Vestibulocochlear Function & Vestibular Syndromes

Question 1

Nystagmus

Answer 1

Fast phase AWAY from affected side

Question 2

Clinical signs associated with peripheral vestibular lesion

Answer 2

NO proprioceptive deficits*

Normal mentation*

Head tilt toward

Only deficits in CN 7 or 8*

Strabismus

Nystagmus

Question 3

Clinical signs associated with central vestibular lesion

Answer 3

Proprioceptive deficits*

Dullness, stupor*

Head tilt

Other CN deficits *

Strabismus

Nystagmus

Paresis*

Cerebellar/forebrain signs*

Question 4

Components of Horner’s Syndrome

Answer 4

Sympathetic dysfunction

Ptosis, miosis, enophthalmos, protruding nictitans

Commonly seen with otitis

Question 5

Most common cause of peripheral vestibular disease

Answer 5

Idiopathic - “old dog vestibular disease”

Severe head tilt and rapid nystagmus

Tx: supportive care - anti-nausea, anti-anxiety, sedatives

Question 6

Causes of peripheral vestibular disease

Answer 6

Idiopathic
Otitis media/interna
Neoplasia

Question 7

Causes of central vestibular disease

Answer 7

Inflammatory (GME)
Infectious
Neoplasia
vascular
Trauma

Question 8

Clinical signs associated with Cerebellar Syndrome

Answer 8

Hypermetria
Ataxia
Intention tremors

(Ipsilateral signs)

Question 9

Types of cerebellar syndromes

Answer 9

Congenital (hypoplasia vs. malformations)

Degenerative

Neoplasia

Infectious (Neospora)

Inflammatory

Vascular

Question 10

What is White Shaker Syndrome?

Answer 10

Young, often white, small-breed dogs

Tremors (limbs, eyes, head)

Opsoclonus, ataxia, hypermetria

CSF: normal to mild lymphocytic pleocytosis

Tx: steroids, diazepam, beta blockers

Question 11

What is paradoxical vestibular syndrome?

Answer 11

Vestibular syndrome in which head tilt is AWAY from the lesion

Lesion is on the same side as the proprioceptive deficits!

Always central!