Idiopathic Head Tremor Syndrome in a 3 year old English Bulldog
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A 3 year old male castrated English Bulldog presented to the Neurology service at Cornell University Hospital for Animals for evaluation of head tremoring episodes starting 2.5 months ago. At the time of presentation, the patient was receiving phenobarbital, zonisamide, potassium bromide, gabapentin and prednisone. Questioning of the owners determined that the intermittent episodes were strictly limited to head bobbing, consistently in a vertical direction. The episodes varied in length and frequency, and could sometimes be interrupted with distraction. Physical and neurologic examination showed obtundation and obesity (BCS 9/9). Based on history, breed, description of clinical signs, and examination of the patient, a presumptive diagnosis of idiopathic head tremor syndrome was reached. A plan was made for weight loss and to wean the patient off of his current medications, with care to avoid withdrawal seizure activity.