Meningoencefalomielites de origem desconhecida no cão
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2015
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O Sistema Nervoso Central (SNC) é composto pelo encéfalo e pela medula espinhal, encontrando-se ambas estruturas revestidas pelas meninges.
A inflamação pode afetar o encéfalo (encefalite), a medula espinhal (mielite) ou as meninges (meningite), individualmente, ou atingir mais do que uma estrutura como no caso de uma meningoencefalite (meninges e encéfalo) ou de uma meningoencefalomielite (meninges, encéfalo e medula espinhal).
As Meningoencefalomielites de Origem Desconhecida (MOD) são um conjunto de doenças inflamatórias, idiopáticas, não infecciosas do Sistema Nervoso Central (SNC). Este termo está relacionado com um diagnóstico presuntivo/antemortem mas sem um exame histopatológico associado. Podem atingir qualquer cão mas afetam principalmente cães de raça pequena, fêmeas, entre os 3 e os 7 anos de idade e os sinais neurológicos refletem a localização das lesões no SNC. Dividem-se em Meningoencefalomielite Granulomatosa (MEG) e em Encefalites Necrosantes (EN) sendo que estas se subdividem em Meningoencefalite Necrosante (MEN) e Leucoencefalite Necrosante (LEN). O diagnóstico definitivo destas subdivisões é conseguido apenas através de uma confirmação histopatológica seja por biópsia antemortem ou por necrópsia. Nesta dissertação, serão abordadas as características gerais, imagiológicas e histopatológicas de cada elemento que compõe as MOD passando também pela abordagem diagnóstica e terapêutica, relativas ao cão, descritas na literatura mais atual.
A componente prática desta dissertação vai incidir na descrição e discussão de 3 casos clínicos relativos a cães diagnosticados com MOD que se apresentaram no Serviço de Neurologia do Hospital Ars veterinária, Barcelona, no decorrer do meu estágio curricular.
The Central Nervous System comprises the brain and the spinal cord and both are surrounded by the meninges. Inflammation can affect the brain (encephalitis), the spinal cord (myelitis) or the meninges (meningitis), individually, or can reach more than one structure as in meningoencephalitis (meninges and brain) or meningoencephalomyelitis (meninges, brain and spinal cord). Meningoencephalomyelitis of Unknown Origin (MUO) are a group of inflammatory, idiopathic, noninfectious diseases of the Central Nervous System (CNS). This classification is related to a presumptive/antemortem diagnosis where a histopathological examination is lacking. These diseases can affect any dog but primarily affect small breed dogs, females, between 3 and 7 years old and the neurological signs reflect the location of the lesions in the CNS. MUO can be divided into Granulomatous Meningoencephalomyelitis and Necrotizing Encephalitis and these last are subdivided into Necrotizing Meningoencephalitis and Necrotizing Leukoencephalitis. The definitive diagnosis of these subdivisions is achieved only through a histopathological confirmation either by an antemortem biopsy or by necropsy. This dissertation will discuss the general features, imaging and histopathologic characteristics of each element that comprises the MUO discussing also the diagnostic and therapeutic approaches for the dog which are described in the current literature. The practical component of this dissertation will focus on the description and discussion of three clinical cases involving dogs diagnosed with MUO presented at the Neurology Department of the Ars veterinaria hospital, Barcelona, in the course of my internship.
The Central Nervous System comprises the brain and the spinal cord and both are surrounded by the meninges. Inflammation can affect the brain (encephalitis), the spinal cord (myelitis) or the meninges (meningitis), individually, or can reach more than one structure as in meningoencephalitis (meninges and brain) or meningoencephalomyelitis (meninges, brain and spinal cord). Meningoencephalomyelitis of Unknown Origin (MUO) are a group of inflammatory, idiopathic, noninfectious diseases of the Central Nervous System (CNS). This classification is related to a presumptive/antemortem diagnosis where a histopathological examination is lacking. These diseases can affect any dog but primarily affect small breed dogs, females, between 3 and 7 years old and the neurological signs reflect the location of the lesions in the CNS. MUO can be divided into Granulomatous Meningoencephalomyelitis and Necrotizing Encephalitis and these last are subdivided into Necrotizing Meningoencephalitis and Necrotizing Leukoencephalitis. The definitive diagnosis of these subdivisions is achieved only through a histopathological confirmation either by an antemortem biopsy or by necropsy. This dissertation will discuss the general features, imaging and histopathologic characteristics of each element that comprises the MUO discussing also the diagnostic and therapeutic approaches for the dog which are described in the current literature. The practical component of this dissertation will focus on the description and discussion of three clinical cases involving dogs diagnosed with MUO presented at the Neurology Department of the Ars veterinaria hospital, Barcelona, in the course of my internship.
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Dissertação de Mestrado Integrado em Medicina Veterinária
Palavras-chave
Cães , Sistema nervoso central , Inflamação , Meningoencefalomielite de origem desconhecida , Meningoencefalomielite granulomatosa , Encefalite necrosante