Neurolocalisation cases Flashcards
Localise this lesion based on the history:
- Obtundation (dull, reduced alertness)
- Circling to the right
- Absent proprioception in left limbs
- Absent menace response in left eye
- Reduced facial sensation in left side
Right forebrain
- Characterised by circling
- Vision reduced on the contralateral side
- Nasal stimulation is similar to the menace test which is also reduced
Localise this lesion based on the history:
- Ataxia with leaning to right
- Head tilt to right
- No proprioceptive deficits
- Right positional strabismus
- Spontaneous nystagmus with fast phase to left
Right peripheral vestibular system
- No paresis, no cerebellar signs (hypermetria, truncal sway, tremors) so it must be a peripheral disease
Localise this lesion based on the history:
- Mild leaning to the right?
- Head tilt to right
- Hypermetria left thoracic limb
- Clumsy hopping on left thoracic limb
Left cerebellum
- Hypermetria tells you it’s a cerebellar lesion
- You also get a paradoxical head tilt away from the lesion (so a right head tilt tells you the lesion is on the left)
- Proprioception is affected on the same side as the cerebellar lesion
Localise this lesion based on the history:
- No menace responses bilaterally
- No PLRs bilaterally
- Normal proprioception
- Normal fundus exam and ERG
Optic chiasm and optic nerves
- If both the PLR and menace response are affected it has to be a cranial (including the chiasm) lesion
Localise this lesion based on the history:
- Generalised ataxia with hypermetria and spasticity (stiff in movement)
- Reduced proprioception in all limbs
- Reduced menace?
- Owner has seen 3 seizures, says dog is a bit difficult to train
Multifocal
- Signs of cerebellar disease: hypermetria, ataxia, reduced menace
- History (seizures and marked behaviours) links to the forebrain
- Degenerative disease that affects different areas of the brain
Localise this lesion based on the history:
- Absent proprioception in the pelvic limbs
- Normal proprioception in the thoracic limbs
- Spinal reflexes unaffected
- Absent pain sensation in the pelvic limbs
- Cutaneous trunci cut-off around TL junction
T3-L3
- Has to be caudal to T3 if only the back legs are affected
- If the reflexes are intact it tells you that L4-S3 is normal
Localise this lesion based on the history:
- Tetraplegia (possibly slight movement…)
- Proprioception absent/reduced in all limbs
- Normal spinal reflexes in pelvic limbs
- Reduced spinal reflexes in thoracic limbs (pain appears present)
C6-T2
- Has to be cranial to T3 as all 4 limbs are affected
Localise this lesion based on the history:
- Monoparesis left forelimb
- Absent spinal reflexes in left forelimb
- Reduced sensation in left forelimb
- Ipsilateral Horner’s syndrome (partial)
Left brachial plexus (very lateralised C6-T2…)
Localise this lesion based on the history:
- Flaccid tetraparesis/plegia
- Absent spinal reflexes in pelvic limbs
- Absent spinal reflexes in thoracic limbs
- Abnormal bark, change in voice
Neuropathy
Localise this lesion based on the history:
- Weakness
- Stiff, stilted gait – no neuro deficits
- Neck ventroflexion; can’t look up!
Myopathy
