Clinical reasoning Flashcards
Differential diagnoses for degenerative neuro disease
Classically storage diseases, chronic progressive diseases, disc diseases
Intervertebral disc disease, Degenerative myelopathy,
Caudal cervical spondylomyelopathy (wobbler syndrome)
Differential diagnoses for anomalous neuro disease
Anatomical abnormalities, congenital or developmental
Atlantoaxial instability,
Arachnoid diverticulum,
Vertebral malformation
Differential diagnoses for Metabolic neuro disease
Often comes and goes but will be very symmetrical
Differential diagnoses for Neoplastic neuro disease
Usually progressive but can present acutely in the spinal cord
Vertebral body osteosarcoma, meningioma,
lymphoma,
glioma
Differential diagnoses for nutritional neuro disease
Not many
Differential diagnoses for inflammatory/infectious/idiopathic neuro disease
Infectious much less common
Idiopathic epilepsy
Myelitis,
Discospondylitis,
Epidural empyaema, Toxoplasma/Neospora
Differential diagnoses for Traumatic/toxic neuro disease
Usually peracute if traumatic
Toxic very symmetrical and generalised
Fracture / luxation,
Acute non-compressive nucleus pulposus extrusion
Differential diagnoses for Vascular neuro disease
Stroke in brain
Fibrocartilaginous embolism
Quite asymmetrical
Signs static or improving with time after an acute episode
Differentials for per-acute onset neuro disease
Trauma
Vascular
Acute non-compressive nucleus pulposus extrusion
Differentials for acute onset neuro disease (spinal)
Intervertebral disc extrusion
Inflammatory/infectious
Neoplasia
Atlanto-axial instability
Differentials for chronic onset neuro disease
Intervertebral disc protrusion
Wobbler syndrome
Degenerative myelopathy
Neoplasia
Arachnoid diverticulum
Differentials for static neuro disease
Trauma
Differentials for deteriorating neuro disease
Inflammatory/infectious
Neoplasia
Intervertebral disc disease (variable)
Differentials for waxing/waning neuro disease
Inflammatory
Metabolic
Differentials for painful neuro disease
Intervertebral disc disease,
Infection/inflammation,
Neoplasia (osteosarcoma),
Trauma,
Differentials for non-painful neuro disease
Vascular,
Degenerative Myelopathy,
Neoplasia (intramedullary),
Anomalous (arachnoid diverticulum),
Signs of painful neuro disease
Crying / vocalising
Reluctance to move
Head down
Reluctance to jump
Depression, reluctance to play, get out of bed
Reaction to palpation
Neuro conditions with pain only
Type 1 IVDH
Steroid Responsive Meningitis Arteritis
Atlantoaxial instability
Discospondylitis
Syringomyelia
Polyarthritis / polymyositis
Intracranial disease
Significant asymmetry common in which neuro disease?
vascular conditions (fibrocartilaginous embolism) and acute non-compressive nucleus pulposus extrusion
Which neuro diseases are often symmetrical?
Metabolic, toxic, nutritional conditions
Medication for painful neuro conditions
NSAIDs
Medication for inflammatory/immune-mediated neuro conditions
Corticosteroids
Medication for discospondylytis, empyaema neuro conditions
Antibiotics
Medication for vascular neuro conditions
No response to any
Signalment for intervertebal disc extrusion
Chondrodystrophic breeds – dachshund, French bulldog
Signalment for degenerative myelopathy
German Shepherd, Pembroke Welsh Corgi, Chesapeake Bay Retriever, Boxer
Signalment for atlantoaxial instability
Chihuahua, Yorkshire Terrier
Signalment for vertebral abnormalities and arachnoid space disorders
Pug, French Bulldog
Signalment for spinocerebellar hereditary ataxia
Jack Russell
Signalment for
Osseous Cervical Spondylomyelopathy (Wobbler Syndrome)
Great dane, mastiffs
Signalment for Disc Associated Wobbler Syndrome
Doberman
More common neuro diseases in juvenile animals (<1yr)
congenital/anomalous conditions e.g. atlantoaxial instability
More common neuro diseases in young animals (1-3yrs)
steroid-responsive meningitis/arteritis, inflammatory conditions
More common neuro diseases in older animals
Neoplasia, degenerative myelopathy
