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Veterinary Medicine > Neurology > Flashcards

Neurology Flashcards

0
Q

Truncal ataxia

A

Postural instability, gait instability - disorderly, wide based gait with inconsistent foot positioning

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1
Q

Appendicular ataxia

A

Jerky uncoordinated movement of the limbs as though each muscle were working independently from the others

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3
Q

Dysmetria

A

Ability to control distance, power and speed of an action is impaired
Combo of hypo and hypermetria

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4
Q

Sensory ataxia

A 
Abnormal postural reactions 
Limb paresis
Loss of sense of limb/body position:
- wide based stance
- Increase stride length
- Swaying/floating
- Knuckling
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5
Q

Vestibular ataxia

A

Unilateral: Head tilt, leaning falling or rolling to one side
Bilateral: Wide excursions of the head +/- head tilt, crouched

Abnormal nystagmus
Positional strabismus
Normal (peripheral) or abnormal (central) postural reactions

Vestibular apparatus: vestibular nuclei (central), vestibular portion of VIII, vestibular receptors (peripheral)

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5
Q

Cerebellar ataxia

A

Wide based stance
Intention tremors (worse during voluntary movement)
Loss of balance and truncal sway
Delayed onset and dismetric hopping
Ipsilateral menace deficits with normal vision
No limb paresis or conscious proprioception deficits
Pendulum nystagmus

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7
Q

Ascending reticular activating system

A

Network of neurons within brainstem

Sends info to the forebrain

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8
Q

Parts of the neuro exam

1. Mentation

A

Level of consciousness (Alert, obtunded, stupor/semicoma, coma)
Quality of consciousness (Appropriate, Inappropriate - compulsion, dementia/delerium)

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9
Q

Parts of the neuro exam

2. Posture

A

Head:
- Tilt (roll) - vestibular
- Turn - forebrain
Limbs:
- Wide based stance (proprioceptive loss)
- Narrow based stance (weakness)
- Decrease weight gain (pain?)
Body:
- Decerebate - rear legs out, straight forelimbs, head up
- Decerebellate - rear end down
- Schiff-Schemington - back problems, front limb extension (in lateral recumbency), hindlimb paralysis

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10
Q

Parts of the neuro exam

3. Gait

A

Require integration of proprioceptive and motor systems

Normal/abnormal? What limbs?

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11
Q

Parts of the neuro exam

4. Postural reactions

A

Requires integration of proprioceptive and motor systems
Similar pathways to gait
Long pathways ‘sensitive/non-specific’
Interpret with gait spinal reflexes, muscle tone

Paw positioning, hopping, wheelbarrowing, hemiwalking, placing (tactile, visual), extensor postural thrust

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12
Q

UMN paresis

A

Muscle tone normal-increased in limbs caudal to lesion
Spinal reflexes normal-increased in limbs caudal to lesion
Stride - normal-increased caudal to the lesion, spasticity
+/- ataxia (sensory), swaying/floating, knuckling

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13
Q

LMN paresis

A

Muscle tone decrease in limbs with a reflex arc containing the lesion
Spinal reflexes decreased to absent
Stride: length normal-decreased, stiff, ‘bunny hopping,’ +/- collapse, +/- ataxia (sensory), knuckling

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14
Q

Excitation-contraction coupling

A
  1. Muscle action potential propragated
  2. Depolarisation of T-tubule causes opening of Ca2+ channel between myoplasm and sarcoplasmic reticulum (SR)
  3. Calcium release from SR - ‘calcium transient’
  4. Calcium binds to Troponin C
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15
Q

After muscle contraction

A

Ca+ ions pumped back in SR (Pump = Ca2+ ATPase, ATP required)
Absence of Ca2+ ions in the SR - no more muscle contraction

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16
Q

Source of dual innervation

A

Parasympathetic - craniosacral division, preganglionic cells bodies in 4 cranial nerves and sacral SC

Sympathetic - thoracolumbar, preganglionic cell bodies in thoracic and 2 lumbar segments of SC

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17
Q

Plexuses

A

Sympathetic post-ganglionic fibres form clusters within thorax, abdomen and pelvis
Fibres leave plexuses to be distributed to multiple organs

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18
Q

Adrenal gland

A

Modified form of post-ganglionic cell bodies that release epinephrine and norepinephrine directly into blood
Mimic symp NS

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19
Q

Hypothalamus

A

Regulates balance between sympathetic and parasympathetic

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20
Q

SMELL

A

Single receptor type
Dramatic convergence of info into glomeruli - interact and form spatial patterns of activity
Supporting cells secrete lipid-rich fluid and mucus to entrap chemicals

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21
Q

Vomeronasal organ

A

Links nasal and oral cavity
Blind ending caudal sacs (bilateral)
Flehman reaction to punp air in and out
Help detect heat (?)

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22
Q

TASTE (gustatory)

A

Receptor have single type

Afferent nerve fibres carry info from several different cell types - cross compared by brain

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23
Q

SIGHT

A

Lights splits rhodopsin in rods and cones - trigger signal through optic nerve (II)

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24
Q

HEARING

A

Sound funnelled to tympanic canal and membrane

Ossicles (maleus, incus and stapes) conducts sound through round window to the cochlea then to brain VII

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25
Q

Neurotransmission support cells

A

Astrocytes (nourish and support)
Oligodendrocytes (increase speed of impulses)
Microglia (phagocytes)
Epidymal cell (epithelium lining CNS)

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26
Q

Action potential

DEPOLARISATION

A

Stimulus causes membrane permeability to Na+ to increase causing reduction in membrane potential

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27
Q

Action potential

THRESHOLD

A

critical voltage reached and voltage sensitive Na+ and K+ undergo confomational change
Permeability to Na+ abruptly increases but K+ increase slowly

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28
Q

Action potential

REPOLARISATION

A

Na+ gates close at +35mV and K+ gates fully open removing K+ and transmembrane potential becomes negative

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29
Q

Neurotransmitters

A

Acetylcholine (released at NMJ, muscarinic or nicotinic)
Catecholamine (norepinephrine acts on adrenoceptors)
Glutamate (excitatory in the brain)
Glycine (inhibitory within spinal cord)
Gama aminobutynic acid (GABA) inhibitory with CNS

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30
Q

Acetylcholine receptors

A

Nicotinic NMJ and autonomic NS preganglionic neurons

Muscarinic postganglionic of parasympathetic NS

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31
Q

Adrenergic recepors

A

Alpha1 - smooth muscle contraction
Beta1 - myocardium - excitatory
Beta2 - smooth muscle relaxation

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32
Q

Diencephalon

A

Epithalamus, thalamus and hypothalamus

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33
Q

Telencephalon

A

Cerebral cortex, limbic system and olfactory bulb

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34
Q

Cerebral Lobes

A

Frontal lobe - planning, anxiety
Parietal lobe - motor, sensory, cutaneous and taste
Occipital lobe - vision
Temporal lobe - hearing and language

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35
Q

Cerebral arterial circle

A

Aka circle of Willis
Vessels within the brain and supply from the basilar artery
Drain to venous sinuses of the dura mater

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36
Q

Cerebral arterial circle

Species variations

A

Ruminant and cats - internal carotid regress to fibrous strands

Cattle - vertebral artery is a large part of blood supply

Dog, man, horse - internal carotid and basilar -> CAC -> most of brain; vertebral artery -> rest of brain

Sheep, cat - anastomosing rami of maxillary artery -> CAC and has rete mirabille; vertbral artery -> medulla oblongata ; basilar drains

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37
Q

Rete mirabille

A

Dense networks of vessels - heat exchange for thermoregulation
Very present in camels

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38
Q

Subarachnoid space

A

Contains CSF leaking from ventricular system
Largest parts are the cistern:
- cerebellomedullary cistern around foramen magnum
- lumbar cistern

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39
Q

Panniculus reflex

A

Sensory T3 - L1
Motor C8 -T1

Lesion 2 vertebral bodies - cranial to cut off

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40
Q

Perineal reflex

A

Sensory and motor from S1-S2

Mediated by pudendal nerve

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41
Q

Forelimb withdrawal

A

Sensory - median, ulna and radial nerves
Motor - median, ulna, musculocutaneous and axillary nerves
C6-T1

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42
Q

Hindlimb withdrawal

A

Sensory - perineal and tibial nerves
Motor - sciatic, peroneal and tibial nerves
L6-S1

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43
Q

Alpha motorneurons

A

Fibres innervate extrafusal (ordinary) muscle fibres

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44
Q

Gamma motorneurons

A

Fibres innervate intrafusal (muscle spindle) activation causes spindle to stretch so tightened during passive stretch
Controls slackness in muscle

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45
Q

Cranial nerve I

Olfactory

A

Sensory

Olfactory epithelium

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46
Q

Cranial nerve II

Optic

A

Sensory

Retina

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47
Q

Cranial nerve III

Oculomotor

A

Motor - Eye movements; dorsal, ventral and medial rectus and ventral oblique
Parasympathetic - pupil size; pupillary constrictor, cilary muscle of eyeball (via ciliary ganglion)

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48
Q

Cranial nerve IV

Trochlear

A

Motor - retractor bulbi and dorsal oblique

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49
Q

Cranial nerve V

Trigeminal

A

Opthalmic - sensory - face
Maxillary - sensory - face
Mandibular - sensory - both of face; motor - muscles of mastication

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50
Q

Cranial nerve VI

Abducens

A

Motor

Abducts eye - Lateral rectus

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51
Q

Cranial nerve VII

Facial

A

Motor - facial expression
Parasympathetic - glands - nasal, salivary, lacrimal
Sensory - inner ear, anterior 2/3 of tongue

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52
Q

Cranial nerve VIII

Vestibulocochlear

A

Sensory - sounds, rotation, gravity, balance and hearing

53
Q

Cranial nerve IX

Glossopharyngeal

A

Sensory - carotid body and sinus, inner ear, pharynx, posterior 1/3 tongue
Motor - styropharyngeous
Parasympathetic - salivary glands

54
Q

Cranial nerve X

Vagus

A

Sensory - pharynx, larynx, external ear, aortic arch and bodies, thoracic and abdominal viscera
Motor - soft palate, pharynx, larynx, upper oesophagus
Parasympathetic - CVS, respiratory and GIT systems

55
Q

Cranial nerve XI

Accessory

A

Motor - sternomastoid and trapezius

56
Q

Cranial nerve XII

Hypoglossal

A

Motor - intrinsic and extrinsic muscles of tongue

57
Q

Equine guttural pouch pathology

A

Facial paralysis (n. VII)
Dysphagia, laryngeal paralysis (n. IX, X)
Lingual paralysis (n. XII)
Horner’s syndrome (sympathetic trunk)
Epistaxis, exsanguination (internal and external carotid)

58
Q

Hearing

Outer ear

A

Directs sound waves to ear canal (boot shaped)

Ceruminous glands line surface of ear canal

59
Q

Hearing

Middle ear

A

Malleus, incus, stapes - mechanical transmission of sound
Stapedius - n. VII
Tensor tympani - n. V through medial pterygoid nerve
Chorda typani nerve - carries gustatory fibre to anterior 2/3 tongue - passes through middle ear

60
Q

Guttural pouch

A

Expansion of distal aspect of eustachian tube (connects middle ear and nasopharynx)

61
Q

Hearing

Inner ear

A

Cochlea has membranous compartments n 3 levels

  • Scala vestibule (upper)
  • Scale tympani (lower)
  • Cochlea duct/scale media (middle)
62
Q

Hearing

Stereocilia (outer hair cell)

A

Bend and change length - changes local amplitude of travelling wave
Bends stereo cilia of inner hair cell -> release of glutamate at their basal poles -> produces excitatory potentials

63
Q

Balance

Semicircular canals

A

When head is rotated in the plane of a particular semicircular canal, endolymph causes a deflection of the cupula

  • > bowing of stereocilia
  • > depolarisation/hyperpolarisation
64
Q

Myasthenia gravis

A

Acquired: production of antibodies against nicotinic acetylcholine receptor (4m-4y or 9y-13y)

Congenital: Abnormal/lack of Ach receptors, 3-8w, often multiple in a litter (large purebred dogs, uncommon in cats)

Most common focal form -> oesophagus, muscle innervated by cranial nerves
Also seen: diffuse paralysis

Generalised form: after 10 min exercise, pelvis limbs first

65
Q

Malformations hydrocephalus

A

Excessive CSF in brain/cranial cavity

Developmental obstructive hydrocephalus - congenital hydrocephalus:

  • Interfere with flow/absorption of CSF
  • Dogs borns with markedly expanded lateral ventricles, wider than normal 3rd ventricle
  • Cerebral hemispheres
66
Q

Cerebellar cortical abiotrophy

A

Common progressive clinical disorder in dogs 9/10w

  • Mild intention head treor
  • Slight stiffness in thoracic limb gait
  • Progresses to obvious cerebellar ataxia
  • After a few months, unable to stand/throw themselves around

Euthanase

67
Q

Feline panleukopenia virus - cerebellar disease

A

Most common diffuse cerebellar disorder in cats
Congenital malformation
Parvovirus - predilection for rapidly dividing cells
Housebound and safe

68
Q

BVD - cerebellar disease

A

In utero infection
Recumbency with opisthotonus and extensor rigidity of the limbs to mildly spastic hypermetric unsteady gait and slight head tremor
Usually alert and responsive with strong voluntary movements
Reduced cerebellum size

69
Q

Facial nerve disorder

A

Lesions where the facial nerve emerges from the stylomastoid foramen -> complete facial paralysis

Signs: ear droops, lower lip droops, palpebral fissure decreases in size, nose and upper deviate to normal side

Incomplete facial paralysis -> lesions on individual branches

Otitis media: most common cause, facial nerve courses through the canal in the petrosal portion of the temporal bone - affected by middle inflammation

70
Q

Canine distemper

A

Paramyxoviridae family: Mobillivirus

Hypermetria, hyperkeratic nose and pads, purulent nasal discharge, head pressing, head tilt,

Inflamed CSF
(Ferrets, foxes, lions)

71
Q

Visual disturbances

A

Optic neuritis: inflammation of optic nerve (autoimmune?)
Disorders affecting optic chiasma: pituitary tumours, infarcts, inflammatory disorders
Lesions caudal to chiasma: neoplasia, trauma
Congenital diseases: hydrocephalus, metabolic storage diseases
Horner’s: disruption of sympathetic innervation to the eye (constricted pupil, protrusion of 3rd eyelid, prolapse of upper eyelid)

72
Q

Hyperalgesia

A

Tissue damage release chemicals which increase sensitivity of nociceptors so even light touch can cause pain

73
Q

Limbic system

A

Fringe around thalamus - group of deeply based structures
Functions: memory, behaviour, motivation, emotion
Components: hippocampus, fornix, cingulate gyrus, mammillary body

Fornix: bunch of fibres that come out of hippocampus
Mammillary bodies: centres in the hypothalamus, connected to hippocampus via fornix
Paleocortex: ventral surface, well developed in domestic species

74
Q

Neocortex

A

Projection area: sensory and motor areas, projected down
Association areas: receive sensory input for sensory areas of cortex analysis received info, selects course of action
Structure: mostly short neurons with many dendrites linking one area to another

75
Q

Sleep

A

Ascending reticulum systems generates arousal generate impulses -> higher centres (may be dampened by sleep centre in hypothalamus)
Slow wave/REM

76
Q

Demyelinating disease

A

Human: multiple sclerosis
Dog: Canine distemper virus encephalitis (morbillovirus)
Got: caprine arthritis encephalitis syndome (lentivirus)
Sheep: Maida Vizna (lentivirus)
Mice: Theiler’s disease (picornavirus), mouse hepititis virus (coronavirus)

77
Q

Stroke

A

Acute neurological deficit following focal disturbances to the vascular perfusion of the brain
Usually arterial blood vessels following thrombosis or emboli
e.g. Canine cerebellar stroke

78
Q

Motor neuron disease

A

UMN: primary lateral sclerosis
LMN: progressive muscular atrophy
UMN and LMN: amyotrophic lateral sclerosis (ALS)

LMN (spinal cord): spinal muscle atrophy (most common)

Equine motor disease: sporadic, 8-10y, excessive sweating from minimal exercise, loss of muscle mass, odd stance, hate standing

79
Q

Cerebellar hypoplasia

A

Calves - cerebellum should be 10% brainweight
In this incidence, is 10 times smaller than normal

BVD (pestivirus): infection before 180d gestation
Border disease (lambs): hairy shakers
(Bluetongue)

80
Q

FPV

Feline parvovirus aka feline panleukopaenia virus

A

Virus attacks rapidly dividing cells
Vomiting, diarrhoea, panleukopaenia (adults)
Cause smalls cerebellum in kitten from infected queen

81
Q

Equine herpesvirus 1 (EHV1)

A

Necrotic haemorrhagic lesions - affecting mostly ventral horns of grey matter
Ischaemic necrosis due to thrombus - ataxia, paralysis, paresis, recumbency
Virus targets epithelial cells - multiple -> thrombosis

CSF sample, isolate horse, lock down yard

82
Q

FIP (CNS form)

A

Fairy uncommon
Mutated form of feline coronavirus
Wet/Dry/Mixed -> granulomatous, effusions

Vascular injury -> inflammatory effusion fills and dilates ventricles (hydrocephalus)

83
Q

Meningitis

A

E.g. nystagmus (shifting from L to R involuntarily), paddling limbs, seizuring, death

Streptococcus suis - most common cause in piglets (Haemophilus parasuis - 2nd most common)

84
Q

Rabies and rabies like infections

A

Excessive salivation, muzzle tremors, tenesmus, behavioural change, abnormal posture, seizures, opisthotonus (head, neck and back), paralysis, death

Rhabdovirus, Lyssavirus (UK bats)

Transmitted via saliva/bite wounds -> Retrograde axonal transport-> hippocampus -> replicates in brain -> travels via cranial nerves -> saliva -> prevents swallowing -> froth -> behavioural change

Negri bodies: intracytoplamic eosinophilic viral inclusion bodies

Diagnosis: histopathology, culture, PCR (brain tissue), immunohostochemistry

85
Q

Parts of the neuro exam

5. Spinal reflexes

A 
Tendon reflexes: 
Biceps, Musculocutaneous nerve - C6-8
Triceps, Radial nerve - C7-T2
Patellar, Femoral nerve - L4-6
Gastrocnemius, Sciatic nerve - L6-S2

Flexor (withdrawal):
Thoracic limb, multiple nerves - C6-T2
Pelvic limb, sciatic nerve - L6-S2

Decreased/absent: lesion in reflex arc, physical limitation to movement, excitement/fear, ‘spinal shock’

Increased: lesion to UMN pathways cranial to spinal cord segments tested, excitement/fear, pseudo-hyperreflexia (loss of antagonism)

86
Q

Parts of the neuro exam

6. Cranial nerves

A

Vision, menace, PLR, Eye position, Eye movement, Palpebral, Corneal, Muscles of mastication, Muscles of facial expression, Schirmer tear test, Auditory/vestibular signs/physiologic nystagmus, Gag reflex, Tongue dysfunction

87
Q

Parts of the neuro exam

7. Palpation

A

Light - swelling, atrophy

Deep - pain

88
Q

Parts of the neuro exam

8. Nociception

A

Conscious perception of pain
Superficial: skin
Deep: bone (periosteum)

89
Q

Neuro Hand Rule

A
  1. Onset
  2. Clinical course
  3. Pain
  4. Lateralising
  5. Neuro localisation
90
Q

DAMNITV

A 
Degenerative
Anomaly
Metabolic
Neoplasia/Nutritional
Inflammatory/Infectious/Idiopathic
Trauma/Toxin
Vascular
91
Q

Focal seizures

A

Simple focal: no loss of consciousness
Complex focal: impairment of consciousness
Focal seizure with secondary generalisation

92
Q

Status epilepticus

A

Prolonged seizure activity

>5min (clinical), >30min (brain damage), life threatening

93
Q

Cluster seizures

A

More than 2 seizures in 24 hours

Serious

94
Q

Events that can mimic seizures

A

Syncope: partial/complete loss of consciousness, lack of motor activity, no post-ictal signs, shorter

Narcolepsy: stimulated often by excitement, food, pharmacologically

Pain

Vestibular syndrome

Movement disorders:

  • Scotty cramp
  • CKCS: episode of tetany, hypertonicity, deer-stalking
  • Norwich terriers
  • Boxers: paryoxsmal dystonic choreoathetosis (Bichon Frise)
95
Q

Idiopathic Epilepsy

Signalment

A

Dogs: 6m-6y

Generalised: Beagles, GSDs, Lab, Golden Retrievers, Burmese Mountain dogs, Belgian Tervuerencs, Keeshunds, Irish Wolfhounds

Mainly partial +/- 2nd generalisation: Vizlas, English Spaniels, Danish Labs, Langotto Romagnole, Standard Poodle, Finnish Spitz

96
Q

Equine Seizures

A

Arab foals: congenital, grow out of it
Foals with perinatal asphyxia: neonatal maladjustment syndrome
Adults: structural or metabolic brain disease (trauma, parasite), intracarotid injection

97
Q

Seizure treatment

When to start

A

1 seizure/every 6w or 2+ seizures with 6m
Lifetime commitment (2/3 dogs respond to anti-epilepsy drugs)
Chart seizure frequency
Side effects!

98
Q

Seizure treatment

Barbiturate mechanism

A

Increase duration of chloride ion channel opening at the GABA receptor - increases efficacy of GABA

99
Q

Seizure treatment

Benzodiazepines

A

Increased frequency of chloride channel opening at GASBA - increases the potency of GABA

100
Q

Gamma-Amino Butyric acid (GABA)

A

Amino acid which acts as a neurotransmitter in the central nervous system
Inhibits nerve transmission in the brain, calming nervous activity

101
Q

Phenobarbitol

A

First line treatment
Dose: about 2.5 mg/kg (loading 600mg/kg over 6d)
Time to steady state: 10-14 days
Therapeutic range: 15.0 - 30 ug/ml
Obtain plasma levels: 14d, 45d, 90d, 180d, 360d
Metabolised in liver
Side effects: sedation, PD, polyphagia, hepatotoxicity

Idiosyncratic reactions: behaviour alterations, immune-mediated neutropaenia, thrombocytopaenia, anaemia, superficial, necrolytic dermatitis, idiosynchratic hepatotoxic reactions

102
Q

Potassium bromide

A

Add on/1st line
Dose: about 30-40 mg/kg (loading 12-24 mg/kg)
Time to steady state: 100-200d
Therapeutic range: 0.7-1.9mg/ml
Obtain plasma levels: 4w, 8-12w, q6m
Side effects: sedation, weakness, PU/PD, GI irritation/pancreatitis
Renal excretion
Diet: High chloride diet with lower serum concentration

Bromide toxicity (rare): severe ataxia, sedation, somnolence, skin reactions -> IV saline

103
Q

Imepitoin

A

Comparable efficacy to Pentobarbitol
Dose: 10-30 mg/kg
Side effects: polyphagia, hyperactivity, PU/PD, somnolence, emesis, hypersalivation, ataxia, apathy, diarrhoea, prolapsed nictitating membrane , decreased sight and sensitivity to sound

104
Q

Refractory epilepsy

A

Non-responder: reduce in seizure frequency of less than 50%

Add on: gabapentin, pregabalin, levetiracetam

105
Q

Seizures

Secondary damage

A

Under 30 min: arterial hypertensions, increased cerebral blood flow, hypoxaemia, hypercabaemia, hyperglycemia, lactic acidosis

Over 30 min: continuous muscle contraction, hyperthermia, acidosis, myolysis (myoglobinuria, hyperkalaemia, renal failure), hypoglycaemia (energy depletion), cardiac arrhythmias

106
Q

Clomipranine

A

Non-selective serotonin re-uptake inhibitor
Elevate mood, reduce anxiety, and block panic development
Takes up to 3 weeks to become clinically apparent

107
Q

Benzodiazepinbes

A

Inhibits memory formation by affected NMDA (glutamate) receptors in the hippocampus - limited use when learning is required
Used for separation anxiety - licensed

Adverse effects: sedation, increased appetite, weight gain, hypotension, anti-allergy activity, delirium, seizure induction, decreased bronchial secretion, hyperthermia, tachycardia, blurred vision, insomnia, constipation, photophobia, dry mouth, narrow angle glaucoma

108
Q

Selegiline

A

Increases the availability of dopamine for inclusion into secretory vesicles

Treatment of fears and phobias and cognitive decline where reduced dopamine levels are implicated

109
Q

Pendular nystagmus

A 
Siamese, Birman and Himalayan
Congenital abnormality (larger number of fibres cross the chiasma)
Cerebellar disorders and visual deficits
110
Q

Horner’s syndrome

A 
Loss of sympathetic innervation to the eye 
- Enophthalmus
- 3rd eyelid protrusion
- Ptosis
- Miosis
(Congested vessels)
111
Q

Cerebellar syndrome

A 
Spastic, dysmetric or hypermetric gait
Intention tremor
Ipsilateral menace deficit and normal vision
Broadbased stance
Postural reactions delayed with exaggerated responses
\+/- contralateral anisocoria
\+/- opisthotonus
\+/- vestibular signs
112
Q

Deafness

A

Test: BAER (brainstem auditory evoked responses)

Sensorineural: sensory dysfunction, neoplasia, infection, otitis interna, toxins, aminogycosides, chemo drugs, congenital (white coat and blue eyes e.g. Dalmation)

Conductive: failure of passage of sound, neoplasia, infection, otitis media, inflammation/inflammatory polyp

113
Q

Megaoesophagus

A

Neurological causes:

  • Nerve dysfunction -> reflex oesophageal dysfunction
  • Myasthenia gravis
  • Oesophagitis
  • Generalised myositis
  • Botulism
  • Brainstem disease
114
Q

Spinal cord anatomy

A

Sensory (proprioceptive) tracts: dorsal and lateral funiculi, ipsilateral, ataxia

  • Tells LMN what to do
  • Facilitates and inhibits flexor and extensor muscle groups

UMN tract: lateral and ventral funiculi, ipsilateral

LMN cell bodies: ventral horn grey matter, ipsilateral

115
Q

Equine Rhabdomyolysis Syndrome

A

Muscle cramping/pain that occurs usually during or following exercise
aka Monday morning disease, set-fast, azoturia, myoglobinuria, tying up

Treat: analgesia, fluids, diuretics (minimise effects of myoglobin on kidneys)

Diagnosis: pre and post (6h) CK measurement

Overexertion:

  • Eccentric contraction
  • Metabolic exhaustion
  • Oxidative injury

Prevent: oral dantrolene, high fat/low carb diet, regular exercise/turn out

Also happens in greyhounds and sled dogs

116
Q

Polysaccharide storage myopathy (PSSM1)

Horses

A

Quarterhorses, warmbloods, draft horses, cobs etc.
Autosomal dominant disease
Cause ER (equine rhabdomyolysis), occasionally muscle atrophy/weakness in draft breeds
Abnormality of glucose metabolism

Diagnosis: DNA test (EDTA blood) or hair pluck
Treat: high fat/low carb diet, regular daily exercise - turning over glycogen in muscle to prevent crystals

117
Q

The exhausted horse

A

Long rides in hot humid conditions in unfit animals

Signs: depression, dehydration, anorexia, decreased thirst, increased RR and HR, pyrexia, poor sweating performance, poor jugular distension, decreased gut sounds, laminitis, synchronous diaphragmatic flutter, muscle pain, stiffness

Treat: fluids +/- electrolytes, cooling, NSAIDs, evidence of rhabdomyolysis

Prevent: training, heat acclimitisation

118
Q

Coccygeal muscle injury

A

Limber tail, cold tail, muddy tail
Labradors, pointers, working breeds
- Pain at tail base, mild elevation in CK
- Recovery over several days

Treat: rest, NSAIDs

119
Q

Fibrotic myopathy

Horses

A

Common in QH: usually semitendinous (sometimes semi-membranous or gracilis)

Causes: muscle tear, IM injection, neuropathy

Treat: rest NSAIDs, surgical resection of fibrous tissue or tenotony

120
Q

Atypical myopathy

A

Acute onset severe myopathy in horses at pasture (increase CK and AST)
Muscle biopsy pre or post mortem

Treat: Riboflavin (vitamin B2 supplementation), carnitine supplementation, support carb metabolism

121
Q

Lumbosacral stenosis

A

Old larger breeds - GSDs
Bladder dysfunction - L4-S3 spinal cord segments
Stenosis of the vertebral canal and/or intervertebral foramina and/or the related vasculature

Hansen type II disc degeneration and protrusion at the lumbosacral junction

  • Subluxation of the articular facets
  • Thickening and folding of the interarcuate ligament
  • Epidural fibrosis
  • Thickened lamina and pedicle
  • Can compress nerve roots
  • Instability and misalignment between the last lumbar vertebrae and the sacrum

Treat: conservatively, dorsal laminectomy

122
Q

Polyneuritis equi

A

Tail paralysis, dilated anus, faecal retention, perineal loss of sensation, muscle atrophy

Pathogenesis: immune-mediated damage to peripheral nerve of cauda equina

Diagnosis: tail head muscle biopsy, lymphocytic infiltrate seen in/around the intramuscular nerves

Treat: usually supportive

123
Q

Assistance of bladder emptying

A

Block sympathetic alpha receptors: phenoxybenzamine, prozasin NB affects blood vessels

Blocked striated urethral muscle - diazepam

124
Q

Autonomic neuropathy

A 
Dilated pupils
Constipation
Decreased tear production
Urinary retention
Hyposalivation
Reduced perianal reflex
Bradycardia
125
Q

Electromyogram

A

Normal EMG is silent

Fibrillation potentials:

  • Denervation, inflammation, biphasic
  • Spontaneous action potentials of single myofibres

Positive sharp waves:

  • Denervation
  • Positive deflection followed by shallow, negative deflection
  • Spontaneous action potentials of single myofibres

Complex repetitive discharges:

  • Polyphasic and serrated - each one has a uniform shape
  • Many myofibrils in near synchrony

Pseudo myotonia:

  • Myotonic potential
  • Amplitude and frequency waxes and wanes due to independent, repetitive discharges of singled, injured myofibres
126
Q

Equine botulism and flaccid paralysis

A

Toxin B important in the UK (C and D abroad, 8 in total)
Outbreaks due to contaminated feed
Toxin irreversibly blocks the release of acetylcholine at the neuromuscular junction

Treat:

  • Antiserum to toxin B (and C and D - USA)
  • Broad spectrum antibiotics for pneumonia, avoid procaine and aminoglycosides
  • Fluid, nutrition, management of recumbent horse
  • Available vaccines

Neuropathic syndrome:
Motor: LMN signs
Sensory: hypoalgesia, hypoaesthetic, CP deficits, self mutilating, reduced reflexes, not atrophy
Autonomic: pupillary changes, decreased tear production and salivation, bradycardia

127
Q

Peripheral neuropathies in large animals

A

Post parturition:

  • Calves: femoral nerve paresis
  • Cows and horses: obturator nerve, compression against ventral ridge of wing of sacrum at delivery

Trauma:

  • Brachial plexus injury
  • Radial nerve paralysis
  • ‘Sweeny’ suprascapular nerve damage with muscle atrophy of supra and infrascapular
128
Q

Myopathic syndrome

A 
Paresis
Exercise intolerance
Stiff, stilted gait
Muscle atrophy or hyperatrophy
Muscle pain on palpation
129
Q

Exercise intolerance

A

Exercise induced collapse often in Labradors
Well muscles
Normal neuro exam between episodes
20-30min of exercise -> collapse (hyperthermia, para-tetraparesis, short rest than mobile)
Gene defect IDed

Treat: exercise restriction

Veterinary Medicine (15 decks)

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