Disorders of peripheral nerves, NMJ and muscles

Question 1

What are the clinical signs associated with neuropathy

Answer 1

Reduced or absent reflexes in regions supplied by the nerve

Reduced conscious proprioception and postural reactions in affected limbs

Reduced muscle tone
- except with ischemic neuromyopathy due to arterial thromboembolism

Flaccid paresis/paralysis

Atrophy of muscle supplied by affected nerve
- contracture and fasciculation of muscle may occur with chronic denervation

Polyneuropathies usually affect motor nerves more greatly than sensory nerves

Although generalized, polyneuropathies may affect hind limbs more severely

Question 2

What would be your differentials for polyneuropathy in cats

Answer 2

Inherited:
- birman cat central-peripheral distal polyneuropathy
- bengal cat polyneuropathy
- spinal muscular atrophy in Maine Coon cats
- hyperoxaluria
- lysosomal storage diseases

Acquired:
- diabetic neuropathy
- hyperthyroidism
- idiopathic polyradiculoneuritis
- chronic inflammatory demyelinating polymyopathy
- paraneoplastic (rare)

Question 3

What would be your differentials for localized or regional peripheral nerve disease in cats

Answer 3

Hyperchylomicronemia with secondary xanthoma formation

Hypertrophic neuropathy

Neoplasia

Trauma

Brachial plexus neuritis

Ischemic
- arterial thrombi
- tumor thrombi

Infectious
- mycobacterial neuritis (rare)