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Boards: Neurology + Ophthalmology > Neuro Emerg > Flashcards

Neuro Emerg Flashcards

1
Q

Which breeds almost never have FCE?

A

chondrodystrophic breeds

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2
Q

What is the typical clinical presentation of FCE?

A
  • peracute onset (<6 hours)
  • usually non-painful but hyperesthesia reported
  • nonprogressive after 24 hours - unless other secondary injury e.g., myelomalacia
  • often asymmetric myelopathy
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3
Q

What does FCE look like on MRI?

A

T2
* hyperintense focal, relatively sharply demarcated intramedullary lesion (grey matter)

T1
* iso- to hypointesne spinal cord grey meatter

MRI may be normal for first 24-48 hours after injury

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4
Q

What does ANNPE look like on MRI?

A

T2
* intramedullary hyperintesity overlying a IV disc with reduced volume and signal intesnsity of the nucleus pulposus
* narrowed disc space
* nucleus pulposus material in the epidural space dorsal to the affected disc

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5
Q

What are negative prognostic indicators for recovery from FCE?

A
  • more severe MRI lesions
  • LMN signs
  • bilateral symmetrical deficity
  • loss of nociception
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6
Q

How fast do dogs usually improve from FCE?

A

within 2 weeks

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7
Q

What are the meninges?

A

dura mater
arachnoid
pia mater

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8
Q

with idiopathic meningoencephalitis (e.g., MUO) where are lesions located?

A

concentric proliferation of inflammatory cells around blood vessels - predominantly in the white matter of the CNS

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9
Q

What is the most common CSF finding in dogs with MUO?

A
  • mononuclear pleocytosis
  • TP elevations
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10
Q

What is the gene mutation responsible for IVDD in chondrodystrophic dog breeds?

A

fibroblast growth factor 4 retrogene on chromosome 12

accelerates IVD degeneration

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11
Q

What is Hansen type I versus II IVDD?

A

Hansen type I: nucleus pulposus herniates through the annulus fibrosus - extrudes into the vertebral canal

Hansen type II: annulus protrudes due to shifting of nuclear material

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12
Q

What MRI changes has been associated with worse outcome and progressive myelomalacia?

A
  • intramedullary T2 hyperintensity
  • CSF T2 hypointensity and attenuation
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13
Q

What MRI sequence is primarily recommended for IVDD diagnosis?

A

T2 weighted sagittal and transverse

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14
Q

What is the main complication from contrast myelography?

A

seizures

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15
Q

When comparing medical with surgical management what is the outcome in TL-IVDD with ambulatory paraparesis?

A

medical: 80%
surgical 98.5%

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16
Q

When comparing medical with surgical management what is the outcome in TL-IVDD with nonambulatory paraparesis?

A

medical 81% - less complete
surgical 93%

17
Q

When comparing medical with surgical management what is the outcome in TL-IVDD with paraplegia but deep pain responsive?

A

medical 60% - prolonged recovery and less complete
surgical 93%

18
Q

When comparing medical with surgical management what is the outcome in TL-IVDD with paraplegia and deep pain negative?

A

medical 21%
surgical 61%

19
Q

What is the minimum recommended duration of restricted activity for TL-IVDD?

A

at least 4 weeks

20
Q

What is the recommendation on corticosteroids for medical management of TL-IVDD?

A

not recommended for routine use of medical management of the acute phase

chronic phase - some dogs may benefit

21
Q

What is the recommendation on NSAIDs for the medical management of TL-IVDD?

A

recommend use for 5-7 days - if no contraindication present

22
Q

What are recommendations for analgesia for medical management of TL-IVDD?

A
  • NSAIDs, gabapentin, pregabalin as options
  • consider muscle relaxants: diazepam or methocarbamol
  • recommend hospitalization if pain severe enoug hto require opioids
23
Q

What is the current recommendation on timing for surgery in TL-IVDD?

A
  • no recommendation made
  • but emphasize that surgery shouldn’t be declined due to prolonged sigs
24
Q

What is Pregabalin’s MOA?

A

involves binding to the alpha-2-delta subunit of voltage-gated calcium channels (VGCCs) in the central nervous system

25
Q

What indicates in a dog with TL-IVDD that it is able to urinate or not?

A

paraplegic - cannot urinate voluntarily

paraparetic (i.e., motor present) and pain perception - can urinate voluntariy

Boards: Neurology + Ophthalmology (14 decks)

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