Meningoencephalitis Flashcards

1
Q

what is meningitis?

A

infiltration of granulocytes, lymphocytes, monocytes, plasma cells
fibrosis

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2
Q

what are the most common types of non-infectious meningoencephalitis?

A

granulomatous meningoencephalitis
necrotizing meningoencephalitis
necrotizing encephalitis

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3
Q

how common is meningoencephalitis of unknown origin?

A

5-25% of all CNS disorders

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4
Q

who was necrotizing meningoencephalitis first described in?

A

pugs: pug dog encephalitis

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5
Q

what are the two forms of necrotizing meningoencephalitis?

A

acute
chronic

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6
Q

what areas of the brain does necrotizing meningoencephalitis often affect?

A

cortex
hippocampus
septal nuclei
thalamus

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7
Q

what is the signalment of necrotizing encephalitis?

A

yorkshire terriers mainly
mean age 4.5 years
no sex or intact status predilection

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8
Q

who usually gets granulomatous meningoencephalitis?

A

middle aged dogs
females>males
small breeds>large breeds

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9
Q

what are the 3 forms of granulomatous meningoencephalitis?

A

ocular form
focal form
disseminated form

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10
Q

what are the histopathological findings of granulomatous meningoencephalitis?

A

white matter most affected
perivascular accumulation of macrophages, lymphocytes, and plasma cells

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11
Q

when should you start an immune modulator?

A

after infectious testing negatives
often 2-3 weeks after starting prednisone

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12
Q

what are some indications for cyclosporine?

A

meningoencephalitis
skin disease
immune hemolytic anemia

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13
Q

what is encephalitis?

A

perivascular cuffing
infiltration granulocytes, lymphocytes, monocytes, plasma cells
necrosis, malacia
neuronophagia
inclusion bodies
gliosis

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14
Q

what are the protozoal causes of meningoencephalitis?

A

toxoplasmosis
neosporosis
sarcocystis-like organinism

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15
Q

what are the common causes of infectious meningoencephalitis in new england?

A

rabies
canine distemper
aspergillum
bastomycosis
Cryptococcus neoformans
Neospora canis, Toxoplasmata gati
Ehrlichia canis
rocky mountain spotted fever

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16
Q

how is meningoencephalitis of unknown origin diagnosed?

A

rule out other things
definitive: histopathology

17
Q

what are the types of meningoencephalitis of unknown origin?

A

necrotizing meningoencephalitis
necrotizing encephalitis
granulomatous meningoencephalitis

18
Q

what are lesions like in necrotizing meningoencephalitis?

A

multifocal, asymmetrical necrosis
collapse of hemispheric gray and white matter

19
Q

where is necrosis and malacia seen in necrotizing meningoencephalitis?

A

adjacent white matter to inflammatory changes in gray matter

20
Q

what is the cause of necrotizing encephalitis?

A

idiopathic

21
Q

what is the distribution of lesions in necrotizing encephalitis?

A

large, focal, asymmetric necrosis, cyst formation
white matter, cortex
meninges mostly spared
mid brain, brainstem, cerebellum

22
Q

what is thee cause of granulomatous meningoencephalitis?

A

idiopathic
most likely immune
infection cannot be excluded

23
Q

where are granulomas mostly in the focal form of granulomatous meningoencephalitis?

A

brainstem

24
Q

is the white matter or gray matter more affected in granulomatous meningoencephalitis?

A

white matter

25
Q

what is the CSF like in meningoencephalitis?

A

mixed or mononuclear pleocytosis
elevated protein

26
Q

is bacterial culture of CSF often negative even with a brain infection?

A

yes

27
Q

how can you treat meningoencephalitis?

A

solumedrol: steroid
dexamethasone
immune modulatory therapy
doxycycline
gastric protectants: steroids

28
Q

what is the total treatment time?

A

12-14 months

29
Q

what are the indications for procarbazine?

A

CNS neoplasia, lymphoma
meningoencephalitis

30
Q

what are the indications for cytarabine?

A

CNS lymphoma
non-infection meningoencephalitis

31
Q

what are the indications for mycophenolate?

A

immune hemolytic anemia
immune mediated thrombocytopenia
SRMA
meningoencephalitis

32
Q

what are the indications for azathioprine?

A

hemolytic anemia
inflammatory bowel disease
myasthenia gravis
SRMA
meningoencephalitis

33
Q

what is leflunomide used for?

A

meningoencephalitis
but no information on penetration of blood brain barrier