Peripheral Neuropathies Flashcards by Courtney Smith

Neuropathic Syndrome

Neurogenic Muscle Atrophy

Flaccid paresis / paralysis

Reduced or absent reflexes

Decreased Pain response

Proprioceptive Deficits

How well did you know this?

Not at all

Perfectly

Peripheral Neuropathies

Motor and sensory nerves

Mono- or Polyneuropathies

Variable Etiologies

*degenerative, neoplastic, metabolic

*nutritional, inflammatory, infectios

*Traumatic

How well did you know this?

Not at all

Perfectly

Classification of Peripheral Neuropathies

Degenerative

giant axonal neuropathy

Hypertrophic neuropathy

Birman cat distal neuropathy

How well did you know this?

Not at all

Perfectly

Classification of peripheral neuropathies

metabolic

Diabetic Neuropathy

Hyperchylomicronemia

Hypothyroidism

How well did you know this?

Not at all

Perfectly

Classification of Peripheral Neuropathies

Neoplastic

Nerve Sheath Tumor

Leukemia

How well did you know this?

Not at all

Perfectly

Classification of peripheral neuropathies

Infection

Botulism, Tetanus

Tick Paralysis

Toxoplasma, Neospora

How well did you know this?

Not at all

Perfectly

Classification of peripheral neuropathies

Inflammatory

Coonhound paralysis

Idiopathic polyradiculoneuritis

Idiopathic , immune-mediated

How well did you know this?

Not at all

Perfectly

Diagnostic pathway for Peripheral Neuropathy

Accurate localization based on examination

Reference access

Clinical features and characteristics alone

Electromyography and Nerve Conduction Velocity studes

MRI

Nerve and Muscle Biopsy

How well did you know this?

Not at all

Perfectly

Traumatic Neuropathy

Monoparesis

Traction, compression, missile, bite, Injection, surgical, ischemia,

LMN signs

Variable return to function: axon intact, axon disrupted, support intact, severed axon and support

How well did you know this?

Not at all

Perfectly

Traumatic Neuropathy

Diagnosis

History,

Clinical signs

EMG
and NCV

How well did you know this?

Not at all

Perfectly

Traumatic Neuropathy

Treatment

Surgical

Conservative care

Amputate if non-functional or no improvement

*4-6 weeks in most

*Rare recovery after 4 months

*Axons regrow at 1-4 mm/day

How well did you know this?

Not at all

Perfectly

Facial Nerve Paralysis

Mononeuropathy

Etiology: Otiis media, Hypothyroidism, Trauma, Idiopathic

How well did you know this?

Not at all

Perfectly

Facial Nerve Paralysis

Diagnosis

clinical

Eliminate differentials

EMG

How well did you know this?

Not at all

Perfectly

Facial nerve Paralysis

Prognosis

poor for recovery

How well did you know this?

Not at all

Perfectly

Facial Nerve Paralysis

Treatment

Supportive

How well did you know this?

Not at all

Perfectly

Facial Nerve Paralysis

How well did you know this?

Not at all

Perfectly

Trigeminal Neuritis

Idiopathic, bilateral

Acute onset jaw paralysis

Some clients will present the dog for polydipsia

Concurrent neuropathy: CN7, Sensory of 5, Horner’s

How well did you know this?

Not at all

Perfectly

Trigeminal Neuritis

Diagnosis

Study These Flashcards

Clinical

Trigeminal Neuritis

Therapy

Study These Flashcards

supportive

Trigeminal Neuritis

Pronosis

Study These Flashcards

Good

Trigeminal Neuritis

Differential Diagnosis

Study These Flashcards

Leukemia / mononuclear cell neoplasia, rabies

Study These Flashcards

Trigeminal Neuritis

Coonhound Paralysis / Idiopathic Polyradiculoneuritis

Study These Flashcards

Hunting dogs (CP), any breed (IP)

Common polyneuropathy

Coonhound Paralysis / Idiopathic Polyradiculoneuritis

Clinical Presentation

Study These Flashcards

onset 7-11 days post-exposure

progressive over 12 hours or up to 10 days

LMN signs

Normal form Neck up

Persists up to 3 months

Sensory Pathways still intact

Coonhound Paralysis / Idiopathic Polyradiculoneuritis Level of effect

Severe affect facial nerve, voice, breathing

Coonhound Paralysis / Idiopathic Polyradiculoneuritis Diagnosis

Clinical EMG/MNCV: both may be normal CBC/Chemistry: normal

Coonhound Paralysis / Idiopathic Polyradiculoneuritis Therapy

supportive care Mechanical ventilation in some cases

Cat with idiopathic polyradiculoneuritis

Tick paralysis

A N-M juction disorder 5-9 days post attachement Progressive over 1-3 days

Tick paralysis Clinical Signs

Diffuse LMN signs Voice change, cough, dysphagia Normal cranial nerves Respiratory paralysis

Tick Paralysis Therapy

Tick removal - rapid recovery

Tick Pralysis Prevention

Isoxazolone preventives are most effective at preventing disease

Botulism

A N-M junction disease (**Type C Toxin Only**) Progressive ascending LMN paralysis Additional Findings: \*Megaesophagus \*KCS \*Dysphagia \*cranial nerve dysfunction Uncommon in dogs and cats

Botulism Treatment

mostly supportive No C Antitoxin 14-24 days for spontaneous recovery

Infectious Polyradiculoneurits

Protozoal Disease Neospora Caninum Toxoplasma Gondii Puppies \< 3 months

Infectious Polyradiculoneuritis Clinical Sings

Extensor Rigidity of pelvic limbs Meningoencephalomyelitis, myositis

Infectious Polyradiculoneuritis Diagnosis

Serology cytology Histopathology

Infectious Polyrradiculoneuritis Treatment

Clindamycin, TMS, Primethamine Ponazuril, Toltrazuril

Chronic Inflammatory Demyelinating Polyneuropathy Chronic Relapsing Polyneuropathy Idiopathic Unclassified Demyelinating Polyneuropathy

poorly classified and spontaneous Variable onset of symptoms and peripheral nerve dysfunction Paresis or paralysis involving all 4 limbs is the expected Recovery is spontaneous in many Immunosuppression helps with some forms

Tetanus

Tetanospasmin from C. tetani Inhibits Glycine and GABA release, protected from anti-toxin in neuron Generalized muscle stiffness, sardonic grin, laryngeal spasm Infected wounds or surgery sites Develop over 2-7 days Takes 30-45 days to resolve

Tetanus Managment

Penicillin or metronidazole (latter preferred) Musle relaxant: \*Acepromazine and methocarbamol: commonly recommend protocol, may need to administer methocarbamol hourly and ace every 4 hrs \*Phenobarbital, diazepam, midazolam, magnesium: more effective, especially in more severe cases \*Gabapentin: May help inhibit extensor tone Nutritional support Tetanus anti-toxin is not effective

Sensory Neuropathies Hereditary or idiopathic

longhairded dachshunds English Pointer

Sensory Neuropathies Sensory and or sensorimotor

Border collie, Rottweiler, Golden Retriever

Sensory Neuropathies

Proprioceptive loss, loss of pain perception, self-mutilation, megaesophagus

Peripheral Neuropathies Flashcards

(44 cards)