Acute idiopathic polyradiculoneuritis

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Sections available in full article Introduction, Presenting signs, Geographic incidence, Age predisposition, Breed predisposition, Cost considerations, Special risks (e.g. anesthetic), Pathogenesis, Etiology, Pathophysiology, Timecourse (incubation, duration), Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Gross autopsy findings, Histopathology findings, Differential diagnosis, Treatment, Initial symptomatic treatment, Monitoring, Subsequent management, Prevention, Control, Prophylaxis, Sequelae, Prognosis, Expected response to treatment, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors Mr Paul Cuddon BVSc DipACVIM
Synonyms Coonhound paralysis

Introduction

  • One of most common polyneuropathies.
  • Signs : similar to distal denervating disease Distal denervating disease , an acute rapidly progressive generalized lower motor neuron flaccid paresis to paralysis with stabilization of signs after 4-5 days.
  • Diagnosis :
    • Acute progressive flaccid tetraparesis to tetraplegia with normal bladder and tail function and normal pain sensation.
    • Electrophysiology and lumbar CSF analysis aid in diagnosis.
  • Treatment : good nursing, preventing sores/hydrostatic pneumonia.
  • Prognosis : good with adequate nursing.

Diagnosis

Clinical signs

  • Pain sensation remains intact. Animal may actually be hyperesthetic.
  • Spinal cord reflexes are weak to absent.
  • Pelvic limb weakness, decreased reflexes, with often progression to a flaccid, symmetrical tetraplegia.
  • If severe: no spinal reflexes, facial weakness, loss of voice, inability to lift head, labored breathing.
  • Perineal reflex is always normal.
  • Normal tail wag.
  • Bladder function is normal.
  • Overreact to sensory stimuli.
  • Aphonia or dysphonia in most dogs.
  • Occasionally facial nerve paralysis.

Diagnosis

Differential diagnosis

  • Tick paralysis.
  • Spinal neoplasia (or other space occupying lesion).
  • Other neuronopathies Peripheral neuropathies.
  • Axonopathies.
  • Motor neurone disease.
  • Paraneoplastic polyneuropathy.
  • Botulism Clostridium botulinum.
  • Distal denervating disease Distal denervating disease.
  • Infectious polyradiculoneuritis.
  • Toxic polyneuropathy.
  • Motor neurone diseases.
  • Polymyopathy Myopathies.
  • Myasthenia gravis Myasthenia gravis (especially fulminant).
  • Ivermectin toxicity Ivermectin toxicity.

Sequelae

Prognosis

  • Depends on accuracy of diagnosis.
  • Most dogs with disease will recover normal motor function.
  • Prognosis is guarded to poor if dog progresses to respiratory paralysis within first 4-5 days.

Expected response to treatment

  • Slow improvement in motor function over weeks to months.

Reasons for treatment failure

  • Severe disease can lead to respiratory paralysis and death
  • Poor nursing care can lead to decubital ulcers, aspiration pneumonia, dehydration, starvation, bacteremia/septicemia.

Sources

Publications

Refereed papers

  • Cuddon P A (1998) Electrophysiologic assessment of acute polyradiculoneuropathy in dogs - comparison with Guillain-Barre syndrome in people. J Vet Intern Med 12 (4), 294-303.
  • High M E (1996) Acute canine polyradiculoneuritis. Can Vet J 37 (5), 305.
  • McGlennon N J (1990) Polyradiculoneuritis and polymyositis due to a toxoplasma-like protozoan - diagnosis and treatment. JSAP 31 (2), 102-104.
  • Cummings J F et al(1988) Canine protozoan polyradiculoneuritis. Acta Neuropathol (Berl) 76 (1), 46-54.
  • Cummings J F et al(1982) Coonhound paralysis. Further clinical studies and electron microscopic observations. Acta Neuropathol (Berl) 56 (3), 167-178.
  • Northington J W et al(1982) Acute canine idiopathic polyneuropathy. A Guillain-Barre-like syndrome in dogs. J Neurol Sci 56 (2-3), 259-273.
  • Northington J W et al(1981) Acute idiopatic polyneuropoathy in the dog. JAVMA 179 (4), 375-379.
  • Chrisman C L (1975) Differentiation of tick paralysis and acute idiopathic polyradiculoneuritis in the dog using electromyography. JAAHA 11 (4), 455-458.

Other sources of information

  • Merck Veterinary Manual. (1998) 8 , 914.
  • Oliver J E (1997) Handbook of Veterinary Neurology 3. pp 187-188.
  • Cuddon P (1997) Coonhound paralysis (polyradiculoneuritis, idiopathic). The 5 minute veterinary consult - canine and feline.pp 476-477.
  • Ettinger S J (1995) Textbook of Veterinary Internal Medicine. 4 (1), 716.
  • Schrauwen E (1995) Postvaccinal acute polyradiculoneuritis in a young dog. Prog Vet Neur 6 (2), 68-70.
  • Dees C (1984) The immunological basis of Coonhound paralysis. Fed Proc 43 (7), 1993.
  • DeLahunta A (1983) Veterinary Neuroanatomy and Clinical Neurology. (2), 74-77.

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