Neurologic Diseases Flashcards
CNS
Brain and spinal cord
Peripheral Nervous System
Cranial nerves and spinal nerves
Autonomic Nervous system
heart muscle, smooth muscle, glands
Somatic nervous system
voluntary skeletal muscles
Parasympathetic division
rest and digest
sympathetic division
active and alert
Brain trauma clinical signs
Aural/oral/oculonasal hemorrhage, seizures, abnormal mentation, shock, cardiac arrhythmias, altered respiratory rate
Diagnoses of brain trauma
Clinical signs, history, advanced imaging (CT and MRI)
trauma to the brain often causes
increased intracranial pressure (ICP) due to edema and/or hemorrhage around the brain
The brain is encased in bone meaning there is no room for
swelling
Brain trauma treatment is aimed at controlling
clinical signs and decreasing ICP
Idiopathic or old dog vestibular disease
an acute disorder of middle-aged to older dogs and cats (not always but usually)
Clinical signs of vestibular disease
loss of balance, nystagmus, disorientation, ataxia, V+, anorexia
Diagnosis of vestibular disease
clinical signs, labs and otic exam to rule out inner ear problem, metabolic disorder, infectious or inflammatory disease, neoplasia
Vestibular disease may be
central or peripheral
TX for vestibular disease
cerenia for motion sickness and treat underlying cause if not idiopathic
Idiopathic Epilepsy
recurrent seizures with no demonstrated cause; believed to be hereditary
Breed disposition for idiopathic epilepsy
German shepherd, toy poodles, cocker spaniels, beagles, golden retrievers, Irish setters
Idiopathic epilepsy seizures on average begin around
1-3 years of age
Pre-ictal phase
animals w/ seizures usually have various clinical signs leading up to the seizure event
post ictal phase
period of time after seizure when animal may appear slightly disoriented
Work up for seizure patient
CBC/CHEM/UA, MRI, CT, CSF tap
Seizures are said to be
intracranial or extra cranial
All animals on seizure medications must have
Therapeutic drug monitoring done periodically, tx is usually life long
Status epilepticus
-a seizure lasting for a prolonged period of time (>5min) -can lead to coma and death -a true emergency
typical signalment for neoplasia
geriatric patients
Clinical signs for neoplasia
altered mentation, seizures, head tilt, vestibular disease, ataxia
What is required to definitively diagnose neoplasia
advanced imaging
tx of neoplasia
control clinical signs and maintain QOL; surgery; chemotherapy
One of the most common diseases in veterinary medicine
Intervertebral Disc Disease (IVDD)
IVDD occurs primarily in
middle0aged chondrodystrophic breeds (3-6 years)
What is chondrodystrophy
a disorder of cartilage formation
Chondrodystrophic dog breeds;
dachshund, bulldog, corgi, pug, French bulldog, basset hound, pekinese, shih tzu, poodle
what is IVDD
herniation of a diseased disc into the spinal cord causing subsequent inflammation and swelling of spinal nerves
Predisposing factors to IVDD
breed disposition, obesity, trauma
Clinical signs of IVDD
acute pain, tense abdomen, hunched appearance, paresis or paralysis, absence of deep pain, incontinence
Dx of IVDD
hx, clinical signs, rads may reveal a narrow disc space, MRI, myelogram
Tx of IVDD
medical and surgical
IVDD grading in K9
-Grade 5: Normal
-Grade 4: cervical or thoracolumbar pain, hyperesthesia
-Grade 3: paresis with decreased proprioception, ambulatory
-Grade 2: severe paresis with absent proprioception, not ambulatory
-Grade 1: Paralysis, decreased or no bladder control, conscious deep pain perception
-Grade 0: paralysis, urinary and fecal incontinence, no deep conscious pain perception
When should gradual active be reintroduced after IVDD
4-6 weeks
V-slot technique allows
direct access to the extruded disk material and direct visualization of the affected spinal cord
Major disadvantage of V-slot technique
potential for hemorrhage associated with laceration of the census sinuses
Most common surgical treatment for thoracolumbar disc disease
hemilaminectomy
fenestration procedure
prevents further extrusions by the removal of the nucleus from the offending disk and other discs which can rupture is sometimes performed in breeds with a high incidence of repeat disc extrusions
Bladder management prevents
UTI’s, over distention, urine scalding
Nursing care for spinal cord injuries
Bladder expressed ever 6-8 hours, clean environment to prevent decubital ulceration (pressure sores), frequent turning, closely monitor skin
The prognosis for functional recovery is good for dogs with grade
2,3, and 4 lesions
In dogs with grade 0 lesions that are treated within - hours of onset, the animal has a chance of making a functional recovery
24-48
Clinical presentation and tx of trauma to the spinal cord is similar to
IVDD
The atlas
the first bone in the neck (C1)
The axis
second bone in the neck (C2)
In several toy breeds, the _ is malformed
dens
Clinical signs for Atlantoaxial Subluxation (AA Lux)
neck pain, abnormal head positions, head tilt, holding head down, ataxic, paralysis, sudden death
Best long term tx for AA lux
surgical stabilization of C1 and C2 joint. Surgery involves fusing the atlas to the axis with surgical screws and bone cement
Cervical Spondylomyelopathy aka
Wobbler’s Disease
Etiology of wobblers disease
malformation or misarticulating of the caudal cervical vertebrae (C5-C7)
What is Cervical Spondylomyelopathy (wobblers disease)
a disease of the cervical spine that is commonly seen inlarge and giant breed dogs and horses characterized by compression of the spinal cord and/or nerve roots which leads to neurological signs and/or neck pain
The term wobbler syndrome is used to describe the
characteristic wobbly gait that affected animals have
For dogs there are at least _ different types of surgery to treat wobbler syndrome
21
Etiology of Degenerative Myelopathy
diffuse degeneration of the white matter in the spinal cord
What is Degenerative Myelopathy
a chronic, progressive disease of the spinal cord and ultimately the brain stem and cranial nerves which at its end stage results in complete paralysis and death
Clinical signs of Degenerative Myelopathy
slowly progressing hind limb paresis, ataxia, muscle atrophy, CP deficits, usually non painful
Signalment of Degenerative Myelopathy
German Shepherd and GS mixes
Etiology of discospondylitis
infectious agents become implanted into the bones of the vertebral column
Clinical signs of discospondylitis
fever, depression, pain, neurologic signs
Diagnosis of discospondylitis
x-rays reveal lysis of vertbral endplates and osteophyte formation; urine and blood cultures positive, Brucella Canis slide agglutination
Tx of discospondylitis
appropriate anti-infective based on C&S; neuter or spay if B.canis
Discospoondylitis is not the same as
spondylosis deformans
Etiology of Fibrocartilaginous Embolism (FCE)
ischemia of the spinal cord caused by a fibrocartilaginous emboli that obstructs the veins and arteries
Clinical signs of FCE
acute onset of neurologic signs with the absence of pain; paresis or paralysis of limbs
Tx of FCE
steroids, supportive care, rest
Px of FCE
guarded to good, recovery may take months
Conductive deafness
secondary to severe otitis, rupture of the tympanic membrane, or damage to middle ear
Neural deafness
may be hereditary or congenital or secondary to drug toxicity
Etiology of metabolic neuropathy
metabolic; typically endocrine: diabetes mellitus, hyperadrenocorticism, hypothyroidism
Clinical signs of metabolic neuropathy
muscle weakness, muscle atrophy, paresis, paralysisv
tx of metabolic neuropathy
correct underlying disease
Laryngeal paralysis (Lar-Par)
paralysis of the larynx
Etiology of Lar Par
Hereditary, Acquired (damage to laryngeal nerve, rabies, lead poisoning), idiopathic
Lar Par also referred to as Laryngeal Hemiplegia in
Horses
Etiology of Laryngeal Hemiplegia in horses
damage to the left recurrent laryngeal nerve
A condition in cats, dogs, and horses where peristalsis fails to occur properly and the esophagus becomes dilated
megaesophagus
Etiology of megaesophagus
Congenital or acquired
Clinical signs of megaesophagus
Regurgitation of undigested food, respiratory signs, failure to thrive/poor body condition
TX for megaesophagus
elevated food platform, meat ball meals, multiple small meals/day, pro-motility drugs, manage aspiration pneumonia
Etiology of tick paralysis
salivary neurotoxin produced by the female dog tick Ixodes spp. and Dermacentor spp.
Clinical signs of tick paralysis
gradual hind-limb incoordination that progresses to a flaccid paralysis; ticks on dog
Coonhound paralysis
A rarely occurring medical condition in dogs that is caused by the bite of a raccoon.
Medical term for coonhound paralysis
polyradiculoneuritis
Client communication for coonhound paralysis
dogs are bed ridden until they can function on their own, during this period muscle loss occurs, making recovery ling. Physiotherapy is needed to keep the muscles active
