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Case of the month December 2006

Case of the month December 2006. Irish Setter, m, 4y. History. For more than two years irregular seizure attacks of about 1 min duration. One week ago cluster of 2 h duration. Since then the dog is in lateral recumbency, unable to get up.

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Case of the month December 2006

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  1. Case of the month December 2006 Irish Setter, m, 4y

  2. History For more than two years irregular seizure attacks of about 1 min duration. One week ago cluster of 2 h duration. Since then the dog is in lateral recumbency, unable to get up.  Referral to the Neurology division of the Vetsuisse Faculty Berne

  3. Results of neurologic • examination • Lateral recumbency, severe tetraparesis • Generalized missing proprioception • Menace response and palpebral reflex bilaterally reduced Localisation diffuse, intracranial  MRI

  4. MRI of the brain FSE T2 transverse dorsal dorsal dorsal right right right

  5. MRI of the brain rostral rostral FLAIR DOR right right rostral rostral rostral right right right

  6. MRI of the brain plain contrast enhanced rostral rostral FE 3D MPR (T1) dor right right rostral rostral right right

  7. Findings ?

  8. Findings In T2 and FLAIR there is a symmetric increase in signal intensity of the gray matter from the areas rostral to the lateral ventricles going caudally to the gyrus dentatus (yellow arrows). The T1-weighted images are unremarkable, there is no contrast uptake.

  9. Comment The distribution of the lesions is typical for polioencephalomalacia. The etiology of this rare condition is unclear. A toxic/metabolic genesis is assumed. It is progressive and cannot be improved by any known therapy. Prognosis is infaust. Symmetric changes either of white or gray matter or both usually are caused by toxic/metabolic conditions. These include hypooxygenism, hepatoencephalopathy or renal failure, storage diseases and intoxications. Some of them show a typical distribution; e.g. hypooxygenism typically leads to signal enhancement of the basal ganglia. However, the available veterinary medical database of these conditions is still small.

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