Vestibular And Paradoxical Disease

Question 1

The __ is affected in both central and peripheral vestibular disease. In peripheral vestibular disease the __ is the anatomic area of concern while in central vestibular disease the __ is the anatomic area of concern.

Answer 1

The vestibular nucleus is affected in both central and peripheral vestibular disease. In peripheral vestibular disease the middle ear/vestibularcochlear apparatus is the anatomic area of concern while in central vestibular disease the flocculonodular lobe is the anatomic area of concern.

Question 2

Peripheral vestibular disease has__ gait abnormalities while central has __

Answer 2

Peripheral vestibular disease has no gait abnormalities while central has vestibular ataxia with tetra or hemiparesis (decreased muscle tone)

Question 3

What nerves run through the bulla of the middle ear and are involved in peripheral vestibular disease?

Answer 3

CN VII and the sympathetic post

Question 4

Central vestibular disease effects CN__

Answer 4

Central vestibular disease effects CN V-XII

Question 5

What type of nystagmus does central vestibular disease have that peripheral should not?

Answer 5

Vertical -> both have horizontal and rotary

Question 6

If a dog has a head tilt and deficits on the left side, what type of disease is it, why?

Answer 6

It’s central vestibular disease because there are postural reaction deficits which peripheral vestibular disease wouldn’t have. It’s not paradoxical because the head tilt is ipsilateral

Question 7

List some common causes of peripheral vestibular disease

Answer 7

• otitis interna/media
• inflammatory polyps
• aural neoplasia
• idiopathic vestibular disease
• toxicity

Question 8

List some common causes of central vestibular disease

Answer 8

• Hypothyroidism
• Intracranial neoplasia
• Thiamine deficiency
• Toxicity from metronidazole
• Vascular accidents

Question 9

Paradoxical disease is from impairment of the __ which is responsible for ___and is largely __. This leads to what clinical signs?

Answer 9

Paradoxical disease is from impairment of the cerebellum which is responsible for fine tuning and is largely inhibitory.

Clinical signs: intention tremor, hypermetria, increased muscle tone, titubation, vestibular signs, decerebellate rigidity

Question 10

Describe decerebellate rigidity

Answer 10

Front limbs extended and pelvic limbs flexed

Question 11

List common causes of paradoxical disease

Answer 11

1. Cerebellar cortical abiotrophy
2. Chiari like malformation
3. Feline cerebellar hypoplasia
4. Canine herpes virus
5. FIP
6. Granulomatous meningoencephalitis
7. Corticosteriod responsive tremor syndrome
8. Neoplasia (meningioma most common)
9. Cerebellar infarction

Question 12

Paradoxical disease has a __ head tilt

Answer 12

Contralateral

Question 13

Paradoxical disease can have nystagmus in __ direction and typically involves CN __

Answer 13

Paradoxical disease can have nystagmus in any direction and typically involves CN V, VII

Question 14

If a dog comes in with a head tilt to the left, postural reaction deficits on the right, and hypermetria what side of the brain is the lesion on and what type of neurological disease is it?

Answer 14

On the right side because the hypermetria indicates paradoxical disease which means the head title is contralateral to the side of the brain effected

Question 15

Gait of paradoxical disease

Answer 15

Vestibular ataxia, paretic, cerebellar ataxia

Question 16

Ampulla

Answer 16

Detects rotational movement

Question 17

Saccule

Answer 17

Vertical acceleration/deceleration

Question 18

Utricle

Answer 18

Horizontal acceleration/deceleration

Question 19

Strabismus

Answer 19

Abnormal eye position

Question 20

Nystagmus

Answer 20

Abnormal eye moments

Question 21

Myoclonus

Answer 21

Repetitive movement of the limb