Neuro - Spinal Cord Diseases

Question 1

What clinical signs are associated with limb dysfunction?

Answer 1

ataxia, hypermetria, paresis, and plegia

Question 2

What are our top differentials for spinal diseases?

Answer 2

Intervertebral disease, trauma (external), neoplasia, myelitis/meningitis, vascular, diskospondylitis/osteomyelitis, and syringmyelia

Question 3

What are the key diagnostics for spinal diseases?

Answer 3

Radiographs, advanced imaging (MR), and CSF analysis

Question 4

What is the most common spinal disease in dogs and cats?

Answer 4

intervertebral disk disease

Question 5

Does intervertebral disease focus on a specific portion of the spinal cord?

Answer 5

no - it can affect any region of the spinal cord

Question 6

Is intervertebral disk disease typically painful?

Answer 6

It can be painful or nonpainful

Question 7

What are the two forms of intervertebral disk disease?

Answer 7

type I - chondroid metaplasia and type II - fibroid metaplasia

Question 8

Chondroid metaplasia is an acute/chronic process that is associated with extrusions/protrusions.

Answer 8

acute, extrusions

Question 9

Fibroid metaplasia is an acute/chronic process that is associated with extrusions/protrusions.

Answer 9

chronic, protrusions

Question 10

What is degenerative myelopathy?

Answer 10

progressive degeneration of the spinal cord

Question 11

What breeds have a higher incidence of degenerative myelopathy?

Answer 11

German Shepherds, Boxers, and Corgis

Question 12

Where do clinical signs of degenerative myelopathy originate?

Answer 12

in the pelvic limbs

Question 13

True or false: Degenerative myelopathy is a non-painful degenerative disease.

Answer 13

TRUE

Question 14

How will degenerative myelopathy look on MR?

Answer 14

normal

Question 15

What will the CSF of patients with degenerative myelopathy show?

Answer 15

it will be normal - it may show increased protein

Question 16

What is often an incidental finding on radiographs of patients with degenerative myelopathy?

Answer 16

spondylosis deformans

Question 17

In patients with fibrocartilaginous emboli, what are clinical signs often associated with?

Answer 17

exercise

Question 18

Is fibrocartilaginous emboli a painful or nonpainful spinous disease?

Answer 18

non-painful

Question 19

Are clinical signs associated with fibrocartilaginous emboli symmetric or asymmetric?

Answer 19

asymmetric

Question 20

What other spinous disease process is fibrocartilaginous emboli clinically indistinguishable from?

Answer 20

traumatic disk disease

Question 21

What are extradural neoplasias?

Answer 21

They are tumors of structures surrounding the spinal cord

Question 22

What are intradural/extramedullary neoplasias?

Answer 22

neoplasias involving the meninges

Question 23

What are intramedullary neoplasias?

Answer 23

neoplasias that arise from within the spinal cord tissues

Question 24

True or False: Clinical signs associated with spinal cord neoplasias can be acute in onset.

Answer 24

true

Question 25

What is myelitis?

Answer 25

inflammation of the spinal cord

Question 26

What is meningitis of the spinal cord?

Answer 26

inflammation of the spinal cord and the meninges

Question 27

Describe how the clinical signs are in patients with myelitis.

Answer 27

They may be diffuse and are often associated with pain

Question 28

Myelitis can be infectious or non-infectious. What can cause infectious myelitis in dogs?

Answer 28

distemper or toxo

Question 29

Myelitis can be infectious or non-infectious. What can cause infectious myelitis in cats?

Answer 29

toxo or FIP

Question 30

Where do you want to collect CSF in myelitis suspect cases?

Answer 30

caudal to where the main problem is - safer

Question 31

What is a consistent clinical sign with diskospondylitis?

Answer 31

pain - either focal or diffuse

Question 32

Aside from pain, what clinical findings may be associated with diskospondylitis?

Answer 32

may have systemic signs, fever, and an inflammatory leukogram

Question 33

What is diskospondylitis?

Answer 33

infection within the disk space due to bacterial or fungal causes

Question 34

What bacteria is associated with diskospondylitis?

Answer 34

Staph, E. coli, and Brucella

Question 35

What is done to diagnose diskospondylitis?

Answer 35

radiographs, blood/urine culture (to determine the infectious cause), and direct culture

Question 36

What will diskospondylitis look like radiographically?

Answer 36

there will be lysis of the end plate and hyperostosis

Question 37

When is the onset of clinical signs due to trauma to the spinal cord?

Answer 37

acute onset

Question 38

What kind of injuries does exogenous trauma cause to the spinal cord?

Answer 38

fractures, luxations, and sub-luxations

Question 39

What shouldn't be done if you have a patient that has had trauma to the spinal cord?

Answer 39

you shouldn't make things worse by moving

Question 40

Are radiographs helpful in evaluating trauma to the spinal cord?

Answer 40

Yes they can be helpful but they may not show all of the injuries. Remember, radiographs only show where the vertebra are now, not how far they have traveled

Question 41

What is syringomyelia?

Answer 41

fluid filled cavities within the spinal cord

Question 42

What can syringomyelia result from?

Answer 42

Other primary disease that affects the spinal cord and often results from pathophysiology often at the caudal skull region

Question 43

What clinical signs are associated with syringomyelia?

Answer 43

none - many dogs are asymptomatic

Question 44

Who is the poster child for Wobbler's syndrome?

Answer 44

middle to older aged doberman and young large breed dog

Question 45

What is Wobbler's syndrome?

Answer 45

cervical vertebral malformation/malarticulation and compression

Question 46

What kind of myelopathy is Wobbler's syndrome?

Answer 46

stenotic myelopathy

Question 47

Where is Wobbler's syndrome usually located?

Answer 47

the caudal cervical area

Question 48

Early on which limbs are typically involved/affected in patients with Wobbler's syndrome?

Answer 48

the pelvic limbs

Question 49

Is Wobbler's an acute or chronic process?

Answer 49

chronic

Question 50

What clinical signs are associated with Wobbler's syndrome?

Answer 50

ataxia and paresis

Question 51

Is pain associated with Wobbler's syndrome?

Answer 51

It is sometimes a feature, however it is inconsistent

Question 52

What diagnostic tool is used to demonstrate compression in patients with Wobbler's syndrome?

Answer 52

advanced imaging (MR)

Question 53

What breeds commonly get atlantoaxial instability?

Answer 53

smaller breeds, often younger

Question 54

What is atlantoaxial instability?

Answer 54

malformation/instability at C1-C2 articulation - likely congenital or genetic, but trauma can cause this as well

Question 55

What diagnostic tool is helpful for diagnosing atlantoaxial instability?

Answer 55

radiographs and MR imaging for a complete diagnosis

Question 56

What is lumbosacral disease also known as?

Answer 56

cauda equina syndrome

Question 57

Is lumbosacral disease painful or not painful?

Answer 57

it is very painful

Question 58

What disease processes can cause lumbosacral disease?

Answer 58

any disease can occur there - tumor, diskospondylitis, and traumatic injury

Question 59

Where is degenerative lumbosacral disease localized?

Answer 59

at the LS junction

Question 60

What other disease process is often associated with degenerative lumbosacral disease?

Answer 60

degenerative IVD

Question 61

What is the most common clinical sign of degenerative lumbosacral disease?

Answer 61

pain

Question 62

What clinical signs are rare with degenerative lumbosacral disease?

Answer 62

paresis