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