vestibular disease:
Symptomatic tx
Spontaneous remission over 1-2 weeks
Mechanism of peripheral vestibular toxicities:
Damage to hair-cell receptors
toxicities that cause peripheral vestibular disease:
Abx (aminoglycosides, minocycline)
Furosemide (high dose long term)
Chemo, NSAIDS, others
Propylene glycol, chlorohexidine, etc
Causes of central vestibular disease:
Inflammatory
Hypothyroidism
Intracranial neoplasia
Thiamine deficiency
Toxicities
Vascular
Intracranial neoplasias that can cause vestibular disease:
Meningioma, choroid plexus tumor, ependymoma, lymphoma
Thiamine deficiencies in cats:
Central vestibular signs and seizures
Toxicities that may cause central vestibular disease:
Metronidazole (>60mg/kg/day)
Lead
