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MNP - cranial nerves Flashcards

1
Q

The aspect of caudal digastricus muscle is associated with the outcome in facial paralysis: true or false?

A

True

Muscle atrophy (89%), hyperintensity in T2W (89%), and pre-contrast T1W (79%) images, as well as contrast enhancement of the affected muscle (74%) and affected facial nerve (47%).

There was no statistically significant correlation between atrophy or enhancement of the affected caudal portion of the digastric muscle nor between enhancement of the affected facial nerve and outcome.

Hyperintensity both in T2W images and precontrast T1W images was significantly correlated with a worse prognosis

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2
Q

In dogs with idiopathic, oculomotor neuropathy, what statement IS false?

  1. Approximately half of all animals improved over time
  2. Improvement concerned only external ophthalmoparesis
  3. Improvement was noted both for external and internal ophthalmoparesis
  4. The majority of cases presented nerve enlargement in MRI
A

3

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3
Q

DDx dropped jaw

A

Idiopathic trigeminal neuritis (most common)
Trauma
Rabies
Lymphoma
Neospora caninum
Rickettsial vasculitis
Hypothyroid neuropathy
Idiopathic polyneuritis

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4
Q

DDx trismus

A

Masticatory muscle myositis
Polymyositis
Extraocular myositis
Muscular dystrophy
Tetanus
Temporomandibular joint luxation
Craniomandibular osteopathy
Retrobulbar abscess
Foreign body

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5
Q

DDx laryngeal paralysis

A

Degenerative: GOLPP

Anomalous: genetic, polyneuropathy complex

Metabolic: hypothyroidism, hypoadrenocorticism, toxic (Pb, organophosphorus)

Neoplastic: thymoma, lymphoma, thyroid carcinoma

Inflammatory: polymyositis, myasthenia, polyneuritis

Traumatic: surgery (ventral slot), wound

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6
Q

What are the clinical features associated with trigeminal nerve tumor?

A

Enlarged trigeminal nerves with marked homogeneous contrast enhancement and a mass effect on the brainstem or outside the cranial cavity along the nerve.

Unilateral clinical (also the case for neuritis)
Sensory impairment (also the case for neuritis)
Ipsilateral noninfectious middle ear effusion (only neoplasia, 33%)
Significantly older than dogs with neuritis and ITN.

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7
Q

Contrast enhancement of cranial nerves VII and/or VIII on MRI was associated with a decreased chance of resolution of the clinical signs: true or false?

A

True

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8
Q

Which ocular abnormalities can we see in optic nerve hypoplasia? Which breed has been associated with this condition?

A

Lack of neurons in ganglionic layer of the retina and atrophy of the optic nerve, possible retinal dysplasia or retinal detachment -> blind, mydriatic and absent direct PLRs.
Miniature poodle

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9
Q

Which 2 breeds have potentially an inherited form of megaoesophagus?

A

Miniature schnauzer
Wire-haired fox terrier

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10
Q

How does hyperchylomicronemia in cats result in neuropathy affecting cranial nerves?

A

deficiency in lipoprotein lipase causes granulomatous masses of lipid and coagulated blood (xanthomas) -> xanthomas in nerve roots and peripheral nerves cause compressive neuropathy with loss of axons and myelin

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11
Q

Give 3 toxic causes of megaoesophagus in small animals.

A

Lead
Organophosphates
Snake venom

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12
Q

What is the proportion of hypothyroid dogs among those with acquired laryngeal paralysis?

A

30%

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13
Q

Toxic causes of megaeosophagous in small animals

A

lead, organophosphates, snake venom

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14
Q

breeds with congenital megaesophagus

A

Newfoundland
Parson Russel Terrier
Samoyed
Spinger Spaniel
Smooth Fox Terrier
Sharpei
Siamese

+ GS2 Swedish lapland
+ Laryngeal paral-polyneuropathy in Dalmatian, Leonberg (1-9y), Pyraneam montain dog, Rottweiler (2-6m)
+ demyelinating polyneuropathy in miniat Schnauzer

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15
Q

Brred with aquired form of megaoesophagus <2y

A

Newfoundland (other breeds 7-15y)

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16
Q

causes of aquired megaoesophagus

A

idiopathic 43% myathenia gravis 38%, polymyositis 14%, musc dystrophy, dysautonomia, stor disease, hypoadrenocort, hypothyroidism
gastroint (esophagitis, oesophageal obstruction, hiatal hernia, volvulus (pyloric dysfunction in cat)
toxic lead, organophosphorus, snake venom

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17
Q

% dogs with generalised myasthenia gravis with megaoeso

A

90%

18
Q

treatment megaoeso + prognosis indic

A

DOG: Betanechol, Sildenafil
CAT: cisapride

+sucralfate, anticids

prognosis indic: response to therapy within 7-10d

19
Q

clinical findings with unilateral mast muscle atrophy

A

50% trigem nerve sheet tumor
other extraaxial mass 20%
idiopathic 30%

20
Q

origin of nerve sheat tumor

A

schwann cells or perineural fibroblast

21
Q

effect radiotherapy trigem nerve sheat

A

improve clinical signs, no effect m atrophy/survival time

22
Q

factor assoc with idiopathic or tumoral/neuritis CN V

A

bilateral: idiopath
sensory imparement: neplasia/neuritis
middle ear effusion: only in dog with neoplasia (33%)
older dog: neop

23
Q

muscle aspect associated with worse prognosis in idiopath facial neuritis

A

caudal port digastricus: T2/pre contraste T1 hyper correlated with worse prognosis

24
Q

MRI abnomalies in idiopath vestib and median/internal otitis

A

idiopath vestib: utricule atrophy in T2, contrast enhanc CN VIII/VII, lack suppression inner ear

median/internal otitis: decrease FLAIR suppression

25
Q

risk factor idiopath vestib compared to others affections

A

higher age, higher bodyweight, pathol nystagmus, facial nerve paresis, periferal neuroloc

cat: non purebreed, without history otitis ext

26
Q

pathologies associated with peripheral vestib

A

29% periferal lesion
33% meningoencephalit or intracran mass

on central 14% perif lesion

27
Q

prognosis facial and vestib neuropathy

A

complete resolution 30%
40% vestib deficit
46% hemifacial contract, 15% facial paral
15% relapse

28
Q

trigem dysfunction : dogs with
1.bilat/unilat
2. sensory
3. middle ear effusion
are more likely to have
4. old

A
  1. bilat: idiopathic trigem neuropathy
    unilat: neoplasia or neuritis
  2. neoplasia (70%) or neuritis
  3. only in dogs with neoplasia (33%)
  4. neop>neuritis
29
Q

muscles controling auditory tube

A

tensor tympani/veli palatini : trigeminal

levator veli palatini/ salphingopharyngeus: vagus

30
Q

origin of nerve sheat tumors

A

Schwann cells or perineural fibroblast
more fqt affected nerve : trigeminal

31
Q

can vestibular idiopath syndrome associated with horner in dog/cat ?

A

no

32
Q

risk factor associated with idiopath vest syndrome in dog/cat

A

dog and cat: improve, not associated with Horner

dog: higher age, higher bodyweight, pathol nystagmus, facial nerve paresis, periferal neuroloc

cat: non purebred, without histoty of otitis ext

33
Q

% long term deficit/relapse with facial and vestib neuropathy of unknow origin

A

40% long term deficit (hemifacial contracture 50%)
15% relapse

34
Q

risk fact aspiration pneumonia after unilat aryt lateralisation

A

megaoesophagus
opioids

no effect metoclopramide, preexisting asp

18-30% aspi pneumonia betwwen 1-5y

35
Q

congenital laryngeal paralysis in Alaskan Huskies:
associated with other nerve dysfunction ?
characteristics of most affected dogs

A

mononeuropathy

blues eyes, white facial marking, oral mucosal tag or tissue band

onset 6m, 40% spontaneous improvement

36
Q

bacterial cult of larynx of dogs with laryngeal paral maj pure/ mixed colony

A

maj pure

37
Q

vestibular peripheral syndrome:
1. % facial paralysis
2. recurrence rate
3. risk factor associated with idiopath
4. factor associated with resolution

A
  1. 60%
  2. 15%
  3. Increasing age
  4. higher bodyweight, imrpoving signs, nystagmus, facial nerve paresis, absence Horner, periferal loca
  5. higher resol: history of previous vestibular episodes
    lower resol: contrast enhancement of cranial nerves VII and/or VIII on MRI
38
Q

% of idiopath vestibular in dogs with idiopath facial paralysis

facial and vestibulocochlear nerves enter the petrous part of the temporal bone through the internal acoustic meatus and are enclosed in a common dural sheath and have the same blood supply

A

70%

39
Q

fact associated with median otitis in vest synd

A

young
male
horner
history periph otitis

40
Q

fact associated with ischemic infarct in vest synd

A

old
peracute
no strabism
central local

41
Q

CSF vestib disease

A

MUO lympho
idiopath/ischem: activated macrophages or normal

sensib TNCC for central/perif diff 49/90%, TP 58/39%

42
Q

cat vestibular syndrome: risk factor for each cause

A

neoplasia: old, chronic, central local
thiamine: female, waxin/waning, bilat, wide excursion head
idiopath: non purebreed, improvement
polype: Horner

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