Inflammatory Disease Flashcards
Name 4 infectious inflammatory CNS diseases (5)
–Viral
–Bacterial
–Protozoal
–Algae
–Parasitic
Name 5 non infectious CNS inflammatory diseases (7)
–GME
–NME
–NE
–SRMA
–Cauda equina neuritis
–Pachimeningitis
–Eosinophilic
Label
A) Grey matter
B) White matter
C) Meninges
D) Ventricles
How do you diagnose:
- GME granulomatous meningoencephalomyelitis
- NME necrotising meningoencephalitis
- NLE necrotising leukoencephalitis
Histopathology
If no histopathology = MUA
What are the clinical signsof inflammatory CNS disease?
–Acute/sub-acute in onset
–Progressive in nature
–Associated with multifocal/diffuse neuroanatomical localisation
–Systemic signs rarely reported
A) What is GME?
B) What is characteristic?
A) Inflammatory (immune-mediated) disease of unknown aetiology
B)
•Characteristic granulomatose, angiocentric encephalitis
–Macrophages
–Lymphocytes
–Plasma cells
With GME is there more:
White matter and meninges OR
Grey matter?
Grey
What 3 things are seen with angeiocentric encephalitis with GME?
–Macrophages
–Lymphocytes
–Plasma cells
What is this?
Angiocentric encephalitis
What are the 2 classifications of GME?
- Clinical
- Histopathological
What are the 3 clinical forms of GME?
•Disseminated
–Most common, acute rapidly progressive multifocal signs
–Cerebrum, caudal brainstem, cerebellum, or cervical spinal cord
•Focal
–Acute or slowly progressive signs reflecting single space-occupying mass lesion
•Ocular
What are the 3 major pattern of lesion distribution with GME?
•Common disseminated form
–Spinal cord, brainstem and mid-brain (<
- Disseminated form with angiocentric expansion (multiple coalescing lesions)
- Focal form, single discrete mass lesion
–Spinal cord, brainstem and mid-brain, thalamus, optic nerves, cerebrum
What are the clinical features of GME?
•Young adult dogs (average age 4.5yrs range from 6 months to 12 years)
- Any gender
- Female, toy and terrier breeds over- represented
What do the clinical signs of GME reflect?
Lesion distribution
What are the clinical signs of GME?
–Vestibulo-cerebellar
–Cranial nerves deficits
–Visual impairment
–Paresis (tetra)
–Cervical pain
–Body turn
–Altered mentation
–Seizures
How do you diagnose GME?
–Rule out systemic dx
–Advanced imaging (MRI)
- Multiple hyperintensities on T2-weighted or (FLAIR) throughout the CNS white matter.
- Variable intensity in T1-weighted
- Variable contrast uptake on T1 post gadolinium
- Variable meningeal enhancement
–CSF
•Mononuclear mixed pleocytosis, increased TP
–Histopathology
- Angiocentric
- Mixed-lymphoid
- With matter encephalitis
- Lymphocytic meningitis
How do you treat GME?
–Supportive
•Mannitol?
–Immunomodulatory
A) What is NME?
B) Where is there pan-encephalitis?
C) Where is mainly affected?
A) Inflammatory (immune-mediated) disease of unknown aetiology
B)
–Meninges
–Grey matter
–White matter
C) Cerebral hemispheres mainly
What is this?
•Non-suppurative, necrotising ME
What are the clinical features of NME?
- Young adult dogs mean age 2Yr (6mo to 7Yr)
- No gender predisposition
- Breeds? Pug, Maltese, Pekingese…
- Rapidly progressive signs
–Seizures
–Depression
–Circling
–Visual deficits
How do you diagnose NME?
–Rule out systemic dx
–Advanced imaging (MRI)
- hyperintense on T2-weighted and FLAIR
- Isointense to slightly hypointense on T1-weighted
- Variable contrast enhancement on T1-weighted
- Loss of grey/white matter demarcation
–CSF (lymphocytic), increased TP
–Histopathology
- Lymphocytic meningitis
- Polioencephalitis
- Necrotising leukoencephalitis
How do you treat NME?
–Supportive
- Antiepileptic
- Mannitol?
–Immunomodulatory
NLE:
A) What is it?
B) What does it cause?
C) What is seen?
A) Inflammatory (immune-mediated) disease of unknown aetiology
B) Non-suppurative, necrotising encephalitis
C)Hemispheric white matter, and brainstem
•Cortex and meninges not involved
What is this?
•Non-suppurative, necrotising encephalitis
