Reversible facial nerve paralysis in a cat suspected to be associated with systemic hypertension

Case summary This report describes the appearance of facial nerve paralysis in a 16-year-old hypertensive cat. MRI was helpful in visualising and characterising mesencephalic and facial nerve lesions thought to be induced by hypertension. Neurological signs rapidly resolved under antihypertensive therapy. Relevance and novel information Systemic hypertension is an important medical condition in geriatric cats causing damage in various target organs, including the brain. Hypertensive encephalopathy is an umbrella term for a multitude of different clinical manifestations of cerebral target organ damage. Facial nerve paralysis secondary to hypertension is recognised in human medicine, particularly in children, but so far has not been reported in veterinary medicine.

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Feline blood pressure measurement: when is it needed?

Companion Animal ◽

10.12968/coan.2021.0063 ◽

2021 ◽

Vol 26 (11) ◽

pp. 222-228

Author(s):

Sarah Caney

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Pressure Measurement ◽

Blood Pressure Measurement ◽

Target Organ Damage ◽

Organ Damage ◽

Target Organ ◽

Systemic Hypertension ◽

Ophthalmological Examination ◽

Target Organs

Systemic hypertension is a common disorder, primarily affecting older cats. Most cases are secondary to underlying medical conditions, such as chronic kidney disease. If left untreated, systemic hypertension has the potential to cause serious damage to certain target organs and can be fatal. Target organs include the nervous system, cardiovascular system, eyes and kidneys. Target organ damage to the eyes is often pathognomonic and is detected on ophthalmological examination in up to 80% of cats with systemic hypertension. Blood pressure measurement is essential in confirming a diagnosis and should be prioritised in cats showing evidence of target organ damage. Blood pressure screening of apparently healthy older cats is justified, since the risk of hypertension increases with age. Systemic hypertension is diagnosed in cats with persistent elevation in their systolic blood pressure of 160 mmHg or higher. Stress and anxiety can cause a transient increase in systolic blood pressure so measurements should be collected in a manner that is as calm and ‘cat friendly’ as possible. In the presence of confirmed target organ damage, a single high systolic blood pressure reading confirms systemic hypertension. Where no target organ damage is detectable, evidence of elevated systolic blood pressure on two or more occasions is needed to confirm the diagnosis.

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Hypertensive ocular disease in cats: A guide to fundic lesions to facilitate early diagnosis

Journal of Feline Medicine and Surgery ◽

10.1177/1098612x18818668 ◽

2018 ◽

Vol 21 (1) ◽

pp. 35-45 ◽

Cited By ~ 1

Author(s):

Jenny Carter

Keyword(s):

Blood Pressure Measurement ◽

Target Organ Damage ◽

Clinical Manifestations ◽

Organ Damage ◽

Evidence Base ◽

Ocular Disease ◽

Systemic Hypertension ◽

Hypertensive Disease ◽

Ocular Lesions ◽

Mild Hypertensive

Practical relevance: Systemic hypertension is common in older cats and can result in damage to organs with a rich arteriolar supply such as the eyes, kidneys, myocardium and brain. Hypertensive disease in these organs is known as target organ damage (TOD). Disease in the eye resulting from hypertension is the most easily identifiable form of TOD and can often be the reason the cat is presented to the veterinarian. Routine blood pressure measurement and fundic examination allows cats with hypertensive ocular lesions to be detected early in the course of the disease, when the lesions have the best chance of responding to treatment. Clinical challenges: Detecting early evidence of TOD in the fundus requires a veterinarian to be competent in recognising lesions associated with mild hypertensive disease, as well as the more easily recognised advanced lesions that frequently result in impaired vision and blindness. Audience: This review is written for all veterinarians who treat cats. It provides information and images to facilitate and guide veterinarians performing fundoscopy in cats, in particular in those over 7 years of age, with the aim of diagnosing hypertensive ocular lesions when they are present. Equipment: The clinical manifestations of hypertensive ocular disease can be detected non-invasively with inexpensive equipment. A summary of the equipment available for general practitioners to perform fundoscopy is provided. Evidence base: This is a comprehensive review of the literature on hypertensive ocular disease in cats. The author has also included images of hypertensive ocular lesions taken in general practice to highlight the variety of lesions that can be detected.

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Target organs in arterial hypertension

Kazan medical journal ◽

10.17816/kazmj83634 ◽

1997 ◽

Vol 78 (5) ◽

pp. 378-381

Author(s):

A. S. Galyavich

Keyword(s):

Arterial Hypertension ◽

Target Organ Damage ◽

Organ Damage ◽

Hypertensive Encephalopathy ◽

Left Ventricular ◽

Vascular Involvement ◽

Internal Organs ◽

Aorta Aneurysm ◽

Target Organs

One of the consequences of long-term BP increase is damage of internal organs, the so-called target organs (target organ damage, end organ damage). These include heart, brain, kidneys, vessels. Heart damage in arterial hypertension may be manifested by left ventricular hypertrophy, angina pectoris, myocardial infarction, chronic heart failure and sudden death, brain damage - by thrombosis and hemorrhages, hypertensive encephalopathy and cerebral lacunae, kidneys - microalbuminuria, proteinuria, chronic renal failure, vascular involvement - lesions of retinal vessels, carotid arteries, aorta (aneurysm).

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The Effective Treatment for Incomplete Recovery after Facial Nerve Paralysis

Korean Journal of Otorhinolaryngology - Head and Neck Surgery ◽

10.3342/kjorl-hns.2013.56.7.397 ◽

2013 ◽

Vol 56 (7) ◽

pp. 397

Author(s):

Jin Kim

Keyword(s):

Facial Nerve ◽

Effective Treatment ◽

Facial Nerve Paralysis ◽

Nerve Paralysis

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Evaluation and management of facial nerve paralysis in MGM medical college

MedPulse International Journal of ENT ◽

10.26611/10161335 ◽

2019 ◽

Vol 13 (3) ◽

pp. 44-48

Author(s):

B K Bhattacharya ◽

◽

Subhajit Sarkar ◽

Keyword(s):

Facial Nerve ◽

Facial Nerve Paralysis ◽

Nerve Paralysis ◽

Medical College

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OSTEOMYELITIS KRONIS MANDIBULA PASCA EKSTRAKSI GIGI DISERTAI BELL’S PALSY

ODONTO Dental Journal ◽

10.30659/odj.6.0.52-55 ◽

2019 ◽

Vol 6 ◽

pp. 52

Author(s):

Yayun Siti Rochmah

Keyword(s):

Facial Nerve ◽

Panoramic Radiograph ◽

Surrounding Tissue ◽

Facial Nerve Paralysis ◽

Muscle Paralysis ◽

Nerve Paralysis ◽

The Right ◽

Spread Of Infection ◽

Nerve System ◽

Intravenous Ketorolac

Background: Chronic osteomyelitis mandibula is one of the complications from dental extraction. Inadequate wound handling can have an impact on the spread of infection in the surrounding tissue like nerve which results in facial nerve paralysis. The purpose is to present a rare case that facilitative nerve paralysis as a result of the spread of osteomyelitis infectionCase Management: A 69 years old woman with chief complains numbness onher lips accompanied by pus out beside the lower teeth. No sistemic disease. Panoramic radiograph showed abnormal bone-like sequester. Extraoral examination appeared the bluish color on the right cheek and there was right facial muscle paralysis. Debridement, sequesterectomy by general anesthesia and medication using ceftriaxone intravenous, ketorolac injection, multivitamin, and corticosteroid, physiotherapy for facial nerve paralyze, also.Discussion: Pathogenesis mandibular osteomyelitis involves contiguous spreadfrom an odontogenic focus infection. The bacteria produce an exotoxin, which, while unable to cross the blood-brain barrier, can have deleterious effects on thePeripheral Nerve System (Fasialis Nerve) in up to 75% of cases, with the severity of presentation correlating with the severity of the infection.Conclusion: Chronic mandibular osteomyelitis can spread the infection to around another anatomy oral cavity like facials nerves.

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