6: Cerebellar Patient

Question 1

Clinical signs of cerebellar disease:

Answer 1

Intention tremor, hypermetria, increased muscle tone, titubation, vestibular signs

Question 2

Paradoxical Vestibular Disease:

Answer 2

Head tilt CONTRALATERAL to lesion
Postural reaction deficits IPSILATERAL to lesion
Lesion in vestibular portion of cerebellum

Question 3

Signalment of cerebellar cortical abiotrophy:

Answer 3

4-6yo staffies

Question 4

Diagnosis of cerebellar cortical abiotrophy:

Answer 4

Atrophy visible grossly & on MRI
Histopath- loss of purkinje neurons and thinning of all layers

Question 5

Pathophys of Cerebellar cortical atrophy:

Answer 5

Degeneration of normal neuronal cell populations after birth
Slow progression

Question 6

Pathophysiology of Chiari malformation:

Answer 6

Caudal occipital malformation syndrome
Herniation of cerebellum through foramen magnum, kinking of medulla, disruption of CSF flow

Question 7

Treatment for chiari malformation:

Answer 7

Gabapentin or pregabalin for pain
Prednisone for refractory cases
foramen magnum decompression

Question 8

Primary brain tumors that can cause cerebellar signs:

Answer 8

Meningioma, glioma, choroid plexus tumor, medulloblastomas, dermoid cysts

Question 9

Secondary brain tumors that can cause cerebellar signs:

Answer 9

Adenosarcoma: mammary, prostatic, pulmonary, pancreatic
Hemangiosarcoma
Lymphosarcoma

Question 10

Viral etiologies of cerebellar disease:

Answer 10

Panleuk
Canine Herpes Virus
Distemper

Question 11

Canine herpesvirus presentation:

Answer 11

cerebellar signs
often <2weeks old
High fatality rate
surviving puppies often have retinal dysplasia

Question 12

Neuro Pathophys of canine herpes virus

Answer 12

Perinatal infection causes cerebellar hypoplasia

Question 13

Canine distemper virus in young animals:

Answer 13

polioencephalomyelopathy (grey matter disease)
Hx of seizures
Rarely survive

Question 14

Canine distemper in older animals:

Answer 14

Leukoencephalimyelopathy (white matter disease)
brain stem, cerebellar, vestibular signs
often results in myoclonus

Question 15

Non-viral infectious etiologies of cerebellar disease:

Answer 15

Fungal: crypto, blasto, coccidioides
Rickettsia: RMSF (rip chris), ehrlichia
Protozoa: toxo, neospora
Algae

Question 16

Granulomatous Meningoencephalomyelitis presentation:

Answer 16

Rare to affect just cerebellum; multifocal signs common
Higher incidence in females

Question 17

Granulomatous Meningoencephalomyelitis histopath:

Answer 17

perivascular cuffing

Question 18

Corticosteroid responsive tremor syndrome:

Answer 18

Little white dogs
Inflammatory, non-infectious
Acute & severe onset
generally responds to immunosuppression

Question 19

Cerebellar Infarction:

Answer 19

peracute onset
(debated) most common location for intracranial infarction
R/o underlying cause
prog based on underlying cause