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Equine > Neurology > Flashcards

Neurology Flashcards

1
Q

list spinal reflexes used in horses NE

A
  • thoracolaryneal adductor response
  • spinal segmental: cervicofacial, panniculus
  • tail/anal
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2
Q

gait factors assessed

A
  • proprioceptive deficits
  • ataxia
  • paresis
  • dysmetria
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3
Q

brain regions

A
  • forebrain
  • brainstem/CNs
  • cerebellum
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4
Q

spinal cord regions

A
  • C1-C6
  • C6-T2
  • T3-L3
  • L3-S5
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5
Q

peripheral neuro regions

A
  • brachial plexus (FLS)
  • HLs
  • NMJs
  • (primary muscle issue)
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6
Q

RAS is active in what brain regions

A
  • brainstem

- cerebrum

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7
Q

hypermetria, intention tremors, strength –> region?

A

cerebellar disease

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8
Q

seizures, blindness, dementia, mild ataxia/weakness –> region?

A

cerebral disease/forebrain

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9
Q

gait deficits, altered consciousness –> region?

A

brainstem

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10
Q

tail/bladder paralysis, perineal hypalgesia –> region?

A

sacral

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11
Q

front limb ataxia worse than hind –> region?

A

C6-T2

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12
Q

what spinal segment lesions may result in horner’s?

A

C1 - C5

C6-T2

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13
Q

3 types of ataxia

A
  • proprioceptive (spinal)
  • vestibular
  • cerebellar
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14
Q

2 types of paresis

A

LMN vs UMN

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15
Q

tests of proprioception

A
  1. Posture
  2. Truncal sway
  3. Circling: circumduction, interference, pivoting
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16
Q

tail pull at rest tests

A

extensor strength - LMNs

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17
Q

tail pull while walking tests

A

extension and flexion

UMNs and LMNs

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18
Q

muscle fasciculations are assoc. w/

A

LMN weakness

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19
Q

Grade 1 ataxia

A

mild/inconsistent ataxia at walk, worse when manipulated

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20
Q

Grade 2 ataxia

A

obvious ataxia at walk, worse when manipulated

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21
Q

Grade 3 ataxia

A

prominent ataxia, fall over if manipulated

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22
Q

Grade 4 ataxia

A

severe + might fall

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23
Q

Grade 5 ataxia

A

recumbent + can’t get up

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24
Q

px hendra

A

euthanasia

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25
Q

Hendra incubation and shedding

A

shed 2 days before CS

5-16 days incubation

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26
Q

Dx Hendra

A
  • rectal, nasal, oral swabs –> EDTA blood

- -> ELISA, virus isolation PCR

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27
Q

medications assoc. w/ seizures if intracarotid

A
  • xylazine, flunixin
  • bute
  • procaine pen (IV at all)
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28
Q

dx of bacterial meningitis and px

A

CSF tap –> poor px

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29
Q

fungal cause of meningitis in WA

A

cryptococcus

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30
Q

ddx for neurogenic blindness

A
  • forebrain dz
  • PPID (optic chiasm compression from macroadenoma formation)
  • trauma
  • neonatal encephalopathy
  • toxins
  • intra-carotid injections
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31
Q

ddx. diffuse/multifocal disease

A
  • arboviral encephalomyelitides
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32
Q

name 2 alphaviruses assoc. w/ encephalomeningitis

A
  • ross river virus

- eastern/western/venezuelan equine encephalitides

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33
Q

names 2 flaviruses assoc. w/ encephalomeningitis

A
  • west nile virus/kunjin variant

- murray valley encephalitis/japanese encephalitis

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34
Q

cs of ross river virus

A
  • polyarthralgia + effusions
  • distal limb oedema
  • systemic illness
  • not usu ataxia
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35
Q

cs of west nile fever/kunjin virus

A
  • muscle tremors (esp. muzzle)
  • variable fevers
  • variable RAS signs - obtundation/hyper-altert
  • ataxia/weakness
  • recumbency
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36
Q

px west nile

A

50% have residual signs
mortality ~ 30%
recovery in 3-4wks

37
Q

rank the encephalitides viruses in order of highest to lowest mortality

A
  1. EEE
  2. VEE
  3. WEE
  4. WNV (Kunjin)
  5. JE
38
Q

CSF tap findings of viral encephalitides

A

neutrophilic –> lymphocytic

39
Q

tx of viral encephalitides

A
  • anti-inflam: flunixin, dex
  • anti-ox
  • cooling
  • IVFT/lytes/glucose
  • anti-oedema tx
40
Q

incubation/pathophys of ABLV

A
  • long, variable incubation period (2wks->6months) –> delayed progression/viral replication in muscle cells at wound
  • ascends via peripheral or cranial nerves to brain
  • reduced production of normal functional proteins –> fatal in 3-10days
41
Q

ABLV CS

A
  • cerebral signs: mania/aggression, seizures, obtundation
  • RAS: altered consciousness
  • CN: dysphagia
  • Spinal: ataxia, weakness, paralysis, cauda equina
42
Q

dx of ABLV

A

PM test –> euthanase

- refrigerated brain –> direct FA test, negri bodies in purkinje cells

43
Q

management of ALBV

A
  • vaccination in endemic areas
  • human vax
  • euthanasia of suspect
44
Q

pathogen of EPM

A

Sarcocystis neurona

45
Q

CS of EPM

A
  • often vague/subtle multifocal disease

- asymm. ataxia/atrophy

46
Q

dx of EPM

A

CSF/serology antibodies

47
Q

Tx of EPM (and px)

A

Ponazuril/Diclazuril - at least 28days

- 60% horses response to tx +/- relapses

48
Q

pathogens of verminous myeloencephalitis

A

usu aberrant migration of;

  • halicephalobus
  • strongylus
  • parelaphostronglylus
49
Q

cerebellar dx in arabian foals ddx

A

cerebellar abiotrophy

50
Q

cs of shivers

A
  • cerebellar disease
  • hindlimb elevation: diff. trimming hind feet, backing, turning
  • high fat, low sugar diet? +/- PSSM
  • draught horses
51
Q

annual and perennial ryegrass toxicity cs

A
  • vestibulocerebellar signs w/ diffuse spinal or peripheral nerve involvement
  • severely affected horses may stumble or fall –> tetanic muscle spasms
  • signs often improve w/ recumbency
  • excitement or blind-folding exacerbates the signs
  • removal from affect fx (recovery 1-3wks)
52
Q

px of annual vs. perennial ryegrass toxs

A

annual –> suddenly dies - may never fully recover

perennial –> usu good recovery

53
Q

toxin in annual ryegrass tox

A

tunicaminyluracil ABs

54
Q

toxin in perennial ryegrass tox

A

lolitrem B

55
Q

ddx. trigeminal neuropathy

A

guttural pouch disease, ear mites, other hyoid disorders, EPM

56
Q

trigeminal neuropathy presentation and cs

A
  • 8-10yrs, Geldings > mares
  • flicking/tossing nose, rubbing nose, snorting
  • often mistaken ‘bee-sting’
57
Q

medical management of trigeminal neuropathy

A
  • cyproheptadine - serotonin antagonist/antihistamine
  • carbamazepine - anti-convulsant
  • nose-nets
58
Q

cs of vestibular syndrome

A
  • head tilt (poll towards lesion)
  • nystagmus
  • ataxia with strength (if peripheral)
  • lean/circle towards lesions, truncal sway
  • other signs if central - weakness, somnolence, CNs
59
Q

ddx peripheral vestibular syndrome

A
  • temporal osteopathy
  • trauma - fx of stylohyoid
  • middle/inner ear disease
  • idiopathic
60
Q

ddx central vestibular syndrome

A
  • trauma
  • EPM
  • abscess/neoplasia/mass
  • migrating parasites
  • tremorgenic toxins
  • diffuse encephalitis
61
Q

signs inc or decrease w/ peripheral vestibular syndrome when blindfolded?

A

worse!! thus signs increase

62
Q

ddx facial nerve paralysis

A
  • trauma, GA (headcollar)
  • multifocal
  • GP disease (Strangles!)
63
Q

Cervical vertebral stenotic myelopathy causes

A

cord compression - stenosis of vertebral canal –> Wobblers

64
Q

typical presentation for Wobblers

A

TBs + WBs
Males > Females * large rapid growth
4 months - 4yrs (and older)

65
Q

2 major CVSM subtypes

A
  1. Dynamic: young horse, C3-5, stenosis is dependent on position
  2. Static: older horse, C6-7, stenosis not position dependent
66
Q

typical CS of type 1 CVSM

A
  • weanling to ~24months
  • symmetric
  • pelvic limbs > thoracic limbs
  • neck pain is rare
  • C3-5
67
Q

typical CS/presentation of type 2 CVSM

A
  • older horses 18mo to 4yrs
  • occ. asymmetry
  • pelvic limbs > thoracic limbs
  • neck pain more likely - OA of facet joints
  • C5-T1
68
Q

list 4 subjective rad measurements when assessing for CVSM

A
  • alignment
  • vertebrae shape and size
  • intervertebral foramen
  • facet joints
69
Q

list 2 objective rad measurements when assessing for CVSM

A
  • intervertebral sagittal ratios: abnormal <0.485

- intravertebral sagittal ratios: abnormal if vertebral canal is less than half the size of the vertebral body

70
Q

limitations of myelography to diagnose CVSM

A
  • requires GA in an ataxic horse

- no as sensitive/specific as first thought

71
Q

treatment of CVSM in foals

A
  • restrict calories
72
Q

tx of cervical facet disease (OA)

A
  • pain w/out neuro signs –> usu older horses

- tx w/ corticosteroids

73
Q

why might a horse present with spinal neuro signs days after a known trauma?

A

they can actually ‘splint’ a fracture w/ their own muscle strength but after a few days they fatigue and fx may displace and cause neuro signs

74
Q

ddx urinary incontinence

A
  • EHV
  • trauma eg. foaling
  • multifocal/systemic neuro
  • chronic sudan grass tox
  • urogenital causes
75
Q

pathophysiology of EHV-1

A

vasculitis (capiliary endothelia) –> thrombosis –> ischaemia –> myeloencephalitis
+/- resp/repro disease

76
Q

cs of EHV-1

A
  • initial biphasic fever: URT infection –> viraemia
  • rapid progression (peaks at 24-48hrs) then plateuaus
  • spinal cord signs usu. ascending - symmetric paresis and ataxia *HLs, bladder atony (overdistension)

+/- CN/brainstem signs
*usu larger horses, >5yo

77
Q

dx of EHV-1

A
  • nasal swab and whole blood (buffy coat) –> PCR and virus isolation
  • serology (paired titres)
  • CSF: xanthochromia, increased protein, normal cell count (albuminocytologic dissociation)
78
Q

management of EHV-1

A
  1. Notifiable disease
  2. NSAIDs
  3. Antivirals: valcyclovir
  4. Anti-coags: heparin
  5. Supportive: limb support, bladder catheter
79
Q

MOA of tetanus

A

blocks GABA release - an inhibitory neurotransmitter –> tetany

80
Q

pathophys of clostridium tetani

A

<1-3wks incubation period

  • peripheral/cranial neuropathy: somatic and autonomic nerves affected, symmetrical
  • hyperaesthesia and hypertonicitiy: spastic paralysis
81
Q

CS of tetanus

A
  • head then limbs
  • muscle rigidity ‘saw-horse’ stance
  • muscle spasms: nictitans prolapse (extraoc. muscles), trismus, dysphagia
  • sympathetic overdrive
  • recumbency
  • resp. failure and death
82
Q

tetanus management

A
  1. reduce stim: dark, quiet, ear plugs
  2. Sedation: ACP, phenobarbital
  3. Muscle relaxation: Methocarbamol, Diazepam, Midazolam CRI, Dantrolene, MgSO4
  4. Source control: Debride and flush wound, metronidazole > Pen.G, antitoxin
83
Q

indicators of good px w/ tetanus

A
  • response to ACP
  • stabilises w/in 48hs
  • able to eat and stand unassisted
  • –> recovery 6-8wks
84
Q

tetanus vax protocol

A

2 primary vaccines 4-6wks apart –> boosters thereafter

85
Q

MOA of botulism

A

prevents ACh release from NMJ –> flaccid paralysis

86
Q

tx for botulism

A
  • resp support
  • nutritional support
  • ABs for secondaries
87
Q

damage to the suprascap nerve causes

A

sweeney

88
Q

stringhalt is caused by what plant?

A

Hypochaeris radicata (yellow daisy one)

89
Q

cs of stringhalt + recovery

A
  • laryngeal hemiplegia
  • recumbency
  • bilateral or polyneuropathy

Equine (7 decks)

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