Neurology Flashcards
What is the filum terminale and what is its relevance to CKCS with syringiomyelia?
FTIL = the length from the end of the SC to the termination of the dural sac
(Shorter) length is correlated to increased owner perceived and spinal pain palpation scores.
Interestingly SC length is not correlated to clinical signs but is associated with the presence of SM (shorter SC predicts lumbar SM)
https://paperpile.com/app/p/2ad09468-75e1-07e1-a448-5aae447390d8
What percentage of dogs with acquired narcolepsy may experience remission from clinical signs with treatment?
75%
https://paperpile.com/app/p/3c6206ca-f0c7-09db-99a2-9b26c20b45fd
What is the relationship of ventricular-arterial coupling (VAC) to dogs with MMVD and there prognosis/MST?
Essentially it gets worse as the disease progresses with stage B2 and C dogs having a worse VAC and worse prognosis. the prognosis with dogs with increased VAC (>0.34) having a MST of 527 days whereas those with a normal VAC had an MST of >1112 days.
https://paperpile.com/app/p/9dab6517-1b28-0281-bd77-f4afe2b477c8
MRI characterises of gliomas?
What feature predicted higher grade tumours?
Smooth margins, T1w hypo intense and more commonly contact ventricles than astrocytomas.
Tumor spread within the brain associated with higher grade tumors.
José-López, Roberto, Rodrigo Gutierrez-Quintana, Cristian de la Fuente, Edgar G. Manzanilla, Anna Suñol, Dolors Pi Castro, Sonia Añor, et al. 2021. “Clinical Features, Diagnosis, and Survival Analysis of Dogs with Glioma.” Journal of Veterinary Internal Medicine / American College of Veterinary Internal Medicine 35 (4): 1902–17.
Survival time in dogs with glioma between definitive or palliative treatments?
Significant difference.
Definitive = 84 days
Palliative = 26 days
Are plyethylene glycol or methyprednisolone beneficial in the treatment of acute IVDD in dogs?
No, no difference found in the study by Olby et al between groups although the study was underppowered. 47.6% of dogs recovered ambulation and 17.5% developed myelomalacia (no association to treatment group).
https://paperpile.com/app/p/133560df-143c-00c7-927b-f88584502fae
What are the phenotypic features of congenical neurological syndrome in short-eared toyger cats and their mode of inheritance?
Autosomal recessive mode of inheritance of a neurological syndrome in short haired toyger cats. Characterised by Ven-
triculomegaly with frequent concomitant supratentorial interhemispheric, communicating ventricular type-1b cysts and multi- ple midline and callosal malformations
Whattest can be used to determine exercise tolerance in dogs with centronuclear myopathy?
6MWT - scores lower in affected dogs
https://paperpile.com/app/p/bb7241b8-3cd7-0c9a-bc36-cdeeaacac607
What breed is affected by a mutation causing neuronal vacuolation and spinocerebellar degeneration?
What breed has a similar disease and phenotype?
Rottweilers - associated with an autosomal recessive RAB3GAP1:c.743delC mutation
Black russian Terriers- get polyneuropathy with ocular abnormalities and neuronal vacuolation
https://paperpile.com/app/p/7599e838-1578-005a-a797-b763dee9caa8
Further notes in Rotties:
Tends to start with clinical signs around 3 months of age. Respiratory difficulties, ataxia and weakness are the most prominant clinical signs. Cerebellar ataxia and inspiratory stridor can also be observed.
What percentage of CKCS with syringiomyelia will become symptomatic, and improve with medical therapy with time?
32% will become symptomatic
13% will improve with medical therapy (56% will worsen)
No imaging features are predictive of worsening
https://paperpile.com/app/p/9f4ee592-77b9-009d-a988-5e3a084650d4
In which spinal cord cell types and location is ET-1 expressed to a higher degree in dogs with myelomalacia?
Expression is higher in astrocytes and lower in neurons in dogs with myelomalacia. Expression occurs at sites distant from the site of disk extrusion.
https://paperpile.com/app/p/ce4d4e6c-9b85-0438-92ab-a3d65b820f2d
What is the MST of dogs with trigeminal peripheral nerve sheath tumours treated with SRT in dogs?
Median disease-specific survival was 745 days (range: 99–1375 days, n = 6).
https://paperpile.com/app/p/81931ce3-4513-0ba0-824c-a0055073a707
What neck position may improve the ability of MRI to detect compressive lesions in dobermans with cervical spondolytic myelopathy?
Extension of the neck, whereas flexion reduces compression
https://paperpile.com/app/p/0f28b837-e1a2-0127-9356-0f1a1be2f97e
What is the taget of frubenvetmab?
Nerve growth factors (it is an anti-nerve growth factor antibody)
What is the plasma T1/2 of frubenvetmab? What dose is found to be effective at reducing pain scores in cats?
7 - 15 days
2mg/kg SC is effective
Doses up to 28mg/kg are safe
https://paperpile.com/app/p/88ec6a47-1e5f-0fdd-bc21-8d6f261dfb72
When does frubenvetmab become effective at improving client assessed outcomes and pain, and how long does it improve felien activity levels for?
3 weeks for the first bit of qn
6 weeks for activity
https://paperpile.com/app/p/08c67555-5df8-0651-8c09-a87c0a5cf58b
When does frubenvetmab become effective at improving client assessed outcomes and pain, and how long does it improve felien activity levels for?
3 weeks for the first bit of qn
6 weeks for activity
https://paperpile.com/app/p/08c67555-5df8-0651-8c09-a87c0a5cf58b
What gene is responsible for neuronal ceroid lipofuscinosis in border collies and australian cattle dogs?
Homozygous for CLN5 nonsense mutations
https://paperpile.com/app/p/eaf67925-dddf-0a0a-9ef6-b7e0cf91099b
What is neuronal ceroid lipofuscinosis?
Progressive neurogegenerative disease that often results in death and is characterised by accumulation of lysosomal storage material in the brain, retina and other tissues.
Breeds = Border Collie and Australian Cattle dogs
https://paperpile.com/app/p/eaf67925-dddf-0a0a-9ef6-b7e0cf91099b
What MRI measurement is associated with survival in dogs with brain herniation?
Transtentorial line to the rostroventral aspect of the cerebellum. this is an indicator of caudal transtentorial herniation.
https://paperpile.com/app/p/1a796599-2758-0db1-ace3-03c6d50258c1
A NSDTR presents with progressive neurological signs including sleep movements, anxiety, noise phobia and gait abnormalities at 3 months of age. What MRI characteristics may be expected and what is the prognosis of this condition? What is its likely genetic inheritance pattern?
MRI: symmetrical, progressively increasing T2-w imaging intensity within caudate nuclei (necrosis secondary to grey matter degeneration).
Poor prognosis
Autosomal recessive mode of inheritance
https://paperpile.com/app/p/df3aa21c-3fea-0eb9-9f0e-65bab49fecf5
Frequency of development and factors that increase chance of development of spinal walking in dogs with irreversible TL injury
- 59% dogs achieved spinal walking in a median of 75.5 days
- age <60 months and bodyweight <7.8kg associated with increased chance of developing spinal walking
- BCS, hospitalisation, type and site of lesion were not associated with development of spinal walking
https://paperpile.com/app/p/3de33c89-a014-0746-a697-ec369545cd7a
Prevalence and risk factors for development of myelomalacia following IVDD in dogs
- 2% prevalence of MM in this population
- Univariate risk factors for development of MM were age <58 years, neurologic grade 5, L5 - L6 herniation, duration of clinical signs <24 hours before becoming non-ambulatoryand detection of T2W hyperintesitt and T2 length >4.57.
n.b. that the IVDD consensus statement probably trumps this
https://paperpile.com/app/p/8c8d606b-ae2c-0ab8-996b-4134f85e19de
What site of menigioencephalocoele is more common and the prognosis
Intranasal, prognosis is fair in these cases if they have mild neurologic signs
https://paperpile.com/app/p/15922122-676d-0d22-982e-af3d2b968947
Sensitivity and specificity of posphorylated neurofilament heavy for diagnosis of degenerative myelopathy
- Phosphorylated neurofilament heavy was increased in CSF of dogs with DM
- Sensitivity of concentration >20.25ng/mL was 80.4% and specificity 93.6% with an AUC 0.94
https://paperpile.com/app/p/3f5d7f1d-47ef-0c7c-9257-80f63145379e
Negative prognostic factors for regaining urinary continence and ambulation in dogs with acute spinal lesions
- L4 - S3 was associated with decreased continance compared to T3 - L3
- Other risk factos included loss of concious pain perception, LMN incontinance and non-compressive lesions
- Negative prognostic facots for regaining ambulationincluded abscence of concious pain perception and being a large non-chondrdystrophic breed.
https://paperpile.com/app/p/2334592b-bce4-0433-8cdc-410af7db13b9
Should dogs with spinal arachnoid diverticula be managed medically or surgically?
Surgically - 80% of surgically managed dogs improved compared with only 30% of medically managed dogs
https://paperpile.com/app/p/8a5d7ebc-cac7-07a7-9f82-ce1f1a24f14d
What is the reported clinical improvement in border terriers that are fed a gluten free diet vs. anti-epileptic therapy?
All dogs fed gluten free had good improvement in clincial signs.
67% dogs had some improvement with anti-epileptic therapy.
https://paperpile.com/app/p/8d82fb42-436f-08f7-97e4-7b106f36110f
What is the most common presentation associated with putative microbleeds in dogs and what is the impact of this finding on clinicopatholigc correlates and survival?
Most common associated presenting sign = vestibular
Associated with proteinuria but not renal disease per se
Finding microbleeds is associated with decreased survival times
https://paperpile.com/app/p/a2ec24df-fc35-0c65-856b-c90a047f171e
Effectiveness of intranasal midazolam vs. rectal diazepam for termination of status epilepticus in dogs?
70% terminated by intranasal midazolam vs. 20% terminated by rectal diazepam.
https://paperpile.com/app/p/27a2c742-803c-032f-90ad-f52773d470fd
MRI features of FIP
- Meningeal contrast enhancement
- Ependymal contrast enhancement
- Ventriculomegaly
- Syringiomyelia
- Framum magnum herniation
https://paperpile.com/app/p/7bf0c80d-d9a3-0237-b389-447739467b2d
Timeline for development of myelomalacia in dogs with IVDD
50% witin the first 48 hours of presentation, otherwise all develop within 5 days.
Clinical Characteristics of Dogs with Progressive Myelomalacia Following Acute Intervertebral Disc Extrusion
Which intra-cranial artery could be used to assess for intracranial hypertension?
The basillar arter, increased systolic to diastolic mean velocity may suggest IC hypertension
How long does 500mg ER levetiracetam given orally to cats maintain therapeutic serum concentrations of 5ug/ml
21 hours
What bacterial species and risk factor has been associated with development of PRN in dogs?
Campylobacter (upsaliensis) and the comsumption of raw chicken
Predictors of short term seizure recurrance in dogs
IE with abdnormal postictal neurologic signs/prosencephalon signs
Structural epilepsy having a seizure within 72h of admission
Reactive = being on long term AED monothreapy
What demographic features may predispose to seizures in dogs in the UK?
Being male and younger and heavier
Which of the following anti-epileptic medications may affect the PK of levetiracetam?
a) Zonisamide
b) KBr
c) Phenobarbital
d) Gabapentin
Phenobarbital
What percentage of dogs with inflammatory CNS disease will have Bartonella detected in CNS?
None
What is the most commonly affected disk space for HNPE
C4 - C5
What is the mode of inheritance of juvenile onset polyneuropath in americal SBT and the most common clinical signs?
Autosomal reccesive
Most common clinical sings include laryngeal paralysis and megaO
What percentage of dogs with tetanus will develop a REM sleep disorder in surviving patients
46%, 43% will resolve within 6 months of discharge
What breed has a focal epilepsy presenting at a very young age been noted in?
Boerbol dogs - autosomal recessive
What percentage of dogs with IE wil have seizure precipitating factors and what factors are most common?
74% with stress, sleep deprivation, weather and hormonal factors
Focal seizures are more liekely to be associated with precipitating factors than generalised seizures
What percetnage of dogfs with unilateral facial atrophy have TNSTs?
47.6% with another 20.6% having another extra-axial mass present.
Which of the following factors is associated with resolution of clinical signs of hydrocephalus following shunt placement?
as) Age
b) Duration of clinical signs
c) Decrease in ventricular volume following shunt placement
d) Maximal ventricular volume at any time
c
What percentage of pugs with spinal diverticula will experience deterioration in clinical signs even after initial improvement>
90%
What is the main difference between sterotactic brain biopsy and standard histopathology in dogs with intracranial neoplasia?
Glioma grade may be underestimated with SBB
Meningioma agreement was perfect with refernce method
Prevalence of sensioneural deafness in white cats?
Breds overrepresented
30.3%
Norweigan forest, Main Coon and Turkish Va
Response rate of rectal levetiracetam for treatment of cluster seizures in dogs?
94%
What CSF factor has been associatedwith the frequency of relapse in dogs with SRMA
TNCC
What predicts clinical disease in dogs with hemivetebrae?
Cobb angle >34.5 degrees
What electrodiagnostic features may be seen in dogs with DLSS?
Cord dorsum potential onset latency, F-wave onset latency and F-ratio
What features predict urinary incontencan in dogs with TL disease?
Presenting with spinal shock
Paraplegia
Intramedullar hyperintestity >40% CSA of SC
Not having NSAIDs
Is IV midazolam superior to intranasal?
No, intranasal results in shorter seizure durations
What are the most consistent abnormalities in cats with acquired MG?
Skeletal muscle weakness
Fatigability wiht weelbarrow exercise stress test
What breed gets pseudomyotonia?
English springer or englich cocker
What mutation has been noted in Golden Retrievers with congenital myasthenia gravis?
COLQ
What thoracolumbar disease should be a DDx for DM in pugs?
Meningeal fibrosis
What region of the brain on MRI that is affected in MUO cases is associated with increased risk of postencephalopathic epilepsy?
Hippocampal lesions
What breeds are more likely to have primary CNS HS vompared to disseminated HS?
Corgi’s and Shelties have higher change of primary lesions whereas Rottweilers more likely to have disseminated disease
What morphologic feature may be less likely in Dalmations wiht congential deafness?
A pigmented head patch
What drug and dietary change may improve paroxysmal dyskinesia in maltese dogs?
acetalxolamide and gluten free diets
What is the most common sites of fracture in dogs vs. cats with cranial trauma?
Dogs = cranial vault
cats = face and base of skull
Deat his more likely in cranial vault fractures
What breed gets a demyelinating polyneuropathy and how does this typically manigest?
Miniature schnauzers, the most common signs are megaoesophagus and aphonic bark
What genetic marker has been noted in dogs with epilepsy?
HMGB1
What seizure type is transcranial magnetic stimulation unlikely to improve?
Cluster seizures
What neurologic conditions is CSF lactate higher in?
Dogs with focal seizures vompared to generalised
Inflammatory or neoplastic disease compared to idiopathic or unknown epilepsy
What is the response rate of IHT (idiopathic head tremor) to imepitoin?
17%
What is the breed and mode of inheritance of feline juvenille onset motor polyneuropathy?
Siberian cats and likely autosomal recessive
What is the main cause of muscle cramps in dogs?
Hypocalcaemia secondary to hypoparathyroidism
What percentage of dogs will achieve seizure control with midazolm CRI?
77.4%
Which breed is most commonly affected by acquired narcolepsy and what diseases should be looked for?
FBND - look for an intracranial or extracranial source of inflammation
What breed of dog has hypomyelinating leukodystrophy been noted in and how does this manfest?
GSD - side to side tremours of the head and trunk in response to goal orientated movements
Which combination of AED reduces daily activity and lowers sleep scores in dogs?
Phenobarbital + KBr reduces activity
KBr lowers sleep scores
What neurofilament (light or heavy) is noted in dogs with MUA
Light
What gene mutation has been asssociated wiht a hereditary sensory and autonomic neuropathy in mixed breed dogs?
RETREG1 missense homozygosity
What percentage of dogs with acquried MG will achieve remission and also not resolve CSx. Risk factors for this
30% will achive remission and 30% will not improve
Risk factors:
- POSTIVIE: younger age, endocrine disease
- Negative: initial AchRAB and regurgitation
What is the most common side effect of vagus nerve stimulators?
Coughing
What neurofilament is higher in dogs with myelomaacia (light or heavy)
Heavy
What electrophysiologic parameter predicts recovery from traumatic brachial plexus injury?
CAMP
What immunotypic/cytokine features are associated with Pugs at genetic risk for NME?
Lower proportion of CD4+ and higher IL-19
What factors are associated with development of dscospondilitis following spinal surgery
Being a GSD
Being > 20kg
What are the earliest radiographic and ultrasonographic features of discospondylitis in dogs?
Rads: narrowed intevetebral disc space
AUS: bulging hypoechoic material and loss of reverberation artifact ventrally at the affected disc site
What are the most common events assocaited with reflex seizures?
Veterinary visits, grooming and boarding facilities
What percentage of cats with juvenille onset seizures may have structural brain disease?
Around 50%
What factors are associated with death during intravranial surgery in dogs?
Pre-operative abnormal neurologic examination or a suboccipital approach
What season is GME diagnosis most commonly reported in?
a) Spring
b) Summer
c) Fall
d) Winter
B
Should animals with congential hydrocephalus be treated with a shunt or prednisolone?
Either! Both have a success rate of around 50%
What reduction in seizure activity may occur with CBD oil supplementation in dogs, what adverse effect may be noted?
33% ALP may increase
