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Patient Care 2 > Neurological disorders > Flashcards

Neurological disorders Flashcards

1
Q

What is meningitis?

A

Dangerous infection causing inflammation to the spinal cord and brain
-Debilitating and potentially life threatening

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2
Q

Identify some clinical signs of meningitis

A
  • Pyrexia
  • Muscle spasms
  • Depression
  • Confusion
  • Drooling
  • Bulging eyes
  • Neck extension
  • Shivering
  • Pruritis
  • Weakness
  • Stiff legs
  • Drowsiness
  • Drooping ears
  • Adnormal chewing
  • Sensitive to touch
  • Nystagmus
  • Ataxic
  • Circling
  • Collapse
  • Unresponsive
  • Paddling
  • Seizures
  • Coma
  • Death
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3
Q

What are some possible causes of meningitis?

A
  • Bacteria
  • Chemicals
  • Fungi
  • Immune-related
  • Injury to head or spine
  • Parasites
  • Protozoa
  • Rickettsia
  • Virus
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4
Q

What diagnostics can be used for meningitis?

A
  • Full clinical history
  • Vaccination status
  • Physical examination
  • Neurological examination
  • Cerebrospinal fluid collection (Lumbosacral space)
  • Blood tests
  • Diagnostic imaging (MRI/CT)
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5
Q

What treatment and nursing care can be done for meningitis?

A
  • Medication under VS direction
  • Antibacterials
  • Antivirals
  • Antiprotozoals
  • Steroids
  • Pain relief
  • IVFT
  • Nutritional therapy
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6
Q

What are some clinical signs of traumatic brain injury?

A
  • Depression
  • Nystagmus
  • Abnormal mentation
  • Epistaxis
  • Blindness
  • Altered gait
  • Abnormal pupil size
  • Head tilt
  • Dysphagia
  • Seizures
  • Ataxia
  • Abnormally pupillary light reflex
  • Lateral recumbency
  • Facial-nerve paralysis
  • Unconsciousness
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7
Q

What treatment and nursing care can be done for traumatic brain injury?

A
  • Supportive care
  • Raised food and water
  • IVFT
  • Sternal recumbancy
  • Management of secondary complications (urinary scalds and pressure sores)
  • Medication under VS direction (anti-inflammatories, anticonvulsants, antibiotics)
  • Injury management
  • Padded accommodation
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7
Q

What are some possible causes for seizures and epilepsy?

A 
Within the brain:
-Idiopathic epilepsy (unknown cause)
-Brain tumours
-Head trauma
-Infection
-Congenital abnormalities 
Outside the brain:
-Metabolic (hypoglycaemia/hypocalcaemia)
-Toxins
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8
Q

What is idiopathic epilepsy?

A
  • Diagnosed only when there is no demonstrable pathologic cause
  • Common in dogs
  • First seizure usually between 6 months to 5 years
  • Takes form of generalised tonic-clonic seizures (still twitching/loose consciousness)
  • Common in beagles, GSDs, boxers, collies, poodles
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9
Q

What are secondary epilepsy causes?

A

Neoplastic causes:

  • Primary or metastatic
  • Abnormality in neurons adjacent to the tumour that are compressed or distorted or have inadequate blood supply
  • Common in cats and dogs >5years

Developmental causes:

  • Hydrocephalus (too much fluid due to over-production or issue with drainage)
  • Enlargement of cerebral ventricular system secondary to increased cerebral synovial fluid
  • Usually congenital
  • More common in toy breeds
  • Present at 2-3 months with behavioural issues
  • Motor function ranges from almost normal to tetraplegic
  • Can occur in adults secondary to other diseases (eg. neoplasia)

Inflammatory and infective causes:
-Any inflammatory or infectious disease has potential to cause seizures if it affects forebrain

Traumatic causes:

  • Seizures may be seen immediately following head trauma
  • Post-traumatic seizures may be seen many weeks to several years later
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10
Q

What are the most common metabolic causes of seizures?

A
  • Hepatic encephalopathy

- Hypoglycaemia

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11
Q

What clinical signs may be seen before a seizure?

A
  • Pre-ictal/phase one
  • Unsettled movements (pacing, jaw clenching, abnormal licking/chewing, hiding/seeking owner)
  • Excessive bodily functions (salivating, urinating, sweating)
  • Heightened anxiety levels (vocalisation, glazed eyes)
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12
Q

What clinical signs may be seen during a seizure?

A
  • Ictal/phase two
  • Muscle stiffening (fall on one side, head back)
  • Leg movements (stretched out with rigid/jerking/paddling movement)
  • Breathing faster and heavier
  • Vocalisation
  • Eyes rolled back
  • Excessive bodily functions (passing urine/faeces)
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13
Q

What clinical signs may be seen after a seizure?

A
  • Post-ictal/phase three
  • May lie motionless before attempting to get up (immediately after)
  • Over next few minutes/days may be disorientated (care with aggression), staggered walking/ataxia, temporary loss of sight, excessive thirst/hunger, uncontrolled bladder/bowel activity
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14
Q

What diagnostics can be done for epilepsy and seizures?

A
  • Monitoring/filming
  • History and neurological exam
  • Blood tests (haematology and biochemistry)
  • Cerebral spinal fluid (CSF) tap
  • MRI
  • CT
  • EEG
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15
Q

How can seizures be classified?

A

-According to the area of the brain

Focal (partial) seizures:

  • Start in and affect just a part of the brain
  • May be large part of one hemisphere or small area in one lobe
  • Characteristics depend on which part of the brain
  • Clinical signs = focal facial twitching, salivation, excessive rubbing of face

Generalised seizures:

  • Affect both sides of brain
  • Most common is tonic-clonic (tonic = loose consciousness, muscles go rigid, 10-30 seconds, clonic = rhythmical movements, running/paddling, chewing)
  • Autonomic activity may start in either tonic or clonic phase
16
Q

What treatment and nursing care can be done for a seizuring patient?

A
  • Monitor vitals and number of seizures
  • Keep diary of progress
  • Regular check ups
  • Keep in position where cannot hurt themselves & make owner aware
  • Remove sensory stimuli where possible (light/sound)
  • Stay calm
  • Medication under direction of VS
  • IVFT
  • O2
  • Lubricate eyes
  • Nutrition
17
Q

What is intervertebral disc disease?

A
  • Discs gradually degenerate with age (gradual degeneration is not associated with pain/weakness)
  • Rupture will cause compression or concussion
  • Damage extent is distinguished by the type of force, degree of force applied to the spinal cord and the length of time that the force was applied
18
Q

What breeds may be more at risk to invertebral disc disease and why?

A
  • Small breeds such as Dachshund, beagle, bassets and cocker spaniels
  • Termed as chonderodystrophoid (genetic form of dwarfism)
  • Average onset of clinical signs 3-6 years of age
  • Defect in development of cartilage throughout the skeleton
19
Q

What types of disc diseases are there?

A

Type I:
-Nucleus pulposus (inner of disc) becomes calcified and extrudes out of the annulus fibrosus (outer of disc)

Type II:

  • Annulus fibrosus (outer of disc) collapses and protrudes (bulges) upwards
  • Slower degenerative process
20
Q

What clinical signs may be seen with disc disease?

A
  • Pain
  • Reluctance to move neck to eat/drink
  • Ataxia
  • Plegia (dragging limbs)
  • Incontinence
  • Proprioception issues
21
Q

What diagnostics can be done for spinal disc disease?

A
  • Bloods
  • X-rays
  • Myelogram
  • CT
  • MRI
  • Spinal tap
22
Q

What aftercare may be needed for a patient after spinal/disc surgery?

A
  • Bladder expressions 3-4 times daily (if necessary)
  • Physical rehabilitation for muscle strength and flexibility
  • Cage rest for at least 4 weeks
23
Q

What complications may be seen after spinal/disc surgery?

A
  • Urinary scalds
  • Seizures
  • May not fully recover
  • Bladder infections
  • Ulcers
24
Q

What is granulomatous meingoencephalomyelitis (GME)?

A
  • Inflammatory disease of brain, spinal cord and meninges of unknown cause
  • Mainly occurs in dogs
  • Clinical signs could vary and may indicate focal or multifocal dysfunction
  • Diagnosis to rule out other disease
  • Treatment = corticosteroids but poor prognosis
25
Q

What is syringomyelia?

A
  • Fluid filled sacs develop in the spinal cord close to the brain
  • Common in Cavaliers (skull too small)
  • Due to obstruction in CSF flow
26
Q

What clinical signs and diagnosis are there for Syringomyelia?

A

Clinical signs:

  • Pain (common in neck)
  • Scoliosis
  • Neurlological defects

Diagnosis:
-Imaging

27
Q

What treatment can be done for Syringlomyelia?

A
  • Analgesics and corticosteroids
  • Drugs to reduce CSF production (omeprazole)
  • Physical therapy (massage and hydrotherapy)
  • Cage rest
  • Surgery in some cases
28
Q

What is myasthenia gravis?

A
  • Neuromuscular disease
  • Presents as muscle weakness
  • Caused by interference with nerve-muscle communication
  • Could effect few specific muscles or whole body
  • Receptors not functioning properly so normal muscle contraction does not occur
29
Q

What clinical signs may be seen with myasthenia gravis?

A
  • Megaoesophagus = regurgitation, coughing, aspriation pneumonia
  • Weakness more pronounced after exercise
  • Fatigued palpebral reflex
  • Immobility
30
Q

What diagnostics can be done for myasthenia gravis?

A
  • Specific lab tests (anti cholinesterase receptor antibody levels)
  • Anti cholinesterase medication (mestinon syrup) or neostigmine (prostigmine)
  • Corticosteroids

Patient Care 2 (13 decks)

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