AISTI > Neurology for vets > Vestibular disease

Vestibular disease

DIFFERENTIAL DIAGNOSES OF THE HEAD TILT

Anatomy and physiology of the vestibular system

Peripheral vestibular system: vestibular (balance) organ and the n.vestibularis.

Central vestibular system: vestibular nuclei in the medulla oblongata.

Vestibular syndrome: head tilt, generalized ataxia, ventral strabismus and pathological nystagmus. Head tilt and strabismus is ipsilateral to the lesion. Differentiation between the peripheral and central vestibular syndrome is based on the proprioceptive positioning reaction: proprioceptive positioning is normal in peripheral and decreased in central vestibular disease.

Paradoxical vestibular syndrome is a form of the central vestibular syndrome. It is seen when the vestibulocerebellum (lobulus flocculonodularis) or its connection (caudal cerebellar peduncle) with the vestibular nuclei is damaged. In the paradoxical vestibular syndrome the head tilt is on the opposite side than the lesion!!!

PERIPHERAL

CENTRAL

Vascular - Brainstem infarction/bleeding

Inflammatory-infectious Otitis media/interna (D,C) Feline infectious peritonitis, granulomatous meningoencephalitis (D), viral, bacterial, protozoal infections (D,C)

Traumatic Fracture of os petrosum (D,C) Brainstem trauma (D,C)

Anomalous Congenital vestibular syndrome (English cocker spaniels, German shepherds, Tibetan terriers, Doberman pinchers, beagles, Akitas, Burmese and Siamese kittens) -

Metabolic Hypothyroidism (D), toxic (streptomycin, gentamycin, polymyxin B, chloramphenicol, iodine, chlorhexidine, benzalkonium chloride, furosemide, cisplatin, propylene glycol, ceruminolytic agents) Thiamin deficiency (D,C)

Idiopathic Idiopathic vestibular syndrome (D,C) -

Neoplastic Tumors of bone or vestibular nerve (D,C) Meningioma (D,C), choroid plexus papilloma (D), medulloblastoma(D), glioma (D,C)

Degenerative Middle ear polyps (D,C) Degenerative brain diseases (D,C)

PS: dog (D), cat (C).