encephalopathy and seizures Flashcards
1
Q
encephalopathy
A
- syndrome of brain dysfuction
- usually forebrain signs
- non-specific
2
Q
primary CNS causes of encephalopathy
A
- neoplasia
- epilepsy
- inflammatory/infectious
- increased ICP
- trauma
- hemorrhage
- vascular
- degenerative
3
Q
metabolic causes of encephalopathy
A
- hepatic
- hypertensive
- toxic
- renal/uremic
4
Q
diagnostics for hepatic encephalopathy
A
- CBC, serum chem panel, UA
- fasted pre- and post-prandial bile acids, ammonia
- AUS, portal/rectal scintigraphy
5
Q
hepatic encephalopathy treatment
A
- low-protein diet
- ion-trapping (lactulose PO or enema)
- antibiotics (metronidazole, neomycin)
6
Q
congenital vs acquired hydrocephalus
A
- congenital
- malformation of ventricular system
- can sometimes prevent deterioration
- cannot reverse damage
- acquired
- secondary
- neoplasia, obstruction, reduced drainage
- choroid plexus tumors
- FIP
- potential to return to normal with treatment
- secondary
7
Q
hydrocephalus treatment
A
- reduce CSF production
- prednisone
- omeprazole
- furosemide, acetazolamide
- crisis: mannitol, hypertonic saline
- establish drainage
- ventriculoperitoneal shunt
8
Q
seizures
A
- forebrain: cerebrum and diencephalon
- etiology
- primary CNS disturbance
- neurologic manifestation of systemic disease
9
Q
classification of seizures
A
- generalized (grand mal, tonic-clonic)
- partial (focal motor seizures, Jacksonian march)
- psychomotor (fly biting, running fits, rage)
10
Q
generalized seizures “petit mal”
A
- mild generalized seizures
- brief loss of muscle tone
- may remain sternal or ambulatory, but ataxic
- episodic weakness, disorientation
- +/- drooling, vomiting, urination, defecation
11
Q
partial seizures
A
- head turning, tonus of one limb, altered behavior, licking, fly biting…
- seizure focus
- localized to one area of the cortex
- does not spread across entire cerebrum, can generalize at any time
12
Q
psychomotor seizures
A
- complex partial seizures, behavioral seizures
- running fits, fly biting, episodic rage, hissing, drooling
- sensory and motor components
- may have autonomic manifestations
- often from the temporal lobe and limbic system
13
Q
cluster seizures
A
- >2 seizures in 24 hours
- period of normalcy in between episodes
- reliable pattern of multiple seizures at each event
- does not matter if generalized or partial seizures
- usually require > 2 meds for adequate control
14
Q
status epilepticus
A
- rapidly recurring seizures with incomplete recovery between episodes
- more likely in large breed dogs
- toxins
- metabolic
- sudden drug withdrawal; ineffective drugs
- progressive disease
15
Q
ddx for possible seizures in dogs
A
- hypotensive episodes (HSA bleeds)
- cardiogenic events (PH, arrhythmias)
- respiratory (BUAS, collapsing trachea)
- hypertensive episodes (pheochromocytoma, PLN)
16
Q
ddx for possible seizures in cats
A
- hypertensive episodes
- 3rd degree AV block
- behavioral
- movement disorder
17
Q
cat seizures
A
- keep checking body temp
- idiopathic cats often require multiple drugs at the onset
18
Q
signalment and history
A
- age: 1-5 yrs
- breed:
- small, terrier type vs large, dolichocephalic
- cat
- chronicity & progression
- acute onset vs long-standing
- seizures along vs other neuro deficits
- concurrent diseases
