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RUSVM Small Animal Medicine I 2016 > Brain Conditions > Flashcards

Brain Conditions Flashcards

1
Q

What are the two types of vestibular disease?

A

Peripheral VD

Central VD

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2
Q

What are the common clinical signs of Vestibular disease

A

head tilt
circling
falling to the affected side
Nystagmus (slow phase to the affected side)

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3
Q

What are the clinical signs of peripheral VD?

A

NO CP deficits or paresis
No depression
Facial nerve paralysis and Horner’s maybe
Horizontal/rotary nystagmus

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4
Q

What is the cause of peripheral VD?

A

ear infection

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5
Q

What are the clinical signs of central VD?

A

Tetra or hemiparesis
Depression
other cranial nerves affected
Nystagmus - horizontal rotary and vertical can be elicited by head movement and eyes can move in different directions

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6
Q

What is the cause of central VD?

A 
Neoplasia 
Encephalitis
hypothyroidism 
metronidazole 
aminoglycoside toxicity 
RMSF
ehrlichia 
cryptococcus
blastomyces
toxoplasma 
neosporum 
thiamine deficiency 
GME
thromboembolism 
septic emboli
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7
Q

Feline Idiopathic vestibular disease

A

unknown etiology associated with circling and falling with spontaneous remission after 3-4 weeks

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8
Q

Canine geriatric vestibular disease

A

middle aged to older dogs with a permanent head tilt. There is no treatment

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9
Q

Congenital peripheral vestibular disease

A

delayed development of the sensory receptors sometimes causing deafness
Seen in GSD, beagles, Doberman, Siamese, and Burmese

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10
Q

Paradoxical Central Vestibular Syndrome

A

lesions of the cerebellum causing lack of inhibition of the vestibular nucleus on the side of the lesion causing head tilt, circling, and falling to the OPPOSITE side

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11
Q

Where would the proprioceptive deficits be located with Paradoxical Central Vestibular Syndrome

A

on the same side as the cerebellar lesion

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12
Q

Cerebellum

A

coordinates motor activity and help maintain equilibrium and control posture

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13
Q

Clinical signs of cerebellar disease

A

wide based stance
truncal ataxia
intention tremor
dysmetria

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14
Q

Dysmetria

A

condition of improper measuring of distance during movement

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15
Q

Hypermetria

A

over-reaching

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16
Q

hypometria

A

under-reaching

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17
Q

decerebellate rigidity

A

severe lesions of the cerebellum lead to extensor rigidity of neck muscles resulting in dorsiflexion of the neck with extension of the thoracic limbs and flexion of the pelvic limbs

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18
Q

Decerebrate rigidity

A

midbrain lesions that cause opisthotonus with extension of all 4 limbs

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19
Q

Shiff Sherrington Syndrome

A

rigid extension of the thoracic limbs with severe spinal cord injuries between T2 and L6/7 due to the damage of the nerve connecting the pelvic and thoracic limbs

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20
Q

What causes cerebellar hypoplasia in cats?

A

intrauterine infections with panleukopenia parvovirus

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21
Q

Clinical signs of cerebellar hypoplasia in cats

A

truncal ataxia
tremor
dysmetria

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22
Q

What is the treatment for cerebellar hypoplasia in cats

A

NO TREATMENT

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23
Q

What is responsible for cerebellar hypoplasia in dogs?

A

Parvovirus

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24
Q

Cerebellar abiotrophy

A

premature death of neurons due to disruption of the metabolic processes int he cells

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25
What viruses cause cerebellar infections?
Distemper Canine herpes FIP
26
What are the two types of cerebellum neoplasia?
Primary | Secondary
27
Common name for Corticosteroid responsive tremor syndrome
Shaker Dog Disease
28
Clinical signs of Corticosteroid responsive tremor syndrome (Shaker Dog Disease)
Tremors in all 4 limbs and head that get worse with exercise or excitement and resolve when the animal sleeps
29
Treatment of Corticosteroid responsive tremor syndrome (Shaker Dog Disease)
Glucocorticoids
30
What are other causes of tremors?
Fear Hypomyelination tremerogens (mycotoxins from old dairy food) Other toxins Orthostatic tremor : shivering while bearing weight head bobbing old dog hind limb tremors
31
Scotty Cramp (episodic muscle hypertonicity)
deficiency of serotonin inhibitory neurotransmitter and a prostaglandin abnormality
32
Clinical signs of Scotty Cramp (episodic muscle hypertonicity)
abduction of the thoracic limbs and then pelvic stiffness after exercise
33
Treatment of Scotty Cramp (episodic muscle hypertonicity)
Fluoxetine ("Prozac")
34
What breed has Episodic falling?
Cavalier King Charles Spaniels
35
Clinical signs of Episodic falling
pelvic and thoracic limb hypertonicity
36
Treatment of Episodic falling
Clonazepam
37
Depression
decreased responsiveness
38
Stupor
unresponsive and arousable with painful stimuli
39
Coma
unresponsive and unarousable
40
Hydrocephalus
dilation of the ventricular system in the brain due to impeded flow of CSF due to neoplasia, subarachoid hemorrhage or meningitis or excessive excretion of CSF
41
What breed have hydrocephalus?
Toy, small, and brachycephalic breeds
42
Clinical signs of hydrocephalus
``` altered mental status slow learners seizures ventrolateral strabismus domed skull open fontanels ```
43
Diagnosis of hydrocephalus
Ultrasound CT/MRI imaging CSF COLLECTION RESULTS IN HERNIATION!
44
Treatment of Hydrocephalus
Shunts
45
What are two important neoplasia of the brain?
Meningiomas | Gliomas
46
What are the most common primary tumors of the brain?
Lymphomas | Gliomas
47
Clinical signs of a brain tumor
Changes in behavior circling seizures
48
Diagnosis of brain tumors
CT | MRI
49
Treatment of benign superficial tumors
Surgical removal
50
How do you treat a meningioma in a dog?
Surgical removal | Radiation after surgery
51
What is the treatment for solitary meningioma in a cat?
surgery
52
What drug can be used to give a good quality of life to an animal with a tumor?
Mannitol
53
What is the prognosis for a meningioma in a dog?
Poor
54
What is the prognosis for a meningioma in a cat?
If encapsulated can be a good prognosis
55
Clinical signs of brain herniation
``` Increased ICP depressed non-responsive or slowly responsive pupillary light reflex breathing pattern irregularities Tetraparesis respiratory arrest ```
56
Treatment of brain herniation
Dexamethasone | Mannitol
57
Clinical signs of Cranial trauma
``` transient loss of consciousness residual confusion ataxia changes in mental attitude contralateral hemiparesis Intracerebral hemorrhages stupor coma cranial nerve deficits ```
58
A decreasing level of consciousness suggests what area of the brain?
brainstem | cortical
59
Asymmetry in the menace response or limb proprioception without cranial nerve deficits indicates....
lesions in the contralateral cerebral hemisphere
60
Stuporous patients with multiple cranial nerve deficits and respiratory pattern irregularity have a lesion where?
brainstem
61
Extensor rigidity with all 4 limbs extended and opisthotonus and stupor/coma is suggestive of what?
involvement of both hemispheres | Decerebrate rigidity
62
What is suspected when pupillary light reflex is not normal?
increased intracranial pressure
63
Mydriasis suggests a lesion where?
progressive lesion in the brainstem
64
Unilateral mydriasis suggests...
unilateral cerebellar herniation or unilateral hemorrhage into the brain stem
65
What is the first signs to treat with cranial trauma?
Shock and other life threatening
66
What fluids are administered to patients with cranial trauma?
hypertonic saline | Hetastarch
67
What do Hypercapnia and Hypoxia cause?
cause vasodilation and increased intra-cranial pressure
68
What kind of prognosis do animals in a coma over 2 days have?
poor
69
What are the characteristics used to develop the coma scale?
Motor activity Brain Stem Reflexes Level of Consciousness
70
Narcolepsy
sudden recurring attacks of sleep
71
Clinical signs of Narcolepsy
``` cataplexy loss or reduction of muscle tone and signs of weakness head drop or collapse for seconds to minutes suddenly falling asleep ```
72
Diagnosis of Narcolepsy
EEG
73
What is the cause of Narcolepsy?
mutation in the orexin receptor gene
74
Treatment of Narcolepsy
Amphetamines | Antidepressants
75
Feline Ischemic Encephalopathy
Ischemic necrosis in the cerebrum caused by Cuterebra migrating through the cribiform plate inducing vasospasms of brain arteries
76
What causes Feline Ischemic Encephalopathy?
Cuterebra
77
Clinical signs of Feline Ischemic Encephalopathy?
``` Respiratory signs seizures abnormal behavior circling hemiparesis unilateral blindness anisocoria head tilt ```
78
Treatment of Feline Ischemic Encephalopthy
Ivermectin to kill the parasite with concurrent use of prednisone and antihistamines
79
Canine granulomatous meningioencephalomyelitis
Inflammatory condition in middle aged dogs that is associated with perivascular infiltration of mononuclear cells in the white matter of the brain and cervical spinal cord
80
Two forms of Canine granulomatous meningioencephalomyelitis
focal form | disseminated form
81
Clinical signs of the dissmeinated form of Canine granulomatous meningioencephalomyelitis
``` ataxia paresis/paralysis seizures behavioral changes circling vestibular signs facial or trigeminal nerve paralysis cervical pain ```
82
Treatment of Canine granulomatous meningioencephalomyelitis
cytosine arabinoside cyclosporin procarbazine
83
What form of FIP causes neurological signs
the dry form
84
Neurological Clinical signs of FIP
Nystagmus Anterior uveitis Chorioretinitis
85
What does Feline Leukemia virus cause?
degenerative myelopathy
86
What is the cause of bacterial meningitis?
S. Intermedius
87
How is bacterial meningitis spread?
Hematogenously
88
Clinical signs of bacterial meningitis
Cervical pain rigidity seizures
89
Steroid responsive meningitis-arteritis
arteritis in the meninges | Subarachnoid hemorrhage
90
Diagnosis of Steroid responsive meningitis-arteritis
peripheral neutrophilia and the CSF usually has increased protein and neutrophilic pleocytosis
91
Treatment of Steroid responsive meningitis-arteritis
Prednisone | Immunosuppressive drugs such as azathioprine in combination with steroids
92
What is the treatment of algal encephalitis?
NO TREATMENT! FATAL!
93
Dysautonomia
degeneration of neurons in sympathetic and parasympathetic ganglia and dysfunction of the autonomic nervous system
94
What is the cause of Dysautonomia?
Clostridium botulinum type C
95
Clinical signs of Dysautonomia in cats?
``` mydriasis prolapsed third eyelids reduced lacrimal secretions regurgitation constipation ```
96
Clinical signs of Dysautonomia in dogs?
``` dysuria dilated bladder mydriasis dry mucous membranes decreased tear production vomitation/regurgitation reduced anal reflex lethargy depression weight loss 3rd eyelid prolapse ```
97
Treatment of Dysautonomia
supportive therapy
98
What are the three types of deafness
Conductive Central Sensorineural
99
Conductive deafness
chronic otitis externa/media which prevent sound being transmitted to the inner ear
100
Central deafness
damage to central auditory pathways and is generally associated with brain stem signs
101
Sensorineural deafness
congenital or acquired abnormalities of the cochlear
102
In what breed does congenital deafness occur?
Dalmations
103
What is sensorineural deafness associated with?
pigment-associated with white, merle and piebald dogs at greater risk
104
What is recommended for bilaterally deaf puppies?
Recommended to destroy them and not breed them
105
What agents are ototoxic?
Aminoglycosides ototoxic antibiotics antiseptic solutions ceruminolytic agents
106
Epilepsy
disease condition characterized by recurrent partial or generalized seizures
107
Primary or idiopathic epilepsy
seizures of unknown cause
108
Secondary or symptomatic epilespy
seizures because of discernible intra-cranial or extra-cranial disease
109
Seizure
begin in a 'focus' in the cerebral cortex where neurons suddenly fire in extremely rapid and frequent bursts. Restricted to the focus causing 'partial' or 'focal' seizures or it spreads to involve both cerebral cortices and cause 'generalized seizures'
110
What causes partial or focal seizures?
post-traumatic lesions, space occupying lesions, cortical developmental disorders
111
Partial motor seizure
lesion in the motor cortex resulting in brief episodes of abnormal movement in the contralateral body part
112
Clinical signs of partial motor seizures
chewing gum fits flexing to one side of the body head turning head bobbing
113
Clinical signs of Partial seizures causing abnormal behavior
``` excessive salivation licking chewing sudden voracious consumption of food or water vocalizing trembling ```
114
Clinical signs of partial sensory seizures
"fly-biting" | "tail chasing"
115
Types of Generalized seizures
``` Generalized tonic-clonic seizure tonic seizures clonic seizures atonic seizures absence seizures incomplete ```
116
What are the three phases of seizures
Pre-Ictal Ictal Post-Ictal
117
Clinical signs of the Pre-Ictal Phase
subtle behavioral changes seeking out the owner restlessness or anxiety
118
Clinical signs of the Ictal Phase
10-30 seconds of widespread sustained muscle contractions - the limbs are extended rigidly, opisthotonos with apnea and cyanosis
119
Ictal Phase
sudden loss of consciousness and simultaneously the animal falls to the ground
120
Clonic clinical signs
``` alternating contraction and relaxation of the body musculature Running paddling chewing gum jaw movements pupillary dilation salivation defecation urination ```
121
Post-Ictal Phase
marked by gradual return to consciousness with varying degrees of depression, fatigue, fright, daze appearance, aimless pacing, thirst, hunger
122
Clusters of seizures
serial seizures separated by minutes or hours
123
Status epilepticus
Continuous seizure lasts for longer than 5 mins or where there are serial seizures between which there is not a full return to consciousness
124
How do you differentiate between REM-behavior disorder and sleep seizures?
owners should attempt to wake the animal during an episode
125
How do you differentiate primary/idiopathic from secondary/symptomatic epilepsy?
Idiopathic epilepsy is treated with anticonvulsant drugs | Symptomatic epilepsy - the underlying disease must be treated
126
What is the most important cause of seizures?
toxicity
127
What kind of patients is idiopathic epilepsy seen in?
1-5 years old
128
What are some possible precipitating factors of seizures?
``` Hypoglycemia High protein meals head trauma visits to the vet lawnmower engines ```
129
What can be used to differentiate between generalized and partial seizures?
EEG
130
What is the decision to institute anticonvulsant therapy based on?
frequency and severity of seizures
131
When should an animal be started on anti-convulsant therapy?
seizures more frequently than once every 6-8 weeks clusters of seizures present in status epilepticus
132
What are the goals of anti-convulsant therapy?
reduce the frequency, duration, or severity of seizures without tolerable side effects
133
What receptors does Phenobarbital act on?
GABA receptors
134
What is a contraindication for phenobarbital?
Liver disease
135
What are the side effects of phenobarbital use?
Polyuria Polyphagia polydipsia Mild to moderate increases in ALT and ALP
136
How does phenobarbital enhance its own metabolism?
inducing cytochrome P450 system
137
How does Bromide work?
by moving through the chloride channels and hyperpolarizing membranes
138
What is Bromide used for?
Add-on drug for epilepsy refractory to or poorly controlled with phenobarbital
139
What kind of diet is contraindicated with the use of Bromide?
High salt diet
140
What are the adverse effects of Bromide?
``` polyphagia polydipsia polyuria irritability attention seeking aimless pacing ```
141
What is a major contraindication with Bromide?
renal insufficency
142
What are some reasons for therapeutic failure?
``` Owner compliance Incorrect dosage due to weight gain Genetic factors Incorrect diagnosis New concurrent disease Hepatic enzyme induction ```
143
What are some therapeutic options besides phenobarbital?
``` surgery: separation of the corpus callosum Vagal nerve stimulation Acupuncture Ketogenic diets Hypoallergenic diets ```
144
Juvenile epilepsy
Generalized tonic-clonic seizures in normal puppies up to 4 months of age
145
What kind of epilepsy are seen in cats 1-5 years of age?
Idiopathic epilepsy
146
Feline audiogenic reflex seizures
seizures in response to high-pitched sounds such as crinkling of tin foil, metal spoon dropping, clinking or tapping
147
What is the drug of choice for seizures in cats?
Phenobarbital
148
What are the contraindications of Bromide in cats?
Feline asthma | renal insufficiency
149
What are the 5 important things to stabilize in a patient?
``` Airway Fluids to maintain BP Temperature Glucose ECG ```
150
What do you do if you cannot control the seizures with phenobarbital or diazepam?
Induce general anesthesia with pentobarbital

RUSVM Small Animal Medicine I 2016 (9 decks)

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