Neuro/MSK Flashcards
What is the MST for cats with intracranial empyema or abscesssation that had surgical or medical management?
Surgical 730
Medical 183
Martin JFMS 2019
For cats with intracranial absessation or empyema, what were the most common:
- region affected?
- extra vs intra-axial
- T1W
- T2W
- FLAIR
- Enhancement on MRI
- CT pre and post contrast
- region affected? Forebrain, esp temporal and frontal
- extra vs intra-axial - predom extra axial
- T1W - homogenous or heterogenous
- T2W - hyperintense to normal grey matter + homogenous or heterogenous
- FLAIR - partially suppressed
- Enhancement on MRI - present, generally heterogenous + approx 1/3rd with rim enhancement
- CT pre and post contrast: hypoattenuating precontrast, and heterogensou rim enhancement post contrast
Martin JFMS 2019
For cats with itnracranial tumours treated with radiation:
- what percentage had improvement in neurological signs after radiation
- what was the median progression-free survival?
- percentage that were free of progression at 1 year?
- median overall survival?
95% had neuro signs improvement
510 days median progression-free survival
55% free of progression at 1 year
515 days median overall survival
Korner JFNS 2019
What breed is benign familial juvenile epilepsy seen in?
what type of seizures are seen?
at what age?
what is the treatment?
What is the cause?
What behavioural changes might they have?
- lagotto romangnolo
- focal onset seizures with whole body tremor, ataxia and stiffness
- start at 5-9 weeks
- spontaneous resolution at 13 weeks.
- mutation in the LG12 gene
- inattention and excitability like ADHD
Jokinen JVIM 2015
What are the reported survival times for dogs with brain tumours treated:
- symptomatically
- surgically
- radiation?
Symptomatic: 65d
Surgical: 312d
Radiation: 351d
Hu JVIM 2015
What are the clinical signs characterizing canine cognitice dysfunction?
- aimless wandering
- staring into space
- avoiding patting
- difficulty finding food
- anxiety
Schutt JVIM 2015
Does the use of phenobarb or bromide change the clearance of levetracetam? And what does this suggest?
Pheno alone or in combo with bromide causes increased keppra clearance => may need to increase dose of levetracetam
bromide didn’t have that effect.
Munana JVIM 2015
What are the two hormonal based patterns of seizures seen in entire female dogs and why?
- during heat - consistent with increased oestroge. oestrogen has proconvulsant effects
- at the end of diestrus - corresponding to drop in progesterone which has a protective effect against seizures
Van Meervenne JVIM 2015
What recommendations may be considered for italian spinone presenting with seizures and why?
- prevalence is higher than general pop (5.3% compared to 0.6%)
- more severe phenotype with icreased euthanasi due to poor control and shorter survival with dogs that have cluster seizures.
Commence antiepileptic medications after second seizure rather than the >3 seizures as usually recommended as this may improve survival
De Risio JVIM 2015
What percentage of patient with supratentorial herniation had no clinical signs of herniation?
75% had no signs of brain herniation
Lewis JVIM 2016
What breed can degenerative encephalopathy with rapid eye movement sleep behaviour disorder be seen in? at what age do signs start? what are the clinical signs? what are the MRI findings what is the likely cause? what is the prognosis?
- Nova scotia duck tolling retrievers
- 2m to 5 years start of signs
- present with episodes of marked movement during sleep, increased anxiety, noise phobia and gait abnormalities
- MRI - symmetical , progressively increasing T2 weighted image intensity within the caudate nuclea consistent with necorsis secondary to gray matter degeneration
- suspected axonal dystrophy due to autosomal recessive hereditary disease
- prognosis guarded - minimal response.
Barker JVIM 2016
What neurological neurological syndrome are Toyger cats potentially predisposed to?
What is the mode of inheritance?
What visiable physical abnormality was associated with affected individuals?
Forebrain commissural malformation, ventriculomegaly, interhemispheric cysts
- austosomal recessive inheritance
- short pinnae and domed craniums.
Keating JVIM 2016
What are the recommendations for commencement of AEDs in dogs?
- identifiable structural lesion, or prior history of brain disease or injury
- Acute repetitive seizures or SE >5m, >/= 3 sezirue in 24h
- > /=2 seizures in 6 months
- Prolonged, severe or unusual postictal periods.
ACVIM consensus 2016
What drugs are recommended as first line monotherapy in dogs with seizures?
- phenobarb
- imepitoin
ACVIM consensus 2016
What are the 6 stages of feline temporal lobe epilepsy that can be seen?
Where in the brain do these ictal signs originate from?
- attention response
- Arrest
- Salivation/licking
- Facial twitching
- Head turining or nodding
- Generalized clonic convulsions.
Ictal signs are due to abnromalities in hippocampus, amygdala or lateral temproal cortex
Kitz JVIM 2017
What are the clinical signs of juvenile onset hereditary ataxia in scottish terriers?
What cells are affected?
When does this first start?
What causes it?
- cerebellar dyfunction
- severe loss of purkinje cells, depleation of granule cells and atrophy of the molecular as well as polyglucosan body accumulation in cerebellar cortex
- onset within first year, but slow progression
- associated with mutation in CFA X
Urkasemsin JVIM 2017
Which is more effective at terminating status epilepticus:
- intranasal midazolam
- rectal diazepam
- intravenous midazolam
intranasal midazolam - stopped SE in 70% while rectal diazepam only stopped SE in 20%.
Charalambous JVIM 2017
Intranasal midazolam stopped SE in 76% of cases compared to IV midazolam in 61% of cases.
Intranasal was also faster - 33s to stop, vs 64s and total time was shorter (100s vs 270s)
Charalambous JVIM 2019
What is the treatment for paroxysmal dyskinesia in border terriers?
- hypoallergenic gluten-free diet.
Stassen JVIM 2017
Bartonella can be associated with CNS granulomas. Is PCR on CSF a useful way to detect this?
No - none detected. May represent these does didnt have bartonell, it was in the CNS but not CSF or was insufficient numbers for detection by PCR?
Bartner JVIM 2017
What is the prevalence of dogs presenting with seizures at primary care vets in the UK?
Which dogs are more likely to be affects?
0.8% prevalence most likely affected are: - male - pugs 3-6 years - over 40kg
Erlen JVIm 2018
What are the clinical signs of GM2 Gangliosidosis Sandhoff disease?
What mutation is it associated with?
- ataxia
- intention tremor
- falling
Homozygous deletion of 3 adjacent base pairs in the HEXB gene.
Wang JVIM 2018
What MHC class and immune cells are seen in MUO and what might this be the result of?
MHC Class II
CD3+ Tcells
suggestive of delayed hypersenstivity reaction.
Hoon-Hanks JVIM 2018
What vessel is transcranial doppler ultrasound performed on?
What measurement is useful to assist in the diagnosis of intracranial hypertension using this method?
- basilar artery
- ratio of systolic to diastolic mean velocity was higher in those with MRI evidence of intracranial hyeprtension and structural disease.
Sasoka JVIM 2018
What breeds are most likely to develop SRMA?
What percentage had 1+ relapse?
What was associated with reduced QOL in these dogs?
Golden retriever Bernese Mountain dog Wirehaired Pointing Griffon Boxer Beagle
48% had relapse
QOL was associated with steroid side effects, at higher dosages but these did not improve clinical outcomes…
Lau JVIM 2019
What are the complications and their % of VP shunts in:
1. dogs
2. Cats
With idiopathic hydrocephalus
Dogs:
- obstruction 10%
- pain 5.5%
- infection 4%
- disconnection 4%
- excesssive shunting 2.7%
- kinking 1.6%
Cats:
- coiling in SC - 15%
- kinking 7%
- obstruction 7%
Gradner JVIM 2018
What signs of focal epilepsy have been noted in Boerboel dogs?
What were the histopath findings?
What is the suggested mode of inheritance?
- fear related behaviour with howling, fearful facial expression and trembling during seizures.
Histopath: single large vacuoles in the perikaryon neurons esp deeper cerebral cortical regions. - suspected autosomal recessive.
What do corpus callosum abnormalities cause?
What is the pathogenesis in humans?
Causes adipsia and hypodipsia -> hypernatremia.
Maybe due to either:
- axons form but fail to cross the midline => probst bundles
- Axons or their parent cell bodes fail to form in the cerebral cortex (no probst bundles).
Johnson JVIM 2018
What is the prevalence of seizure precipitating factors in dogs with idiopathic epilepsy?
What are common seizure precipitating factors?
Are they more likely to precipitate a seizure in dogs with focal or generalized seziures?
74% stress sleep deprivation weather hormonal
mosre likely in focal onset seizures.
Forsgard JVIM 2018
What clinical findings are suggestive of cushing’s reflex and increased ICP?
- decreased mentation
- hypertension
- bradycardia
Kuo VCNA 2018
What are the 3 clinical syndromes associated with CNS FIP?
What is the MST for CNS FIP after diagnosis?
- T3-L3 myelopathy
- Central vestibular syndrome
- Multifocal CNS disease
MST 14d (2-115d)
Crawford JVIM 2017
what are common MRI changes associated with CNS FIP?
- meningeal contrast enhancement
- ependymal contrast enhancement
- ventriculomegaly
- syringomyelia
- foramen magnum herniation
Crawford JVIm 2017
What are the pathogenesis of neuronal ceroid lipofuscinoses?
What mutation has been found in Australian cattle dogs and border collies?
- progressive neurodegenerative disease die tp acci,i;atopm pf autpf;iprescent lysosomal storage material in the brain, retina and other tissues.
Mutatio CLN5
Kolicheski JVIM 2016
What are the signs of juvenile onset polyneuropathy in AmStafs?
what is the progression?
What is the likely mode of inheritance?
generalized motor and sensory neuromuscle signs +
- laryngeal paralysis
- megaoesophagus
slowly progressive with good QOL
Autosomal recessive inheritance.
Vandenberghe JVIM 2018
Which cats are more likely to have congenital sensorineural deafness?
solid white cats (30%) with 1 (44%) or 2 (50%) blue irises.
- Turkish Vankedisi
- Main coon
- Norwegian forest
Mari JVIM 2018
RAB3GAP1:c.743delC mutation is found in what breeds and associated with what condition?
Rotties and black russian terriers
assocaited wtih hereditary neuronal vacuolation and spinocerebellar degeneration.
Mhlanga-Mutangadura JVIM 2016
What are the signs of acute polyradiculoneuritis?
What part of the CNS is most affected
What has it been associated with as a possible causitive agent?
acute onset of LMN signs with rapid ascending flaccid paresis or plegia.
Immune mediated disorder affecting the ventral spinal nerve roots
campylobacter esp with raw chicken
Martinez-Anton JVIM 2018
What are the MRi findings of extraparenchymal spinal cord haematomas?
T2 weighted hyperintensity
- generally no contrast enhancement
Hague JVIM 2015
what is the estimated heritability of symptomatic syringomyelia in CKCS?
0.81
Thofner JVIM 2015
What disc are most likely to be affected by progressive myelomalacia following acute IVD extrusion?
T12-T13 and between L3-L6
Castel JVIM 2017
what were negative prognostic factors associated with recovery of ambulation and urinary continence in dogs with acute lumbosacral spinal cord injury?
Continence
- lesion at L4-S3
- loss of concious pain perception
- LMN incontinecne
- non-compressive lesions
Ambulation:
- absent concious pain perception
- large non-chondrodysplastic breed.
Shaw JVIM 2017
What percentage of dogs with spinal arachnoid diverticula treated surgical vs medically improved?
what about pugs?
Surgically - 82%
Medically - 30%
Mauler JVIM 2017
85% of pugs that had initial improvement post surgery developed late onset recurrence of clinical signsand deteriorated
Alisauskaite JVIM 2018
What is the likelihood of finding abnormalities on abdominal ultrasound in dogs with neurological disease?
When is it a lower yeild test?
58% had abnormalities on abdo u/s
considered a low yield test in young dogs and daschunds
Tong JVIM 2015
What does increased CSF lactate correlate with?
- nucleated cell coung
- absolute large mononuclear cell count
- absolute small mononuclear cell coung
- absolute neutrophil cell count
- protein.
suggestive of inflam disease. increased in 47% of those dogs with inflam disease.
Mariani JVIM 2019