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Clinical Neurology > Neurological Syndromes in Small Animals > Flashcards

Neurological Syndromes in Small Animals Flashcards

1
Q

What are the 5 main Neurological Syndromes in small animals?

A

1) Myopathic and Neuropathic Syndromes
2) Spinal Cord Syndromes: cervical, cervicothoracic, thoracolumbar, lumbosacral
3) Brain Syndromes: cerebral, pontomedullary, midbrain, vestibular, cerebellar
4) Multifocal Syndrome
5) Paroxysmal Syndrome

note: these syndromes can be used to localize a lesion in the neurological system

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2
Q

What are the clinical signs associated with Myopathic Syndrome?

A
  • Generalized weakness
  • Exercise intolerance
  • Stiff, stilted gait
  • Localized or Generalized Muscle atrophy
  • Generalized muscle hypertrophy
  • Dimple contracture
  • Muscle pain on palpation
  • Limited joint movement
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3
Q

What is the definition of Lower Motor Neuron?

A

The efferent neuron of the PNS that connects the CNS with the muscle to be innervated. The cell body in CNS axons project into the PNS via spinal nerves or cranial nerves

“the worker”

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4
Q

What is the definition of Upper Motor Neuron?

A

The system that is confined to the CNS and is responsible for the initiation of voluntary movement, the maintenance of muscle tone for support of the body against gravity and the regulation of posture

“the manager”

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5
Q

What is the definition of myopathy?

A

Disease relating to the muscle

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6
Q

What is the definition of neuropathy?

A

Damage or dysfunction to one or more nerves

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7
Q

What are the clinical signs associated with Neuropathic syndrome of the Motor neurons?

A
  • Generalized weakness
  • Flaccid paresis/ paralysis
  • Neurogenic muscle atrophy: marked muscle loss
  • Reduced/ absent reflexes and muscle tone
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8
Q

What are the clinical signs associated with Neuropathic syndrome of the Sensory neurons?

A
  • Decreased pain response (hypalgesia) or sensation (hypaesthesia)
  • Proprioceptive deficits
  • Abnormal Sendation/ sensitivity of the face, trunk, limbs
  • Self-mutilation
  • Reduced/ absent reflexes without muscle atrophy
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9
Q

What are the clinical signs associated with Neuropathic syndrome of the autonomic neurons?

A
  • May be seen alone or in combination with sensorimotor neuropathies
  • Anisocoria/ or dilated pupils
  • Decreased tear production
  • Decreased salivation
  • Bradycardia
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10
Q

Define Tetraparesis

A

Reduced voluntary motor function of all 4 limbs (sub-divided into ambulatory or non-ambulatory)

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11
Q

Define Tetraplegia

A

Total absence of voluntary motor function in all 4 limbs

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12
Q

Define Paraparesis

A

Bilateral motor dysfunction in pelvic limbs

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13
Q

An animal presents with paresis of the limb associated with acute onset of severe muscle atrophy. Upon limb flexion and extension there is little to no resistance, also there is little to no spinal reflexes
Is this UMN or LMN involvement?

A

LMN

Lower Motor Neuron

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14
Q

An animal presents with paresis of the limb associated with chronic onset of muscle atrophy from not using the limb. Upon limb flexion and extension there is slight resistance, also there is normal spinal reflexes/ exaggerated
Is this UMN or LMN involvement?

A

UMN

Upper Motor Neuron

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15
Q

Which nerves supply the brachial plexus and thus thoracic limb?

A

C5 - T1

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16
Q

Which nerves supply the sacral plexus and thus pelvic limb?

A

L4 - S4

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17
Q

Define Flaccid or LMN paresis/ paralysis

A

Reduced or absent spinal reflexes in one or more limbs

18
Q

Define Spastic or UMN paresis/ paralysis

A

Normal or increased spinal reflexes in one or more limns

19
Q

Define “Nerve Root Signature”

A

Pain apparent on palpation or traction of the limb due to a lesion irritating the nerve roots (e.g. slipped discs)

20
Q

Cervical Syndrome includes which spinal cord segments?

A

C1 - C5

21
Q

A dog presents with:

  • Spastic paresis/ paralysis in all four limbs
  • Normal to increased reflexes and muscle tone in all limbs
  • Postural reaction deficits in limbs
  • Has cervical muscle spasms, pain and rigidity
  • Has urinary incontinence
  • Nerve Root Signature

This is suggestive of which neurological syndrome?

A

Cervical Syndrome

22
Q

Horner’s Syndrome can sometimes be seen on which neurological syndromes?

A

Cervical Syndrome

Cervicothoracic Syndrome

23
Q

A dog presents with:

  • Weakness/ paralysis in all four limbs
  • Depressed reflexes and flaccid muscle tone with muscle atrophy in the Thoracic limbs
  • Normal/ increased reflexes and tone without atrophy in the Pelvic limbs
  • Postural reaction deficits in the TL limbs
  • Hypanesthesia at the level of the lesion
  • Hypaesthesia behind the lesion
  • Paniculus reflex is depressed/ absent
  • Has urinary incontinence

This is suggestive of which neurological syndrome?

A

Cervicothoracic Syndrome

24
Q

Cervicothoracic Syndrome includes which spinal cord segments?

A

C6 - T2

25
Q

Thoracolumbar Syndrome includes which spinal cord segments?

A

T3 - L3

26
Q

A dog presents with:

  • Spastic weakness/ paralysis of the pelvic limbs
  • Pelvic limb reflexes are normal
  • No atrophy in the pelvic limbs
  • Postural reaction deficits in the pelvic limbs
  • Increased local sensitivity at the level of, and behind the lesion
  • Has urinary incontinence
  • +/- Sciff-Sherrington posture: marked increase in extensor tone of thoracic limbs with severe thoracic cord lesion

This is suggestive of which neurological syndrome?

A

Thoracolumbar Syndrome

27
Q

Lumbosacral Syndrome includes which spinal cord segments?

A

L 4 - S3

all nerve roots that form the cauda equina: femoral, sciatic, obturator, pudendal, pelvic and coccygeal

28
Q

A dog presents with:

  • Flaccid weakness/ paralysis of the pelvic limbs + tail
  • Depressed pelvic limb reflexes and flaccid muscle tone
  • Postural reaction deficits in the pelvic limbs
  • Dilated anal sphincter
  • Hypaesthesia of the perineal region, pelvic limbs or tail
  • Has urinary incontinence
  • Has fecal incontinence
  • +/- Nerve Root Signature

This is suggestive of which neurological syndrome?

A

Lumbosacral Syndrome

29
Q

What part of the brain is responsible for the generation of the gait?

A
  • Pons + Medulla
30
Q

What part of the brain is responsible for fine-tuning movement, and thus controls unconscious proprioception?

A

Cerebellum

31
Q

What part of the brain is responsible for intellect and behaviour, along with voluntary movement?

A
  • Cerebrum
32
Q

A dog presents with:

  • Normal gait
  • Altered mental status: apathy, depression, disorientation, lethargy, coma
  • Change in behaviour: loss of training, failure to recognize owner, aggression, hyperexcitability
  • Abnormal movements/ postures: pacing, wandering, circling, head-pressing
  • Postural reaction deficits in contralateral limbs
  • Visual impairment
  • Seizures

This is suggestive of which neurological syndrome?

A

Cerebral Syndrome

33
Q

A dog presents with:

  • Symmetrical ataxia and preservation of strength
  • Dysmetric gait: altered rate, range or force of movement
  • Hypermetria: spastic, goose-stepping gait in all limbs, especially thoracic limbs
  • Intention tremor of the head and eyes
  • Broad-based stance
  • postural reactions delayed with exaggerated responses

This is suggestive of which neurological syndrome?

A

Cerebellar Syndrome

34
Q

A dog presents with:

  • Head-tilt
  • Disorientation
  • Falling/ rolling
  • Nystagmus
  • Ventrolateral strabismus

This is suggestive of which neurological syndrome?

A

Vestibular Syndrome

35
Q

Vestibular Syndrome can be divided into 2 distinct classifications, what are they?

A

Peripheral Vestibular disease/ syndrome: affecting the CN 8

Central vestibular disease/ syndrome: affecting the brain

36
Q

How can Central and Peripheral Vestibular Syndrome be differentiated?

A

It cant always be differentiated, as clinical signs are very similar, however Central Vestibular disease can cause a vertical and positional nystagmus
But Peripheral Vestibular disease wont cause a vertical and positional nystagmus

Central Vestibular disease may also present with cerebellar signs, mental depression and hemiparesis deficits
Peripheral Vestibular disease wont cause the above

37
Q

A dog presents with:

  • Spastic paresis/ paralysis: all 4 limbs or contralateral to the lesion
  • Increased reflexes and muscle tone: in all 4 limbs or contraleteral
  • Postural reaction deficits: in all 4 limbs or contraleteral
  • Mental Depression + coma
  • Ipsilateral oculomotor deficits: VL strabismus, dilated and unresponsive pupils, normal vision, ptosis
  • Hyperventilation

This is suggestive of which neurological syndrome?

A

Midbrain Syndrome

note: pretty uncommon to get midbrain sydromes

38
Q

A dog presents with:

  • Spastic paresis/ paralysis: in all 4 limbs or ipsilateral limbs
  • Normal or increased reflexes and muscle tone in all 4 limbs
  • Multiple creanial nerve deficits: 5, 7, 9, 10, 12
  • Irregular respiration
  • Mental depression

This is suggestive of which neurological syndrome?

A

Pontomedullary Syndrome

note: pretty uncommonly seen

39
Q

A dog presents with:

  • Altered mental status: disorientation, lethargy, coma
  • Normal gait
  • Abnormal temperature regulation
  • Abnormalities in appetite
  • Impaired vision
  • Endocrine disturbances: usually diabetes insipidus/ hyperadrenocorticism

This is suggestive of which neurological syndrome?

A

Diencephalic Syndrome

note: uncommonly seen
Usually due to a pituitary tumour
Impaired vision can be due to disturbances or damage to the optic chiasm

40
Q

What is a Multifocal Syndrome?

What is it usually caused by? (3)

A 
When the animal is showing signs that reflect 2 or more syndromes
These are usually due to:
- Inflammatory diseases
- Storage diseases
- Intoxication
41
Q

What is a Paroxysmal Syndrome?

A

A group of sporadically occurring disorders that often have no discernible structural lesions within the nervous system
Often normal between events = EPISODIC
- Classic example would be seizures: cant figure out why the animal is having seizures and is normal between events

42
Q

What are some examples of Paraxysmal Syndromes? (7)

A
  • Episodic seizures
  • Episodic sleep- narcolepsy
  • Episodic syncope
  • Episodic muscle cramping
  • Episodic weakness
  • Episodic tetany
  • Episodic myoclonus

Clinical Neurology (17 decks)

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