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18- SA- Neurology > Neurology > Flashcards

Neurology Flashcards

(109 cards)

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1
Q

Define Parapesis

A

partial loss of voluntary motor ability in 2 limbs - most commonly affecting the hindlimbs

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2
Q

define paraplegia

A

complete absence of any voluntary motor ability in 2 limbs - most commonly affecting the hindlimbs

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3
Q

List 7 common clinical conditions causing parapesis/ paraplegia in dogs/cats

A

IVDD
ischaemic myelopathy
FCE
spinal fracture
neoplasia
MUO
degenerative myelopathy

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4
Q

what is MUO

A

meningoencephalomyelitis of unknown origin

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5
Q

define tetraparesis

A

partial loss of voluntary motor ability - weakness in the ability to generate gait - in all 4 lilmbs

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6
Q

Define tetraplagia

A

complete absence of any voluntary motor ability in all 4 limbs

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7
Q

List 6 common clinical conditions causing tetraparesis/ tetraplegia/ cervical pain in dogs and cats

A

IVDD
MUO
SRMA
FIP
discospondylitis
atlantoaxial subluxation

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8
Q

what is SRMA

A

steroid responsive meningitis arteritis

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9
Q

List 3 common clinical conditions that cause generalised neuromusclular weakness in dogs/ cats

A

clostridial diseases
poly myositis
IPRN-idiopathic polyradiculoneuritis

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10
Q

what is IPRN

A

idiopathic polyradiculoneuritis

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11
Q

Describe the presentation of MUO

A

usually chronic, painful, progressive and multifocal

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12
Q

Describe how MUO occurs

A

autoimmune idiopathic inflammation of the meninges in the brain and spinal cord

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13
Q

Decsribe how to diagnose MUO

A

non definitive but:
MRI
bloods
CSF tap

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14
Q

Describe how to treat MUO

A

high immunosuppressive dose of steroids and/or immunosuppressive agents

variable prognosis

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15
Q

Describe the pathophysiology of FCE

A

is a focal embolus of fibrocartilage within the ascending artery of the spinal cord- can be bilateral or unilateral

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16
Q

Decsribe how to diagnose FCE

A

MRI

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17
Q

Describe how to treat FCE

A

conservative management - assess bladder and bowel function

they usually recover with time and physio

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18
Q

Describe the presentation of FCE

A

sudden onset non-painful paresis/paralysis, especially if unilateral - highly suspicious of FCE

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19
Q

Describe the 3 manifestations of IVDD

A

type 1 - nuclear extrusion (disc bursts an pushes out

type 2 - protrusion (disc shifts upwards)

disc cyst - small amount of nuclear material comes out of the spinal cord and is very hydroscopic which causes a build up of water around the disc

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20
Q

Describe how to diagnose IVDD

A

radiography or MRI

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21
Q

Describe the presentation typically seen with IVDD type 2

A

= protrusion
usually progressive in onset, clinical signs predominantly by compression

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22
Q

Describe the typical presentation of IVDD type 1

A

= extrusion
usually sudden onset pathology (but can get multiple episodes which can resolve spontaneously without intervention)

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23
Q

Describe how to treat IVDD

A

referral for surgical removal

conservative - rest and NSAIDs

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24
Q

Describe the pathophysiology of degenerative myelopathy

A

progressive degeneration of the spinal cord

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25
Describe the presentation of degenerative myelopathy
chronic progressive hindlimb ataxia non-painful condition
26
Describe how to diagnose Degenerative Myelopathy
is by exclusion (IVDD protrusion) there are no signs yet identified on MRI
27
which breed commonly gets Degenerative Myelopathy
GSDs
28
Describe how to treat Degenerative Myelopathy
no effective therapy physio been shown to slow the rate of progression but not prevent
29
Describe the pathophysiology of spinal fracture
needs significant trauma unless there is a pathological fracture
30
Describe the presentation of spinal fractures
acute onset of clinical signs- can be exacerbated by movement of unstable structures
31
Describe how to diagnose a spinal fracture
conscious radiography
32
Describe how to treat a spinal fracture
conservative management if fracture is stable - rest and analgesia euthanasia refer for surgical stabilisation
33
what is the prognosis of a spinal fracture
determined by the degree of concussion, compression or laceration damaged sustained by the spinal cord
34
Describe ischaemic myelopathy
loss of blood supply to the spinal cord - caused by some form of blockage
35
Describe how neoplasia affecting CNS generally present
progressive with focal presentation can be painful or non-painful
36
Describe how to treat neoplasia that affect the CNS
no effective chemo protocol corticosteroids at anti-inflammatory doses Surgical excision is unlikely to be curative due to the inability to remove a surgical margin
37
Describe the pathophysiology of discospondylitis
is infectious inflammation within the nucleus pulposus of the disc
38
Describe how discospondylitis presents
chronic progressive spinal pain without obvious neurological deficits that may be focal on palpation of difficult to localise. Chronic pain but can occasionally progress to ataxia or some paresis
39
Describe how to diagnose discospondylitis
radiography- in chronic cases CT/MRI
40
Describe how to treat discospondylitis
systemic antibiotics (for 6 weeks) can perform surgey to lance the abscess
41
Describe the pathophysiology of polymyositis
autoimmune inflammation within the muscles leads to large amounts of pain
42
Describe how polymyositis presents
chronic lameness or lethargy secondary to generalised pain
43
Describe how to treat polymyositis
corticosteroids at an immunosuppressive dose
44
Describe how to diagnose polymyositis
definitive on muscle biopsy
45
why do toy breeds more commonly get atlantoaxial subluxations
they have laxity of the tendons holding C1 and C2
46
Decsribe how to diagnose an atlantoaxial subluxation
radiography - conscious or GA with careful dynamic views CT/MRI
47
How does atlantoaxial subluxation present
Variable: - cervical pain - intermittent collapse - tetraparesis
48
DEcsribe how to treat a atlantoaxial subluxation
immobilise the joint for 6 weeks and provide analgesia neck brace and cage rest some cases will need surgical stabilisation
49
what are atlantoaxial subluxations associated with
significant trauma incident (eg dogs running into patio doors with forced head ventroflexion) OR in young toy breed dogs where anatomical factors will predispose.
50
Name a common spinal tumour seen in cats
lymphosarcoma
51
what neurological signs can metronidazole cause at high doses
vestibular signs
52
How does wet FIP present
oedema in tissues
53
Describe how dry FIP presents
rapidly progressive - causes granulomas in tissues (can occur in nervous system) sudden hindlimb ataxia which can progress
54
Describe how to diagnose neurological FIP
bloods MRI
55
Describe how to treat FIP
Supportive care: anti-inflammatories, appetite stimulants (mirtazapine), vitamin B12, s/c fluids at home, anti-oxidants Remdesivir Euthanasia?
56
Describe how to diagnose clostridial disease
CSF tap MRI bloods
57
Describe how botulism presents
sudden onset neuromuscular weakness affecting all limbs- flaccid paralysis
58
Describe how to treat botulism
remove the animal from the source of the toxin (generally dead animal) - should be recover after this
59
Describe how tetanus presents
varies from mild stiffness to severe spasm and inability to stand
60
Describe how to treat tetanus
clean wounds supportive therapy anti-toxin- not as important as in horses
61
Describe the pathophysiology of IPRN
inflammation of the nerve roots, travels from the back legs forwards - stops at cervical region of goes further and takes out the diaphragm
62
Describe how IPRN presents
progressive ascending lower motor neurone weakness, initally of the distal himdlimbs progressing to all limbs
63
Describe how to treat IPRN
usually left limiting no specific treatment- conservative therapy with support and physio
64
Describe the pathophysiology of SRMA
is an autoimmune condition with inflammation targeted towards the arteries in the meninges.
65
Describe how SRMA presents
in young dogs around 12 months old acute onset severe neck pain without evident neuro deficits
66
Describe how to diagnose SRMA
CSF tap - will see neutrophils MRI- to rule out other differentials
67
Describe how to treat SRMA
extended course of corticosteroids at immunosuppressive doses - 6 weeks min
68
How does neospora present
generalised muscle issue not paralysis hindlimb rigidity in young dog muscle pain
69
describe central vestibular syndrome
lesions affecting nerve roots within the brain
70
describe peripheral vestibular syndrome
lesions affecting peripheral nerve roots
71
List 4 common clinical conditions causing central or peripheral vestibular syndrome in dogs or cats
idiopathic vestibular disease otitis interna MUO neoplasia
72
List 3 common clinical conditions causing cranial nerve dysfunction in dogs and cats
trigeminal neuropathy facial paralysis trigeminal neoplasia
73
what is a notifiable disease causing neurological signs in dogs and cats
rabies
74
DEfine seizure
abnormal electrical activity within the brain causing episodes and neurological deficits and the disruption of the autonomic nervous system during episodes
75
List 4 common clinical presentations producing seizures in dogs and cats
idiopathic epilepsy metabolic brain disease structural brain disease neurotoxicity
76
what are head tilts commonly associated with
vestibular disease OR ear infections
77
define nystagmus
involutary rapid eye movements
78
List the clinical signs of vestibular disease
head tilt ataxia wide-based stance circling leaning falling positional strabismus
79
will bilateral vestibular disease have a head tilt or nystagmus
no
80
List the clinical signs seen with central vestibular disease
possible paresis or proprioceptive deficits consciousness may be depressed, stuporous or comatose CN 5-7may be affected horizontal, rotary or vertical nystagmus may be present
81
List the clinical signs seen with peripheral vestibular disease
alert CN 7 affected possible horner's syndrome horizontal or rotary nystagmus
82
Describe how to differentiate central from peripheral vestibular disease
both will have head tilt towards lesion, nystagmus, circling, nausea central will have other neurological signs
83
Describe how to diagnose idiopathic vestibular syndrome
by exclusion
84
Describe how to treat idiopathic vestibular disease
conservative management- if nausea significant part of presentation can try anti-emetic no specific treatment
85
Describe presentation of trigeminal neuropathy
sudden onset dropped jaw can maually close jaw with no pain
86
Describe how to diagnose trigeminal neuropathy
by exclusion (TMJ problems and masticatory myositis)
87
Describe how to treat trigeminal neuropathy
conservative therapy (support eating and drinking)- return to function in 4-6 weeks
88
Describe how facial paralysis presents
facial asymmetry absence of blink lateral deviation of the nose
89
Describe presentation seen with trigeminal neoplasia
progressive head assymmetry secondary to atrophy of temporal and masseter muscle unilaterally
90
Describe how to diagnose trigeminal neoplasai
CT/MRI
91
Describe how to diagnose neospora
serology
92
Describe how to treat neospora
Clindamycin if caught early PTS -
93
a case present with its first seizures with no known aetiology - what is the first diagnostic test?
biochem and haematology
94
a cat present with a right head tilt and nystagmus - where is the lesion ?
right vestibular lesion
95
what do seizures with altered mentation mean between them mean
forebrain lesion
96
what drugs are used to control seizures
benzodiazapeam and phenobarbitone
97
List the side effects of using phenobarbital to control seizures
risk of hepatic damage sedative effect PU/PD
98
how long does phenobarbital take to get to a therapeutic dose to control seizures
2 weeks
99
why would we use imepitoin instead of phenobarbital to control seizures
if worried about liver pathology
100
why don't we do blood test with imepitonin
it has a big therapeutic range
101
what seizure case is phenobarbitone licensed in
progressive cases frequent seizures cluster seizure
102
when is imepiton licensed in small animal seizures
idiopathic epilepsy
103
why can we us Benzodiapazerm as an anticonvulsant in cats but not dogs
dogs develop a tolerance
104
what can we give if diazepam hasn't stopped a seizures
phenobarbital CRI propofol
105
what is the lesion is you have a vestibular disease plus any neurological deficits
central vestibular lesion
106
what are signs of bilateral vestibular disease
head swings side to side shifting nystagmus
107
what cranial nerves effect swallowing
CN 9, 10, 12
108
dog present with dysphagia - how do you decide if it bilateral or unilateral
the tongue will hang out of one side if unliateral
109
is dysphagia is profoundly bilateral - where must the lesion be
brainstem- effecting multiple CN

18- SA- Neurology (11 decks)

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