Neurolocalisation

Question 1

What problems can arise from the forebrain?

Answer 1

*Hearing
*Vision
*Behaviour
*Conscious perception of touch
*Pain
*Temperature
*Body position
*Fine motor activity

Question 2

What can be observed with problems of the forebrain?

Answer 2

*Disorientation, depression
*Contralateral blindness
*Circling
*Seizures
*Hemi-neglect syndrome

Question 3

What problems can arise from the brainstem?

Answer 3

*Cranial nerves
*Vestibular nuclei
*Regulatory centres (CV + Resp)
*All sensory + motor tracts

Question 4

What can be observed with problems of the brainstem?

Answer 4

*depression, stupor, coma
*cranial nerve deficits (III –XII)
*vestibular signs
*paresis of all or ipsilateral limbs
*decerebrate rigidity
*↓postural responses in all limbs or just in ipsilateral limbs
*respiratory or cardiac abnormalities

Question 5

What problems can arise from the cerebellum?

Answer 5

• coordinates and smoothes out movement
  induced by UMN system:
  – spinal cord function and postural tonus
  – also more skilled movement
• inhibits vestibular system

Question 6

What can be observed with problems of the cerebellum?

Answer 6

*ipsilateral abnormal menace with normal vision and PLR
*vestibular signs
*ataxia, broad-based stance, hypermetria
*intention tremors
*decerebellate rigidity
*delayed initiation and then often hypermetric postural responses

Question 7

What problems can arise from the vestibular system?

Answer 7

*Head tilt - usually towards lesion (unless cerebellar)
*Nystagmus - lesion on side of slower phase
*Ataxia, leaning + falling

Question 8

What is a paradoxical head tilt?

Answer 8

*When lesion on opposite side of head tilt
*Seen in cerebellum

Question 9

What problem is always a sign of only forebrain lesions?

Answer 9

Seizures

Question 10

What problem is always a sign of only cerebellar lesions?

Answer 10

Hypermetria

Question 11

Where is lesion cranial to if all 4 legs affected?

Answer 11

Must be cranial to T2

Question 12

What is seen with lesions in C1-C5?

Answer 12

• tetra or hemiparesis/plegia
• normal spinal reflexes in all limbs
• Horner’s syndrome, respiratory
  difficulties, urinary retention

Question 13

What is seen with lesions in C6-T2?

Answer 13

• tetra or hemiparesis/plegia; possible monoparesis
• reduced spinal reflexes in thoracic limbs, reduced muscle tone, muscle atrophy in TLs
• possibly reduced/absent cutaneous trunci reflex
• nerve root signature, Horner’s syndrome, respiratory difficulties, urinary retention

Question 14

What are the grades of severity of disease?

Answer 14

*Grade 1 = no deficits, just spinal pain
*Grade 2 = ambulatory paresis
*Grade 3 = non-ambulatory paresis
*Grade 4 = paralysis
*Grade 5 = paralysis and loss of pain sensation

Question 15

What are the 3 categories of neuromuscular diseases?

Answer 15

*Neuropathies - peripheral nerve
*Junctionopathies - n-m junction
*Myopathies - muscle

Question 16

What is seen with motor neuropathy?

Answer 16

• flaccid paresis and reduced tone and muscle atrophy

Question 17

What is seen with sensory neuropathy?

Answer 17

*↓ sensation or paraesthesia (self-mutilation)

Question 18

What are examples of stuff causing pre, post-synaptic and enzymatic junctionpathies?

Answer 18

• pre-synaptic (e.g. botulism)
• post-synaptic (e.g. MG)
• enzymatic (e.g. organophosphates)

Question 19

Why are cats with myopathies of the head more easily detected?

Answer 19

-Dogs have nuchal ligament holding head up
-Cats don’t so heads down - more obvious

Question 20

What is the more likely cause if focal + lateralised lesion of the brain?

Answer 20

*Neoplasia
*Vascular

Question 21

What is more likely cause if multifocal lesions of the brain?

Answer 21

*Inflammatory
*Infectious
*Metastases

Question 22

What is more likely cause if diffuse + symmetrical lesion of the brain?

Answer 22

*Metabolic
*Toxic