Neuro - neuromuscular diseases Flashcards

1
Q

What is the name for the connection between the nerve and the muscle?

A

Neuromuscular endplate

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2
Q

What is the acronym for assessing motor units?

A

RAT
Reflex arc decreased/absent
Atrophy of the muscle
Tone of muscles decreased

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3
Q

How do you test for muscle activity? What is abnormal?

A

Electrodiagnostic assessment - needle into leg, record muscle activity
Spontaneous electrical activity - myopathy/axonopathy

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4
Q

What can cause generalised acute loss of reflexes followed my muscle atrophy?

A

Polyradiculoneuritis
Botulism
Metabolic diseases

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5
Q

What can cause focal acute loss of reflexes followed my muscle atrophy?

A

Brachial plexus avulsion

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6
Q

What is polyradiculoneuritis?

A

Immune mediated disease attacking motor nerve axons of dogs
Causes acute flaccid tetraparesis

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7
Q

What is a differential for polyradiculoneuritis which is characterised by generalised neuromuscular neurolocalisation + megaoesophagus?

A

Myasthenia gravis

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8
Q

What is the treatment/prognosis for polyradiculoneuritis?

A

Physiotherapy
NO STEROIDS
Very good prognosis but takes 1-3 months

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9
Q

What is brachial plexus avulsion?

A

Focal neuromuscular disorder from trauma/scratch/wound disrupting reflexes of thoracic limbs
Often in cats

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10
Q

What is the main differential for brachial plexus avulsion?

A

Thromboembolism

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11
Q

What diseases can cause predominantly loss of muscle mass?

A

Polymyositis
Congenital myopathy
Nerve sheath tumour (focal)

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12
Q

What can cause polymyositis?

A

Immune mediated
Infectious
Paraneoplastic

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13
Q

What is a differential of a deteriorating lameness with marked pain and muscle atrophy?

A

Brachial plexus tumour

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14
Q

What is the treatment and prognosis of a brachial plexus tumour?

A

Surgery - tumour removal +/- amputation
Guarded prognosis - months to years

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15
Q

What diseases cause insidious onset fatigue with possible loss of reflexes and muscle mass?

A

Myasthenia gravis
Degenerative polyneuropathy
(CV and metabolic diseases)

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16
Q

What is myasthenia gravis?

A

Disease of the neuromuscular endplate
Immune system destroys acetyl choline receptors
Not enough acetyl choline to muscles, preventing them from initiating muscle contraction

17
Q

How do you diagnose myasthenia gravis?

A

Regurgitation clinical sign - radiograph for megaoesophagus
Tensilon test - detect antibodies for the acetyl choline receptors

18
Q

What is the treatment for myasthenia gravis?

A

Pyridostigmine - acetylcholinesterase inhibitor
Postural feeding for megaoesophagus

19
Q

What is the prognosis for myasthenia gravis?

A

Guarded - aspiration pneumonia common complication

20
Q

What is degenerative polyneuropathy? Where does it affect first?

A

Disease of peripheral nerves affecting larynx first then spreading to pelvic then thoracic limbs
Causes symmetrical non painful weakness and reluctance to walk, stirtor

21
Q

How do you diagnose degenerative polyneuropathy?

A

Rule out metabolic differentials
Electrodiagnostics
Genetic testing

22
Q

What is an early sign of degenerative polyneuropathy?

A

Laryngeal paralysis
Stirtor - difficulty breathing

23
Q

What is the treatment/prognosis for degenerative polyneuropathy?

A

No cure - supportive treatment
Guarded prognosis

24
Q

What are cranial neuropathies?

A

Conditions affecting the cranial nerves

25
Q

What are some examples of acute cranial neuropathies?

A

Idiopathic facial nerve paralysis
Idiopathic peripheral vestibular syndrome

26
Q

What are the signs of idiopathic facial nerve paralysis?

A

Peracute asymmetrical non painful
Facial asymmetry
Eye changes
Drooping face on one side

27
Q

How do you test for idiopathic facial nerve paralysis?

A

Schirmer tear test
Corneal ulcer

28
Q

What is the most common differential for peripheral vestibular disease?

A

Idiopathic peripheral vestibular syndrome

29
Q

What is idiopathic peripheral vestibular syndrome?

A

Sudden onset vestibular signs - ataxia, circling, head tilt, nystagmus
Non painful

30
Q

What is the prognosis of idiopathic peripheral vestibular syndrome?

A

Very good - dont euthanise!
Marked improvement over first 72 hours

31
Q

What is a differential for idiopathic peripheral vestibular syndrome?

A

Otitis media/interna - check dogs ears

32
Q

What are the clinical signs of a tail pull injury?

A

Flaccid tail
Flaccid anus
Urinary incontinence
Sciatic nerve deficits

33
Q

What is the treatment/prognosis for tail pull injuries?

A

Bladder management - lifelong
Fair to guarded prognosis depending on severity - if no improvement after 6 weeks then unlikely to regain function

34
Q

What is the localisation of a tail pull injury?

A

S1-S3