Neuro articles Flashcards
Transpalpebral ultrasonographic measurement of the optic nerve sheath diameter in healthy dogs
Joshua J. Smith et al jvecc 2018
ONSD may be measured via US
- Bilaterally increased diameter may indicate incr ICP
- Unilateral asymmetric incr likely indicate 1ry optic nerve dz
ONSD incr w/ BW and decr w/ age + BCS
May be able to measured via transpalpebral approach
A serious adverse event secondary to rapid intravenous levetiracetam injection in a dog
Allison A. Biddick et al jvec 2018
60 mg/kg keppra IV undiluted over 5-10s –> suspet anaphylaxis: tachycardia, hyperglycemia, hypotension and dull mentation
Responded to fluid bolus + epinephrine –> develop resp signs = NCPE -> ventilation -> died
*Rec dilute or if undiluted, give it slowly. Likely idiosyncratic rx here
Retrospective characterization of coma and stupor in dogs and cats presenting to a multicenter out-of-hours service (2012–2015): 386 animals
Christopher A. Parratt BVSc, MRes et al jvecc 2018
Cats > dogs (chihuahuas)
Dogs= TBI, hypoglycemia, shock, seizures, rena/liver dz
Cats= TBI, renal/liver dz, intoxication, hypoglycemia, shock
46% dogs and 41% cats survived
Death less likely if caused by hypoglycemia
Traumatic atlantoaxial subluxation in dogs: 8 cases (2009-2016).
Sonya C Hansen, et al jvecc 2019
75% nonambulatory tetraparetic, cervical myelopathy
Usually trauma inflicted by another animal
Rec CT and MRI to determine extent + sx plan
7/8 had sx, complication= aspiration pneumonia, 50% ambulatory at discharge but the remaining became ambulatory within 2 months
A pilot study evaluating the effect of mannitol and hypertonic saline solution in the treatment of increased intracranial pressure in 2 cats and 1 dog naturally affected by traumatic brain injury.
Isabella Ballocco, et al jvecc 2019
Dehydration of brain tissue is more pronounced on the contralateral side of the lesion, where the brain tissue is preserved
Mannitol:
- 1st: Rheological effect: reduces blood viscosity and promotes plasma expansion and cerebral oxygen delivery. In response, cerebral vasoconstriction occurs due to autoregulation, and cerebral blood volume is decreased.
- 2nd: Osmotic effect that occurs 15–30 mins after when gradients are established between plasma and cells –> decrease in brain water content.
HTS: Plasma expanding and osmotic effect
*Both mannitol and 3% HTS decrease ICP and improve CPP
Acute kidney injury, seizures, and hypertonic hyponatremia secondary to mannitol intoxication in a dog.
Maëlle F Clabots, et al jvecc 2019
Mannitol-induced AKI (MIAKI): afferent renal arteriolar constriction, vacuolization of the proximal tubular epithelial cells –> partial tubular obstruction (osmotic nephrosis) and hypovolemia
Sz d/t acute hyperosmolality –> cell shrunk, hemorrhage
Hyperosmolar hyponatremia
Maintain maintain <55 mOsm/kg
Ketamine-dexmedetomidine combination and controlled mild hypothermia for the treatment of long-lasting and super-refractory status epilepticus in 3 dogs suffering from idiopathic epilepsy
Gioeni jvecc 2020
Dexmed:
- Decr central NE release = attenuate SNS stimulation on CNS
- Decr cerebral VO2 and metabolic ratae
- Cerebral vasoconstriction = decr CBF and cerebral edema
- Maintain CPP by preserving MAP
Ketamine:
Decrease excitatory glutamate activity (over expressed during SE)
Neuroprotective by blocking NMDA receptor-mediated glutamate-excitotoxicity + cell death
Reliability of interpretation of neurologic examination findings for the localization of vestibular dysfunction in dogs
C. Elizabeth Boudreau javma 2018
70% agreement b/w MRI and neuro exam for central vestibular
1/3 of exam identified peripheral dogs had central lesions found on MRI
Seizure etiologic classification and long-term outcome for cats with juvenile-onset seizures
Muna Qahwash javma 2018
Cats that developed seizures at < 12 months of age were more likely to have structural epilepsy than idiopathic epilepsy or reactive seizures.
Randomized blinded controlled clinical trial to assess the effect of oral cannabidiol administration in addition to conventional antiepileptic treatment on seizure frequency in dogs with intractable idiopathic epilepsy
McGrath JAVMA 2019
CBD was no better than placebo
Had sig. incr in ALP in CBD group
CBD possible AED MoA:
- Binding to certain transient receptor potential channels –> decreased release of glutamate
- activation of 5-hydroxytryptophan 1A receptors
- Inhibition of adenosine reuptake
CCM 2019
Association Between Elevated Mean Arterial Blood Pressure and Neurologic Outcome After Resuscitation From Cardiac Arrest: Results From a Multicenter Prospective Cohort Study.
Having higher BP (SBP>90mmHg) for first 6h after resuscitation from CPR associated w/ good neuro function at discharge
Seizure-precipitating factors in dogs with idiopathic epilepsy.
Johanna A Forsgård jvim 2019
74% had precipitating factors
Stress-related situations, sleep deprivation, weather, hormone
More common in focal than generalized sz
Open-label clinical trial of rectally administered levetiracetam as supplemental treatment in dogs with cluster seizures.
Giulia Cagnotti, jvim 2019
IV/rectal diazepam + IV pheno, then either PB only vs PB plus 40 mg/kg keppra PR
Response rate was 94% in rectal lev group vs 48% in control group
Cerebrospinal fluid lactate in dogs with inflammatory central nervous system disorders.
Christopher L Mariani jvim 2019
CSF lactate no diff b/w dz categories
CSF lactate is increased in all inflammatory CNS disorder
Comparison of intranasal versus intravenous midazolam for management of status epilepticus in dogs: A multi-center randomized parallel group clinical study.
Marios Charalambous, et al jvim 2019
In nasal midaz via atomizer was successful in stopping status (76%) and faster than IV when IVC placement time taken into account
Sedation + ataxia seen in 88% dogs
