Paroxysmal Disorders Flashcards

1
Q

What is effected by episodic or paroxysmal events?

A

Behavior, movement, sensation, autonomic function and consciousness

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2
Q

What is a paroxysm?

A

sudden outburst, recurrence or intensification of symptoms

fit, spasm or seizure

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3
Q

What are the 3 main etiologies of paroxysmal events?

A

Epileptogenic - brain/seizure
Non-Epileptogenic - syncopal or neurologic
Unknown - episodic pain

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4
Q

How can you differentiate seizures from mimics?

A

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

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5
Q

What are some major signs of narcolepsy?

A

Trigger: Pasing out when trying to eat
Sudden collapse
Flaccid
Consciousness partially impaired
Anesthesia can worsen it

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6
Q

What is cataplexy?

A

Abrupt and complete loss of all muscle tine - sleep paralysis

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7
Q

What is the neurotransmitter that is progressively lossed with aging making the animal narcoleptic-catapley?

A

Orexin (Maintain wakefulness vs sleep)

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8
Q

What are your differentials for a dog that is flybiting several times a week, will respond during the episode and has no apparent triggers?

A

Seizure (haullicinations), Gastrointestinal or Eye Disorder

-GI - esophagus issue trying to pass food

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9
Q

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?

A

Diff: Focal seizure, GIT, Behavior (OCD)
Diagnostics: CBC, Chem, UA, Bile Acid, Fecal, Abdominal ultrasound, GI endoscopy
Diagnosis? Upper GIT disease

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10
Q

Episode:
Breed Disposition: Border Collies
Chasing rabbits not there
Conscious
No autonomic
Young
Aggression on recovery
Diagnostics:
Diagnosis:

A

CBC, Chem, UA, EEG (bad) and MRI/CSF
Diagnosis: Epilepsy

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11
Q

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?

A

Transient Vestibular Attacks
-Hypothyroid, hypertension

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12
Q

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:

A

IVDD - prednisone
Diagnosis: Dystonia - Scottie cramp or hypertonicity
Treatment: grow out, SSRI, goes away on own, non-painful or harmful

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13
Q

What is dystonia?

A

Muscle condition that causes them to contract

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14
Q

What causes a saw horse stance, diarrhea, dyskinesia and dystonia in a Border Terrier?

A

Gluten sensitivity
Treatment: Gluten Free Diet

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15
Q

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:

A

Idiopathic Head Tremor
Breeds Predisposed: Bull dog, doberman, boxer, lab
Treatment: distract them during episode and take of seizure meds (doesn’t fix)

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16
Q

Scenario:
Progressive seizure 9 months
-Fall over, leg stiffness, relax, urinates, unconscious
- less 30 seconds multiple times a day
Normal between
ASD not helping
Brady cardia, 3rd degree AV block
Diagnosis:
Treatment:

A

Syncope
Pacemaker

17
Q

Scenario:
sudden collapse, unresponsive, urination, floppy, immediate recovers, few seconds
Differnitals:

A

Diff: syncope, narcolepsy or atonic seizure

17
Q

Scenario:
Fall over unconcous, leg stiff, then relax, goes to bathroom, autonoic, myoclonus followed by flaccidity

A

Syncope

18
Q

Scenario:
older, multifocal diffues intracrnial sign, nodding motion of head, few times a day

A

Episodic postural repetitive myocolus of head

19
Q

What is myoclonus?

A

brief involuntary contraction of a muscle or group followed by relaxation (Sign)

Twitch or jerk movement of head, muscle fasciculations

20
Q

What are the stages of a seizure?

A

Prodromal - before seizure light signs
Aura - Earliest sign of seizure (bitter taste, dizz)
Ictus - during seizure
Post-ictal - Recovery
Inter-ictal - Between Seizure