Approach to disease of the brain, spinal cord, and the neuromuscular system

Question 1

What is the approach to diagnosis and formulating a treatment plan?

Answer 1

Presenting compaint -> history, physical and neuro exam -> problem list (neurolocalisation) -> differential diagnosis -> diagnostic tests -> diagnosis -> treatment plan

Question 2

What are the 8 parts of the neuro-exam?

Answer 2

• Mentation
• posture
• gait
• postureal reactions
• spinal reflexes
• cranial nerves
• palpation
• nociception

Question 3

What clinical signs are associated with condroid degeneration of the nucleus pulposus?

Answer 3

• Spinal pain
• neuro defecits
• may or may not be symmetrical

Question 4

How is IVDD treated?

Answer 4

Can be treated medically, or surgically
- Medically: gentle physio, short lead walks, strictly rested, +/- NSAIDs, +/- gaba, +/- paracetamol

• Surgical: when neuro signs are severe, aims to decompress spinal cord