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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
Q

What viruses cause cerebellar infections?

A

Distemper
Canine herpes
FIP

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26
Q

What are the two types of cerebellum neoplasia?

A

Primary

Secondary

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27
Q

Common name for Corticosteroid responsive tremor syndrome

A

Shaker Dog Disease

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28
Q

Clinical signs of Corticosteroid responsive tremor syndrome (Shaker Dog Disease)

A

Tremors in all 4 limbs and head that get worse with exercise or excitement and resolve when the animal sleeps

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29
Q

Treatment of Corticosteroid responsive tremor syndrome (Shaker Dog Disease)

A

Glucocorticoids

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30
Q

What are other causes of tremors?

A

Fear
Hypomyelination
tremerogens (mycotoxins from old dairy food)
Other toxins
Orthostatic tremor : shivering while bearing weight
head bobbing
old dog hind limb tremors

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31
Q

Scotty Cramp (episodic muscle hypertonicity)

A

deficiency of serotonin inhibitory neurotransmitter and a prostaglandin abnormality

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32
Q

Clinical signs of Scotty Cramp (episodic muscle hypertonicity)

A

abduction of the thoracic limbs and then pelvic stiffness after exercise

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33
Q

Treatment of Scotty Cramp (episodic muscle hypertonicity)

A

Fluoxetine (“Prozac”)

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34
Q

What breed has Episodic falling?

A

Cavalier King Charles Spaniels

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35
Q

Clinical signs of Episodic falling

A

pelvic and thoracic limb hypertonicity

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36
Q

Treatment of Episodic falling

A

Clonazepam

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37
Q

Depression

A

decreased responsiveness

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38
Q

Stupor

A

unresponsive and arousable with painful stimuli

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39
Q

Coma

A

unresponsive and unarousable

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40
Q

Hydrocephalus

A

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

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41
Q

What breed have hydrocephalus?

A

Toy, small, and brachycephalic breeds

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42
Q

Clinical signs of hydrocephalus

A 
altered mental status
slow learners 
seizures
ventrolateral strabismus
domed skull 
open fontanels
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43
Q

Diagnosis of hydrocephalus

A

Ultrasound
CT/MRI imaging
CSF COLLECTION RESULTS IN HERNIATION!

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44
Q

Treatment of Hydrocephalus

A

Shunts

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45
Q

What are two important neoplasia of the brain?

A

Meningiomas

Gliomas

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46
Q

What are the most common primary tumors of the brain?

A

Lymphomas

Gliomas

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47
Q

Clinical signs of a brain tumor

A

Changes in behavior
circling
seizures

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48
Q

Diagnosis of brain tumors

A

CT

MRI

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49
Q

Treatment of benign superficial tumors

A

Surgical removal

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50
Q

How do you treat a meningioma in a dog?

A

Surgical removal

Radiation after surgery

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51
Q

What is the treatment for solitary meningioma in a cat?

A

surgery

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52
Q

What drug can be used to give a good quality of life to an animal with a tumor?

A

Mannitol

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53
Q

What is the prognosis for a meningioma in a dog?

A

Poor

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54
Q

What is the prognosis for a meningioma in a cat?

A

If encapsulated can be a good prognosis

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55
Q

Clinical signs of brain herniation

A 
Increased ICP 
depressed 
non-responsive or slowly responsive pupillary light reflex
breathing pattern irregularities
Tetraparesis 
respiratory arrest
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56
Q

Treatment of brain herniation

A

Dexamethasone

Mannitol

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57
Q

Clinical signs of Cranial trauma

A 
transient loss of consciousness
residual confusion 
ataxia
changes in mental attitude
contralateral hemiparesis
Intracerebral hemorrhages
stupor
coma
cranial nerve deficits
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58
Q

A decreasing level of consciousness suggests what area of the brain?

A

brainstem

cortical

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59
Q

Asymmetry in the menace response or limb proprioception without cranial nerve deficits indicates….

A

lesions in the contralateral cerebral hemisphere

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60
Q

Stuporous patients with multiple cranial nerve deficits and respiratory pattern irregularity have a lesion where?

A

brainstem

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61
Q

Extensor rigidity with all 4 limbs extended and opisthotonus and stupor/coma is suggestive of what?

A

involvement of both hemispheres

Decerebrate rigidity

62
Q

What is suspected when pupillary light reflex is not normal?

A

increased intracranial pressure

63
Q

Mydriasis suggests a lesion where?

A

progressive lesion in the brainstem

64
Q

Unilateral mydriasis suggests…

A

unilateral cerebellar herniation or unilateral hemorrhage into the brain stem

65
Q

What is the first signs to treat with cranial trauma?

A

Shock and other life threatening

66
Q

What fluids are administered to patients with cranial trauma?

A

hypertonic saline

Hetastarch

67
Q

What do Hypercapnia and Hypoxia cause?

A

cause vasodilation and increased intra-cranial pressure

68
Q

What kind of prognosis do animals in a coma over 2 days have?

A

poor

69
Q

What are the characteristics used to develop the coma scale?

A

Motor activity
Brain Stem Reflexes
Level of Consciousness

70
Q

Narcolepsy

A

sudden recurring attacks of sleep

71
Q

Clinical signs of Narcolepsy

A 
cataplexy 
loss or reduction of muscle tone and signs of weakness
head drop 
or collapse for seconds to minutes
suddenly falling asleep
72
Q

Diagnosis of Narcolepsy

A

EEG

73
Q

What is the cause of Narcolepsy?

A

mutation in the orexin receptor gene

74
Q

Treatment of Narcolepsy

A

Amphetamines

Antidepressants

75
Q

Feline Ischemic Encephalopathy

A

Ischemic necrosis in the cerebrum caused by Cuterebra migrating through the cribiform plate inducing vasospasms of brain arteries

76
Q

What causes Feline Ischemic Encephalopathy?

A

Cuterebra

77
Q

Clinical signs of Feline Ischemic Encephalopathy?

A 
Respiratory signs 
seizures
abnormal behavior 
circling 
hemiparesis 
unilateral blindness
anisocoria
head tilt
78
Q

Treatment of Feline Ischemic Encephalopthy

A

Ivermectin to kill the parasite with concurrent use of prednisone and antihistamines

79
Q

Canine granulomatous meningioencephalomyelitis

A

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
Q

Two forms of Canine granulomatous meningioencephalomyelitis

A

focal form

disseminated form

81
Q

Clinical signs of the dissmeinated form of Canine granulomatous meningioencephalomyelitis

A 
ataxia 
paresis/paralysis 
seizures
behavioral changes
circling 
vestibular signs 
facial or trigeminal nerve paralysis
cervical pain
82
Q

Treatment of Canine granulomatous meningioencephalomyelitis

A

cytosine arabinoside
cyclosporin
procarbazine

83
Q

What form of FIP causes neurological signs

A

the dry form

84
Q

Neurological Clinical signs of FIP

A

Nystagmus
Anterior uveitis
Chorioretinitis

85
Q

What does Feline Leukemia virus cause?

A

degenerative myelopathy

86
Q

What is the cause of bacterial meningitis?

A

S. Intermedius

87
Q

How is bacterial meningitis spread?

A

Hematogenously

88
Q

Clinical signs of bacterial meningitis

A

Cervical pain
rigidity
seizures

89
Q

Steroid responsive meningitis-arteritis

A

arteritis in the meninges

Subarachnoid hemorrhage

90
Q

Diagnosis of Steroid responsive meningitis-arteritis

A

peripheral neutrophilia and the CSF usually has increased protein and neutrophilic pleocytosis

91
Q

Treatment of Steroid responsive meningitis-arteritis

A

Prednisone

Immunosuppressive drugs such as azathioprine in combination with steroids

92
Q

What is the treatment of algal encephalitis?

A

NO TREATMENT! FATAL!

93
Q

Dysautonomia

A

degeneration of neurons in sympathetic and parasympathetic ganglia and dysfunction of the autonomic nervous system

94
Q

What is the cause of Dysautonomia?

A

Clostridium botulinum type C

95
Q

Clinical signs of Dysautonomia in cats?

A 
mydriasis
prolapsed third eyelids
reduced lacrimal secretions 
regurgitation 
constipation
96
Q

Clinical signs of Dysautonomia in dogs?

A 
dysuria
dilated bladder 
mydriasis 
dry mucous membranes
decreased tear production 
vomitation/regurgitation 
reduced anal reflex 
lethargy 
depression 
weight loss
3rd eyelid prolapse
97
Q

Treatment of Dysautonomia

A

supportive therapy

98
Q

What are the three types of deafness

A

Conductive
Central
Sensorineural

99
Q

Conductive deafness

A

chronic otitis externa/media which prevent sound being transmitted to the inner ear

100
Q

Central deafness

A

damage to central auditory pathways and is generally associated with brain stem signs

101
Q

Sensorineural deafness

A

congenital or acquired abnormalities of the cochlear

102
Q

In what breed does congenital deafness occur?

A

Dalmations

103
Q

What is sensorineural deafness associated with?

A

pigment-associated with white, merle and piebald dogs at greater risk

104
Q

What is recommended for bilaterally deaf puppies?

A

Recommended to destroy them and not breed them

105
Q

What agents are ototoxic?

A

Aminoglycosides
ototoxic antibiotics
antiseptic solutions
ceruminolytic agents

106
Q

Epilepsy

A

disease condition characterized by recurrent partial or generalized seizures

107
Q

Primary or idiopathic epilepsy

A

seizures of unknown cause

108
Q

Secondary or symptomatic epilespy

A

seizures because of discernible intra-cranial or extra-cranial disease

109
Q

Seizure

A

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
Q

What causes partial or focal seizures?

A

post-traumatic lesions, space occupying lesions, cortical developmental disorders

111
Q

Partial motor seizure

A

lesion in the motor cortex resulting in brief episodes of abnormal movement in the contralateral body part

112
Q

Clinical signs of partial motor seizures

A

chewing gum fits
flexing to one side of the body
head turning
head bobbing

113
Q

Clinical signs of Partial seizures causing abnormal behavior

A 
excessive salivation
licking
chewing 
sudden voracious consumption of food or water
vocalizing 
trembling
114
Q

Clinical signs of partial sensory seizures

A

“fly-biting”

“tail chasing”

115
Q

Types of Generalized seizures

A 
Generalized tonic-clonic seizure
tonic seizures
clonic seizures
atonic seizures
absence seizures
incomplete
116
Q

What are the three phases of seizures

A

Pre-Ictal
Ictal
Post-Ictal

117
Q

Clinical signs of the Pre-Ictal Phase

A

subtle behavioral changes
seeking out the owner
restlessness or anxiety

118
Q

Clinical signs of the Ictal Phase

A

10-30 seconds of widespread sustained muscle contractions - the limbs are extended rigidly, opisthotonos with apnea and cyanosis

119
Q

Ictal Phase

A

sudden loss of consciousness and simultaneously the animal falls to the ground

120
Q

Clonic clinical signs

A 
alternating contraction and relaxation of the body musculature 
Running
paddling 
chewing gum jaw movements
pupillary dilation 
salivation
defecation 
urination
121
Q

Post-Ictal Phase

A

marked by gradual return to consciousness with varying degrees of depression, fatigue, fright, daze appearance, aimless pacing, thirst, hunger

122
Q

Clusters of seizures

A

serial seizures separated by minutes or hours

123
Q

Status epilepticus

A

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
Q

How do you differentiate between REM-behavior disorder and sleep seizures?

A

owners should attempt to wake the animal during an episode

125
Q

How do you differentiate primary/idiopathic from secondary/symptomatic epilepsy?

A

Idiopathic epilepsy is treated with anticonvulsant drugs

Symptomatic epilepsy - the underlying disease must be treated

126
Q

What is the most important cause of seizures?

A

toxicity

127
Q

What kind of patients is idiopathic epilepsy seen in?

A

1-5 years old

128
Q

What are some possible precipitating factors of seizures?

A 
Hypoglycemia 
High protein meals 
head trauma
visits to the vet 
lawnmower engines
129
Q

What can be used to differentiate between generalized and partial seizures?

A

EEG

130
Q

What is the decision to institute anticonvulsant therapy based on?

A

frequency and severity of seizures

131
Q

When should an animal be started on anti-convulsant therapy?

A

seizures more frequently than once every 6-8 weeks
clusters of seizures
present in status epilepticus

132
Q

What are the goals of anti-convulsant therapy?

A

reduce the frequency, duration, or severity of seizures without tolerable side effects

133
Q

What receptors does Phenobarbital act on?

A

GABA receptors

134
Q

What is a contraindication for phenobarbital?

A

Liver disease

135
Q

What are the side effects of phenobarbital use?

A

Polyuria
Polyphagia
polydipsia
Mild to moderate increases in ALT and ALP

136
Q

How does phenobarbital enhance its own metabolism?

A

inducing cytochrome P450 system

137
Q

How does Bromide work?

A

by moving through the chloride channels and hyperpolarizing membranes

138
Q

What is Bromide used for?

A

Add-on drug for epilepsy refractory to or poorly controlled with phenobarbital

139
Q

What kind of diet is contraindicated with the use of Bromide?

A

High salt diet

140
Q

What are the adverse effects of Bromide?

A 
polyphagia 
polydipsia
polyuria
irritability 
attention seeking 
aimless pacing
141
Q

What is a major contraindication with Bromide?

A

renal insufficency

142
Q

What are some reasons for therapeutic failure?

A 
Owner compliance
Incorrect dosage due to weight gain 
Genetic factors
Incorrect diagnosis 
New concurrent disease
Hepatic enzyme induction
143
Q

What are some therapeutic options besides phenobarbital?

A 
surgery: separation of the corpus callosum 
Vagal nerve stimulation 
Acupuncture
Ketogenic diets
Hypoallergenic diets
144
Q

Juvenile epilepsy

A

Generalized tonic-clonic seizures in normal puppies up to 4 months of age

145
Q

What kind of epilepsy are seen in cats 1-5 years of age?

A

Idiopathic epilepsy

146
Q

Feline audiogenic reflex seizures

A

seizures in response to high-pitched sounds such as crinkling of tin foil, metal spoon dropping, clinking or tapping

147
Q

What is the drug of choice for seizures in cats?

A

Phenobarbital

148
Q

What are the contraindications of Bromide in cats?

A

Feline asthma

renal insufficiency

149
Q

What are the 5 important things to stabilize in a patient?

A 
Airway 
Fluids to maintain BP 
Temperature
Glucose
ECG
150
Q

What do you do if you cannot control the seizures with phenobarbital or diazepam?

A

Induce general anesthesia with pentobarbital

RUSVM Small Animal Medicine I 2016 (9 decks)

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