Lesions that affect the central vestibular system typically have additional clinical signs suggestive of brainstem involvement. Such lesions often involve the reticular formation as well as ascending and descending motor and sensory pathways to the ipsilateral limbs. Therefore, abnormal mental status, ipsilateral paresis, and conscious proprioceptive deficits are commonly associated with central vestibular disorder (VD). Deficits of cranial nerves V through XII (except CN VII = facial nerve) can also be associated with central VD. The presence of vertical nystagmus and nystagmus that changes in direction on changing position of the head can also be used to identify a central vestibular lesions. Although animals with a peripheral VD have a normal level of consciousness and no evidence of weakness or postural reaction deficits, the absence of these signs does not rule-out the presence of a central VD. If in doubt about the localization of the lesion, the cat should evaluate the animal for central VD as well as peripheral VD.
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