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Neurology > Vestibular Disease > Flashcards

Vestibular Disease Flashcards

1
Q

Where is the vestibular apparatus located?

A

Inner ear (part of temporal bone)

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2
Q

What comprises the vestibular apparatus?

A

Cochlea, semicircular canals, vestibule

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3
Q

Which CN provides vestibular neurons?

A

Vestibulocochlear nerve (CN 8)

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4
Q

Where does CN 8 enter the skull?

A

Internal acoustic meatus

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5
Q

Where does CN 8 terminate?

A

Lateral wall of 4th ventricle

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6
Q

The efferent pathway of the vestibulospinal tract inhibits what?

A

Ipsilateral flexor and contralateral extensor muscles

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7
Q

What are clinical signs of peripheral vestibular system disease?

A

Head tilt, circling, horizontal/rotary nystagmus, facial nerve paralysis or Horner’s syndrome

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8
Q

Which way will a head tilt or circling be with peripheral vestibular disease?

A

Toward the side of the lesion

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9
Q

With pathologic nystagmus, which direction will fast phase be?

A

Away from the side of the lesion

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10
Q

Though rare in animals, what is the main clinical sign of bilateral peripheral vestibular system disease?

A

Wide crouching stance w/wide swaying of the head

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11
Q

Can you determine the side of the lesion with central vestibular system disease?

A

No

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12
Q

With central vestibular disease, conscious proprioceptive deficits or hemiparesis can be seen on which side of the lesion?

A

Same side

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13
Q

What are clinical signs of Horner’s syndrome?

A

Miosis, ptosis, enophthalmos

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14
Q

Does Horner’s syndrome indicate central or peripheral vestibular disease?

A

Peripheral

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15
Q

Conscious proprioceptive deficits indicate a lesion in which region of the CNS?

A

Brainstem

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16
Q

Does multiple cranial nerve deficits usually indicate central or peripheral vestibular disease?

A

Central

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17
Q

The presence of a head tremor indicates _____ disease

A

Cerebellar

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18
Q

Does altered mentation indicate central or peripheral nervous disease?

A

Central

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19
Q

What type of lesions typically cause spontaneous nystagmus w/horizontal and rotational components?

A

Acute peripheral lesions

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20
Q

What type of lesions can cause purely vertical, horizontal, or rotational nystagmus?

A

Central lesions

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21
Q

What ancillary tests can be done once you localize a lesion to the peripheral nervous system?

A

Otoscopic exam, typmanic bulla rads, thyroid test, BAER/CT

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22
Q

What ancillary tests can be done once you localize a lesion to the central nervous system?

A

CT/MRI, CSF analysis

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23
Q

Which disease is often peracute without apparent cause and will start to improve within several days w/o tx?

A

Idiopathic vestibular syndrome

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24
Q

What clinical sign of idiopathic vestibular syndrome doesn’t usually resolve completely?

A

Head tilt

25
Q

How do you dx idiopathic vestibular syndrome?

A

Dx of exclusion

26
Q

What is a very common cause of vestibular disease in most species?

A

Otitis media and interna

27
Q

What is otitis media/interna commonly treated with?

A

Enrofloxacin

28
Q

How long should abx therapy to treat otitis continue?

A

Up to 8wk

29
Q

What abx is contraindicated for otitis?

A

Aminoglycosides

30
Q

How do you treat otitis media/interna that is refractory to medical therapy?

A

TECA-BO

31
Q

What is the most common substance implicated in ototoxicity?

A

Chlorhexadine

32
Q

What abx can cause ototoxicity?

A

Aminoglycosides

33
Q

Where do nasopharyngeal polyps most commonly appear in cats?

A

In the typanic cavity

34
Q

How does hypothyroidism cause vestibular disease?

A

Polyneuropathy with vestibular signs

35
Q

How can a tumor cause central vestibular signs?

A

Cerebella-pontine angle, brainstem compression, brain herniation

36
Q

Which abx toxicity can cause central vestibular system disease?

A

Metronidazole >30mg/kg/day

37
Q

How does Metronidazole toxicity often present?

A

Acute onset, even in patients with chronic treatment

38
Q

Often vestibular w/other CNS signs as part of multifocal brain disease

A

Inflammatory brain disease

39
Q

Generally sudden onset that may be idiopathic or 2* to hypertension, neoplasia, endocrinopathies, or sepsis

A

Cerebrovascular disease

40
Q

Most commonly occurs from overcooked meat diets or all fish diets

A

Thiamine deficiency

41
Q

Three ducts at right angles to each other and each filled w/perilymph

A

Semicircular ducts

42
Q

What turns perilymph movement into nerve conduction?

A

Ampulla

43
Q

What are the macula of the inner ear?

A

Utriculus and sacculus

44
Q

What do macula do?

A

Detect movement in the dorsal and sagittal planes

45
Q

What do the ampulla do?

A

Detects angular movement and acceleration

46
Q

Where in the brainstem does the central vestibular apparatus live?

A

Cranial aspect of medulla

47
Q

What are signs of vestibular ataxia?

A

Circling, leaning, falling, rolling

48
Q

CP deficits, vertical or changing nystagmus, CN signs other than Horner’s and facial nerve paralysis are associated with which type of vestibular disease?

A

Central

49
Q

Ear polyps are relatively common in young _____

A

Cats

50
Q

Are inflammatory causes of central vestibular disease more common in cats or dogs?

A

Dogs (granulomatous meningioencephalitis and necrotizing encephalitis - aka sterile inflammatory dz)

51
Q

What are the most common causes of infectious central vestibular disease in cats?

A

FIP, cryptococcus, toxoplasmosis

52
Q

What is the most common toxic cause of central vestibular disease?

A

Metronidazole

53
Q

What is in fish that causes a thiamine deficiency?

A

Thiaminase

54
Q

With central vestibular disease, what type of nystagmus will you have?

A

Vertical

55
Q

Conscious proprioceptive deficits are assoc. w/which type of vestibular disease?

A

Central

56
Q

Head tilt, nystagmus, and circling will be in which direction with respect to the lesion?

A

Toward the lesion

57
Q

With paradoxical vestibular disease, which direction will clinicals signs be w/respect to the lesion?

A

Away from the lesion

58
Q

If you see peripheral signs in one direction but central signs in the other, where is the lesion?

A

Lesion is on side of central deficits

59
Q

When a lesion causes vestibular signs and CP deficits, where is the lesion?

A

Same side as CP deficits

Neurology (19 decks)

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