seizure disorders

Question 1

neonatal maladjustment syndrome etiology

Answer 1

birth hypoxia?

imbalance of inflammatory mediators and neuroendocrine factors in foal’s brain

Question 2

clinical signs of neonatal maladjustment syndrome

Answer 2

deranged cerebral function: loss of suckle reflex, cannot find udder, aimless wandering, hyperesthesia, hyperexcitability, jerky stiff movements, abnormal respiratory patterns

followed by depression and unresponsiveness: hypothermia, acidosis, seizures and coma

signs of spinal cord damage: weakness, extensor sapsms of neck, limbs, tail

Question 3

neonatal maladjustment syndrome diagnosis

Answer 3

PE, neurological exam

CBC-anemia, concurrent sepsis

Chem: renal, liver function, electrolytes

CSF tap: r/o meningitis

Question 4

DDx for neonatal seizures

Answer 4

perinatal complication

infection

development

idiopathic epilepsy in arabian foals

neonatal maladjustment syndrome

Question 5

treatment of neonatal maladjustment syndrome

Answer 5

maintenance of body temp, hydration, caloric intake, electrolye/acid-base balance and blood gluose

oxygen therapy

plasma

broad spectrum abx

tx of cerebral edema: DMSO, Mannitol

intesive physiotherapy

diazepam, phenobarbital

Question 6

px for NMS

Answer 6

highly dependent on complications

poor px: development of septicemia, never stood up following delivery, no improvement in neurological function by day 3 to 4x

Question 7

intracranial masses types

Answer 7

cholesteatoma-older horses

pituitary adenoma-Cushing’s , DST: cortisol >1 ug/dL

streptococcus equi: stangles

Question 8

dx of seizures

Answer 8

thorough history

PE

CBC

chem-electrolytes, glucose, renal and liver status

ophthalmic exam: papillary edema

CSF evaluation

EPM testing

CT/MRI skull

EEG

Question 9

epilepsy

Answer 9

repeated generalized or partial seizures

normal neurologic exam between seizures

any forebrain lesion potentially can act as a seizure focus with epilepsy beginning days to years after the initial lesion

a real problem in large horses that can hurt owner and anyone working with them

Question 10

epilespy dx

Answer 10

history of head trauma, previous neurologic disease

physical and neurologic exam

videotape of seizure activity

skull rads

CSF tap

testing for EPM