SA neurology

Question 1

Describe the changes associated with forebrain lesions. (x8)

Answer 1

Altered mental status, normal gait, compulsive pacing, circling, reduced postural response, behavioural changes, normal to increased spinal reflexes/ muscular tone, decerebate rigidity

Question 2

In which direction would a dog circle with a forebrain lesion? Why?

Answer 2

Towards the lesion - decreased activity on that side!

Question 3

On which side of the body would a dog with a forebrain lesion show postural deficits? What would the deficits be like?

Answer 3

Knuckling on the contralateral side to the lesion

Question 4

Describe decerebrate rigidity.

Answer 4

No mentation, extended fore and hindlimbs with extended neck

Question 5

Describe decerebellate rigidity.

Answer 5

Mentation present, extended neck and forelimbs and flexed hindlimbs

Question 6

Describe the changes associated with cerebellum (x9).

Answer 6

Normal mentation, hypermetric gait/ delayed initiation, intention tremors, circling, truncal ataxia, reduced postural responses, normal spinal reflexes/ muscle tone, altered urination, decerebellate rigidity

Question 7

In which direction would a dog circle with a cerebellar lesion? Why?

Answer 7

Away from the lesion - increased activity on the lesion side (less inhibition)

Question 8

On which side of the body would a dog with a cerebellar lesion show postural deficits? What would the deficits be like?

Answer 8

Ipsilateral side - wide-based stance/ splayed

Question 9

Describe the path of neurones leading to the PLR.

Answer 9

Optic to hindbrain to occulomotor nerve

Question 10

Describe the path of neurones leading to the menace.

Answer 10

Optic to forebrain to facial

Question 11

What changes may be seen with a lesion of the hindbrain? (x7)

Answer 11

Depression/ stupor/ coma, CNS deficits/ vestibular signs, Paresis, decerebrate rigidity, reduced postural response, normal to increased reflexes/ tone, respiratory/ cardiac abnormalities

Question 12

What changes may be seen with a lesion of the vestibular system? (x6)

Answer 12

Ipsilateral head tilt, atazia, wide-based stance, nystagmus, tight circling, positional stabismus.

Question 13

What changes would be seen with a neuropathy?

Answer 13

Flaccid paresis, reduced reflexes

Question 14

What signs would be seen with an UMN lesion?

Answer 14

Ataxia, slow propagation, normal to increased reflexes, normal muscle tone/ bulk

Question 15

What signs would be seen with an LMN lesion?

Answer 15

Stiff/ bunny hop gait, normal propagation, reduced reflexes, muscle atrophy/ reduced tone

Question 16

What signs may be seen with a junctionopathy?

Answer 16

Exercise intolerance, sensory normal, intact tendon reflexes

Question 17

What signs may be seen with a myopathy?

Answer 17

Atrophy/ hypertrophy, normal sensory, generalised/ focal signs

Question 18

What breeds are predisposed to an idiopathic tremor?

Answer 18

Small breeds - terriers/ toys - worsening head tremor with stress

Question 19

What treatment is used for an idiopathic tremor syndrome

Answer 19

Steroids + other immunosuppressives - may relapse

Question 20

What clinical signs are seen with bacterial meningioencephalitis

Answer 20

Pyrexia, obtunded, CN deficits

Question 21

What pressures make up the overall intra-cranial pressure?

Answer 21

Brain volume , vascular and CSF pressure

Question 22

An increase in ICP may be characterised by what clinical signs?

Answer 22

Changes in mentation, occular (anisocoria, miosis, mydriasis), bradycardia/ hypertension, impaired vestibular eye movements, decerebrate/ cerebellar rigidity, abscent oculocephalic reflex

Question 23

How do you treat an increase in intracranial pressure?

Answer 23

Oxygenation, fluid therapy, diuresis (mannitol/ hypertonic saline), assess temperature and blood pressure, general nursing

Question 24

Which breeds are associated with hydrocephalus? How can it be treated?

Answer 24

Toy breeds -steroids, furosemide, AEDs, ventriculoperitoneal

Question 25

What clinical signs are associated with hydrocephalus?

Answer 25

Domed head, persistent fontanellae, abnormal behaviour, cognitive dysfunction, obtund, circling, seizures, vestibular disease

Question 26

Which breeds are predisposed to lissencephaly?

Answer 26

Lhasa apso/ korat cats

Question 27

What metabolic product can cause encephalopathy? What clinical signs are associated?

Answer 27

Ammonia (no conversion to urea) - seizure, circling, head pressing, mentation changes. Give lactulose, antibiotics and low protein diet

Question 28

Hypernautraemia can be characterised by what clinical signs?

Answer 28

Mentation and seizures - gradually correct levels

Question 29

What neurological signs characterise hypocalcaemia?

Answer 29

* Muscle spasm/ twitching/ cramps * Trembling * Stiffness * Mental depression * Tonic-clonic * Episodic regidity * Tetraparesis * Seizures

Question 30

What neurological signs characterise hypercalcaemia?

Answer 30

* Muscle spasm/ twitching/ cramps * Trembling * Mental depression * PUPD * Constipation

Question 31

What neurological signs characterise hypoglycaemia?

Answer 31

Anxiety, lethargy, PP, tremors, seizures, coma - caused by hepatic dysfunction and insulinoma

Question 32

Laforas disease may be seen in which dog breed?

Answer 32

Daschund - causes progressive myoclonic epilepsy. Feed antioxidant rich diets

Question 33

Beta-amyloid plaque accumulation causes what disease?

Answer 33

Cognitive dysfunction

Question 34

Define cerebrovascular accident.

Answer 34

Rapid loss of brain function due to vascular disturbance, usually ischemia

Question 35

What conditions may predispose dogs to a cerebrovascular accident?

Answer 35

Chronic kidney disease, hyperadrenocorticism, hypertension

Question 36

MUO

Answer 36

Meningioencephalomyelitis of unknown origin

Question 37

What breeds are predisposed to granulomatous MUO?

Answer 37

Young adult toy and terrier breeds

Question 38

What breeds are predisposed to necrotising MUO?

Answer 38

Pug, chihuahua, yorkie, ST - treated with immunosuppressive doses of corticosteroid/ cytosine

Question 39

What neurological signs may be associated with FIP?

Answer 39

Cerebellomedullary signs - paresis/ ataxia, progressive, ocular lesions

Question 40

What nervous structures may be affected by otitis media/ interna?

Answer 40

Facial nerve, vestibulocochlear nerve, sympathetic trunk

Question 41

Which parts of the brain may be damaged with a thiamine deficiency?

Answer 41

Lateral genticulate nucleus, caudal colliculo, vestibular and facial nucleus

Question 42

What antibiotics may be associated with ventibular toxicity/ ototoxicity?

Answer 42

Metronidazole, gentamycin, streptomycin (remember to check tympanic membrane before putting drugs down an ear!!)

Question 43

What is idiopathic vestibular disease?

Answer 43

Peracute vestibular signs which improve gradually over a few weeks

Question 44

Facial and vestibular neuropathy of unknown origin may be seen in which breed of dog?

Answer 44

Cockers

Question 45

What generalised signs may be seen with a neuromuscular disorder?

Answer 45

Tetraparesis, exercise intolerance, stiff/ stilted gait, muscular atrophy, altered reflexes, tremors/ fasciculations

Question 46

What is myaesthenia gravis?

Answer 46

Immune-mediated attack against acetylcholine receptors leading to AP blockage

Question 47

What is the most prominent clinical outcome of myaesthenia gravis in dogs? How is it managed?

Answer 47

Megaoesophagus

Question 48

Why are cats with myaesthenia gravis less likely to suffer with megaoesophagus?

Answer 48

They have less smooth muscle in their oesophagus

Question 49

What test is used to diagnose MA?

Answer 49

Edrophonium, gold standard = antibody test, electrodiagnostics

Question 50

What treatment options are their for MA?

Answer 50

Anticholinesterases (pyridostigmine), immunosuppression, thymectomy, postural feeding

Question 51

What clinical signs are associated with botulism

Answer 51

NACh - acute tetraparesis + CN deficits + resp muscle problems. MACh - urinary, GI dysmotility mydriasis, reduced tear production

Question 52

Paraneoplastic myositis may occur as a result of which types of tumour?

Answer 52

Thymoma/ lymphoma

Question 53

What parasites can cause myositis?

Answer 53

Neospora/ toxoplasma

Question 54

What can lead to an ischemic myelopathies?

Answer 54

Fibrocartilagenous embolism of spinal vasculature - leading to per-acute, non-painful weakness +/- proprioceptive deficits and decreased reflexes

Question 55

What breeds are predisposed to ischemic myelopathies?

Answer 55

Mini schnauzers, cats

Question 56

SRMA

Answer 56

Steroid-responsive meningitis arthritis

Question 57

What breeds are predisposed to SRMA?

Answer 57

Young dogs, boxers and beagles - pyrexia, pain, lethargy - steroids/ immunosuppressive

Question 58

What bacterial may cause discospondylitis?

Answer 58

Staph intermedius

Question 59

Discospondylitis

Answer 59

Discospondylitis is an infection of the vertebrae and intervertebral disc spaces

Question 60

Describe chiari-like malformation.

Answer 60

Toxic CSF accumulations (syringomyelia) and dilated central canal (hydromyelia) - NSAIDS, steroids, gabapentic, surgical decompression

Question 61

What is the difference between extrusion and protrusion IVDD?

Answer 61

Extrusion the annulus through the spinal cord (dasch) and protrusion in large breed dogs