Paroxysmal Disorders Flashcards
What is effected by episodic or paroxysmal events?
Behavior, movement, sensation, autonomic function and consciousness
What is a paroxysm?
sudden outburst, recurrence or intensification of symptoms
fit, spasm or seizure
What are the 3 main etiologies of paroxysmal events?
Epileptogenic - brain/seizure
Non-Epileptogenic - syncopal or neurologic
Unknown - episodic pain
How can you differentiate seizures from mimics?
History: Breed/age onset, interepisodic exam findings, trigger, body parts effected, symmetry, conciousness, muscle tone, autonomic dysfunction, frequency, duration, rate of recovery
Cameras and video help
What are some major signs of narcolepsy?
Trigger: Pasing out when trying to eat
Sudden collapse
Flaccid
Consciousness partially impaired
Anesthesia can worsen it
What is cataplexy?
Abrupt and complete loss of all muscle tine - sleep paralysis
What is the neurotransmitter that is progressively lossed with aging making the animal narcoleptic-catapley?
Orexin (Maintain wakefulness vs sleep)
What are your differentials for a dog that is flybiting several times a week, will respond during the episode and has no apparent triggers?
Seizure (haullicinations), Gastrointestinal or Eye Disorder
-GI - esophagus issue trying to pass food
Signs: Lip smacking, repeated swallowing, occur within an hour of eating, nervous before episode, variable in length, vomit after episode, no response to treatment to antibiotics
Trigger: feeding
Autonomic: Vomit
Differentials?
Diagnostics?
Diagnosis?
Diff: Focal seizure, GIT, Behavior (OCD)
Diagnostics: CBC, Chem, UA, Bile Acid, Fecal, Abdominal ultrasound, GI endoscopy
Diagnosis? Upper GIT disease
Episode:
Breed Disposition: Border Collies
Chasing rabbits not there
Conscious
No autonomic
Young
Aggression on recovery
Diagnostics:
Diagnosis:
CBC, Chem, UA, EEG (bad) and MRI/CSF
Diagnosis: Epilepsy
Episode:
Confusion and staring in space couple times a week
Consciousness: Dazed
Wobbly
Wont respond to owner
normal interictal
Keppra no help
Exam: Nystagmus, vestibular ataxia
Diagnosis?
Transient Vestibular Attacks
-Hypothyroid, hypertension
Episode:
Breed: Scottish Terrier
Hx: stiffness and difficulty walking over past 2 weeks, painful and hunched since puppy, normal between
Diff:
Exam: Kyphosis, 2 engine gait
Tigger: excitement
Muscle tone: Spastic
Diagnosis:
IVDD - prednisone
Diagnosis: Dystonia - Scottie cramp or hypertonicity
Treatment: grow out, SSRI, goes away on own, non-painful or harmful
What is dystonia?
Muscle condition that causes them to contract
What causes a saw horse stance, diarrhea, dyskinesia and dystonia in a Border Terrier?
Gluten sensitivity
Treatment: Gluten Free Diet
Scenario:
Bull dogs
Focal facial seizure since 6 months
Normal interictal, normal diagnostic, no response to phenobarbital and high level
PU/PD
Signs: head shaking, conscious, responsive (up or down or side to side)
Trigger: stress
Younger than 4 years
Diagnosis:
Treatment:
Idiopathic Head Tremor
Breeds Predisposed: Bull dog, doberman, boxer, lab
Treatment: distract them during episode and take of seizure meds (doesn’t fix)