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RUSVM Small Animal Medicine I 2016 > Neurology > Flashcards

Neurology Flashcards

1
Q

Neuropraxia

A

degeneration of the myelin sheath due to loss of blood supply, pressure from the weight of the animal during anesthesia, tourniquets etc.

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2
Q

Axonotmesis

A

degeneration of axons but the endoneurium and Schwann cells remain intact allowing regeneration

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3
Q

Neurotmesis

A

complete severance of a nerve and degeneration of the distal portion and its Schwann cells
No regeneration can occur

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4
Q

symptoms of Peripheral nerve injury

A

non- progressive LMN signs

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5
Q

Treatment of peripheral nerve injuries

A

glucocorticoids to decrease inflammation
protect the limb during recovery
decompress nerve surgically
Amputation after 6 months

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6
Q

What can occur with peripheral nerve injuries?

A

Self-mutilation due to abnormal sensations

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7
Q

Brachial plexus avulsion

A

abduction of the front limb forcing it cranially or caudally resulting in avulsion of the nerve roots

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8
Q

Disruption of the nerve roots at C6-T1 leads to what signs?

A

denervation of the extensors and flexors of the elbow and carpus

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9
Q

Disruption of the nerve roots at C6-C7

A

Denervation of the extensors and flexors of the shoulder

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10
Q

What reflex is lost with damage to the C6-T1?

A

Panniculus reflex

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11
Q

What syndrome develops from injury to T1 ventral nerve roots and the preganglionic sympathetic nerve fibers?

A 
Horner's Syndrome: 
Miosis
ptosis
enophthalmos 
Protrusion of the membrana nictitans
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12
Q

What is the treatment for brachial plexus avulsion?

A

Protect the affect limb
Physiotherapy
Amputate after 6 months of no improvement
STEROIDS DO NOT HELP!!

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13
Q

What is a predictor of recovery for brachial plexus avulsion?

A

deep pain response

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14
Q

What are the signs of a Nerve root or peripheral nerve neoplasia?

A

Chronic progressive monoparesis
neurogenic muscle atrophy
hyperesthesia with limb palpation and manipulation

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15
Q

What do you use to diagnose Nerve root or peripheral nerve neoplasia?

A

CT scan
Myelogram
MRI

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16
Q

What is the treatment for Nerve root or peripheral nerve neoplasia?

A

Surgical resection

Amputation depending on the nerve affected

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17
Q

Where do fibrocartilaginous emboli originate from?

A

the nucleus pulposus of the intervertebral discs

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18
Q

What do fibrocartilaginous emboli cause?

A

Ischemic myelopathy

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19
Q

What breed is fibrocartilaginous emboli common in?

A

Large breed dogs

Miniature Schnauzers

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20
Q

What aggravates/causes fibrocartilaginous emboli?

A

vigorous exercise

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21
Q

What is used to diagnose fibrocartilaginous emboli?

A

MRI
CSF examination
Myelogram

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22
Q

What is the treatment for fibrocartilaginous emboli?

A

Dexamethasone
Supportive therapy
cage rest
physio therapy

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23
Q

Degenerative myelopathy

A

degeneration of axons and myelin sheaths in the thoracolumbar spinal cord

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24
Q

What are the breeds affected by Degenerative Myelopathy?

A

Large breed dogs

GSDs

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25
Q

What are the clinical signs of Degenerative Myelopathy?

A

Gradual loss (over 6-20 months) of voluntary motor functions and position sense
Knuckling, dragging of the toes, crossing of legs
dysmetria and ataxia of pelvic limbs
muscle atrophy of pelvic limbs
UMN hind limbs

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26
Q

What is the treatment for Degenerative Myelopathy?

A

None
Supportive therapy
physio therapy

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27
Q

Lumbosacral malarticulation malformation, cauda equina syndrome, lumbosacral stenosis, spondylolisthesis

A

forces generated by the hind limbs are transferred to the spinal column leading to Hansen type II degeneration of the L7/S1 disc and compression of the cauda equina
Also causes the proliferation of the interarcuate ligaments and formation of osteophytes on articulation facets

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28
Q

What are the clinical signs of Cauda Equina syndrome?

A

Pain on palpation of the lumbosacral area
LMN signs in the sciatic and pudendal nerves
Difficulty rising and negotiating stairs

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29
Q

What are the tests used to diagnose Cauda Equina syndrome?

A

“Lordosis test”

“Tail Jack test”

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30
Q

What is used to diganose Cauda Equina syndrome?

A 
Radiographs
Myelography
epidurography
MRI 
CT scans
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31
Q

What is the treatment for Cauda Equina syndrome?

A 
Cage Rest
NSAIDs
Dorsal Laminectomy 
Surgery to remove bone and ligaments putting pressure on the nerves
Surgical stabilization 
Dorsolateral foramenotomy
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32
Q

Thoracolumbar Intervertebral disk-disease

A

As the dog ages the gel-like nucleus pulposus degenerates and is replaced with cartilage (hyaline or fibrocartliage)
Dorsal displacement of the nucleus pulposus can result in stretching of the dorsal ligament and spinal cord damage

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33
Q

What are the two types of Thoracolumbar Intervertebral disk-disease?

A

Hansen Type I

Hansen Type II

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34
Q

Where is cauda equine syndrome seen in the vertebral column?

A

L7/S1

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35
Q

Thoracolumbar Intervertebral disk-disease Hansen Type 1

A

an explosive extrusion of nuclear pulposus material into the spinal canal through the annulus fibrosis

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36
Q

What breeds are more prone to Hansen Type 1?

A

Chrondrodystrophic breeds

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37
Q

Thoracolumbar Intervertebral disk-disease Hansen Type II

A

small tears appear in the annulus fibrosis and there is slow protrusion of the nucleus pulposus

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38
Q

What breeds are more prone to Hansen Type II

A

Large breed dogs

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39
Q

Where is calcification seen in cats?

A

upper cervical and mid-lumbar areas

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40
Q

What are the clinical signs of Thoracolumbar Intervertebral disk-disease?

A

hyperesthesia
paralysis
anesthesia

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41
Q

What is the order of loss of function in Thoracolumbar Intervertebral disk-disease?

A
  1. Conscious Proprioception
  2. voluntary motor function
  3. control of urination and defecation
  4. superficial pain sensation
  5. deep pain sensation
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42
Q

How do you diagnose Thoracolumbar Intervertebral disk-disease?

A

Myelography
CT scan
MRI imaging

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43
Q

How do you treat Thoracolumbar Intervertebral disk-disease?

A

depending on the clinical signs and severity
Cage Rest
NSAIDs
Predisone
NO STEROIDS!!
Surgery: Dorsolateral hemilaminectomy and durotomy
Physiotherapy

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44
Q

What are the Grades of Thoracolumbar Intervertebral disk-disease?

A

Grades 1-5

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45
Q

Thoracolumbar Intervertebral disk-disease Grade 1 neurological effects

A

Spinal hyperesthesia without neurological defects

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46
Q

Thoracolumbar Intervertebral disk-disease Grade 2 neurological defects

A

Paresis but ambulatory

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47
Q

Thoracolumbar Intervertebral disk-disease Grade 3 neurological defects

A

paresis but non-ambulatory

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48
Q

Thoracolumbar Intervertebral disk-disease Grade 4 neurological defects

A

paralysis with deep pain sensation intact

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49
Q

Thoracolumbar Intervertebral disk-disease Grade 5 neurological defects

A

paralysis with no deep pain sensation

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50
Q

What treatment is recommended for all Grade 4 animals?

A

Surgery

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51
Q

What is the surgery of choice for a Grade 4 Thoracolumbar Intervertebral disk-disease?

A

Dorsolateral hemilaminectomy

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52
Q

Diskospondylitis

A

infection of the cartilaginous endplates

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53
Q

What are the most common agents causing Diskospondylitis?

A

S. Intermedius
B. canis
Streptococcus spp.

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54
Q

What are the clinical signs of Diskospondylitis?

A 
hyperesthesia
pyrexia
depression 
weight loss
Spinal cord signs due to compression
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55
Q

How do you diagnose Diskospondylitis?

A

Radiographs
MRI
Serology for B. canis on intact dogs

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56
Q

How do you treat Diskospondylitis?

A

analgesics
antibiotics parenterally
Treatment is usually 1 year long

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57
Q

What are the 4 types of neoplasia seen in the spine?

A
  1. intramedullary
  2. metastatic intramedullary
  3. Intradural-extramedullary
  4. extradural
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58
Q

What are the most common neoplasia of the spine?

A

Extradural: vertebral osteosarcoma, chondrosarcoma, multiple myeloma, hemangiosarcoma, and fibrosarcoma or metastases

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59
Q

What is the second most common tumor in dogs?

A

Hemangiosarcoma

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60
Q

What is the most common spinal cord neoplasia in cats?

A

Extradural lymphosarcoma

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61
Q

How does the Intramedullary tumor appear on the myelogram?

A

dye columns thin and diverge

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62
Q

How does the intradural-extramedullary tumor appear on the myelogram?

A

characteristic “golf-tee” sign

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63
Q

How does the extradural tumors appear on the myelogram?

A

cause one side of the dye column to deviate towards the lumen of the spinal cord

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64
Q

What is the treatment for a Meningioma?

A

resection

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65
Q

What is the treatment for neoplasia of the spine?

A

Resection if possible
Radiation
Chemo therapy

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66
Q

What are the clinical signs of vertebral fractures or luxations?

A 
history of trauma
spinal hyperesthesia 
decreased or absent voluntary motor activity 
misalignment of the spine 
Schiff-Sherrington
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67
Q

Schiff-Sherrington

A

stiff front legs (like tetanus) from a lesion in the spinal cord that knocks out the inhibitory neurons between the front and back legs leading to stiff front limbs

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68
Q

How do you diagnose vertebral fracture or luxation?

A

Radiographs

CT/MRI

69
Q

How do you treat vertebral fracture or luxation?

A

Treat the shock or life threatening conditions
Methylprednisolone succinate
Mannitol once hypovolemia is corrected
Surgery
Cats: Splinting and confinement or dorsal hemilaminectomy and stabilization of the fracture

70
Q

Hemivertebrae

A

Failures of the left and right center of ossification to fuse

71
Q

Block or fused vertebrae

A

incomplete segmentation of two or more adjacent vertebrae

72
Q

Spinal dysraphism

A

spinal cord does not close at the top

73
Q

Sacrococcygeal dys/agenesis

A

no development of the tail/sacrum causing no nerves to the bladder or rectum causing incontinence

74
Q

Spinal synovial cysts

A

multiple cervical cysts causing neck pain

75
Q

Spondylosis deformans

A

vertebral osteophytes form spurs or complete bony bridges at intervertebral spaces

76
Q

Old Dog Hind Limb Tremors

A

mild tremors seen in one or both hind limbs most obvious when the dog is standing or sitting/laying

77
Q

Dancing Dobermans

A

Flexion of the pelvic limbs while standing

May lead to atrophy of the gastrocnemius

78
Q

Where is Hansen Type I cervical disc extrusion seen in chondrodystrophic breeds?

A

C2/3

Caudal to C4

79
Q

Where is Hansen Type I seen in large breeds?

A

C3-4
C5/6
C6/7

80
Q

Where is Hansen Type II cervical disc prolapse found in Dobermans and Rottweilers?

81
Q

What are the clinical signs of cervical disc disease?

A 
Severe neck pain 
holding their heads in a fixed position 
Yelp in pain with minor movements
will not eat unless food is elevated
Neurological deficits due to spinal cord compression
82
Q

How do you diagnose cervical disc disease?

A

Radiographs

Myelography

83
Q

How do you treat cervical disc disease?

A

cage rest
Prednisone with diazepam or methocarbamol
Surgery: Ventral fenestration or ventral decompression

84
Q

Common name for Cervical spondylomyelopathy

A

Canine Wobbler’s

85
Q

Cervical Spondylomyelopathy

A

common condition characterized by compresison of the spinal cord in the caudal cervical area

86
Q

What breeds are susceptible to Cervical spondylomyelopathy?

A

Large and Giant Breed dogs: Great Danes (3-18 months), Rottweilers, Mastiffs, and Mountain Dogs

87
Q

What are the causes of Cervical spondylomyelopathy ?

A
  1. congenital stenosis of the vertebral column
  2. Hansen type II disk protrusion
  3. hypertrophy of the ligamentum flavum
  4. boney proliferation of articular processes
88
Q

Tipping

A

bony changes of the dorsal lamina or craniodorsal ridges of the vertebral body

89
Q

Cervical spondylomyelopathy Hansen Type II disk protrusion

A

hypertrophied dorsal annulus compresses the ventral aspect of the spinal cord at C5-6 or C6-7

90
Q

What are the factors leading to Cervical spondylomyelopathy?

A 
Genetics
Congenital spinal canal stenosis
Over-nutrition 
Rapid Growth 
Abnormal stresses/motility in synovial joints
Hypercalcitonin
91
Q

Clinical signs of Cervical spondylomyelopathy?

A 
Cervical Hyperesthesia
neck guarding 
low-neck posture
Paresis in the pelvic limbs 
hypometria (stiff gait) in the front limbs
92
Q

Diagnosis of Cervical spondylomyelopathy?

A

Radiographs
Myelography
MRI

93
Q

Treatment of Cervical spondylomyelopathy?

A

Medical therapy is palliative
condition is progressive
exercise restriction to minimize dynamic compression
Prednisone for inflammation
Surgical decompression: Dorsal laminectomy and stabilization with screw/pins or Ventral decompression
Poor prognosis in dogs with tetraplegia

94
Q

Atlanto-axial subluxation

A

dorsal displacement of the axis causing spinal cord compression

95
Q

What are the three mechanisms of Atlanto-axial subluxation?

A

Absence or hypoplasia of the odontoid process/dens
odontoid fracture between the dens and C2
Rupture of the ligamentous supports

96
Q

What breeds is Atlanto-axial subluxation common in?

A

Toy breeds or miniature breed 6-18 months of age

97
Q

Diagnosis of Atlanto-axial subluxation

A

Radiographs of the dens in ventrodorsal view

98
Q

Treatment of Atlanto-axial subluxation

A

Hemilaminectomy and immobilization by wires and screws

99
Q

Syringomyelia

A

fluid filled cavities in the parenchyma of the spinal cord as a result of abnormal CSF movement

100
Q

What breeds are Syringomyelia common in?

A

King Charles Spaniels and other small breeds

101
Q

What causes Syringomyelia to form?

A

Caudal occipital malformation syndrome Chiari type I malformation

102
Q

What causes Syringomyelia to form?

A

Caudal occipital malformation syndrome

103
Q

Clinical signs of Syringomyelia

A

Cerebellovestibular disease caused by the impaction in to the foramen magnum/herniation
neuropathic pain and spinal dysfunction caused by pressure of the syrinx on the dorsal horns
Face neck and shoulder scratching
head/neck pain
vocalization
vestibular signs
tetraparesis

104
Q

Treatment of Syringomyelia

A

Drugs to control the signs: Prednisone, gabapentin

105
Q

What are the clinical signs of myopathies

A

generalized weakness
exercise intolerance
stiff “plodding” gait

106
Q

What are the causes of infectious myopathies?

A

Toxoplasmosis
neosporosis
FELV
FIV

107
Q

What is the best way to diagnose Toxoplasma and Neospora?

108
Q

What are the 5 P’s of Prednisone?

A 
Polyuria
Polydipsia
Polphagia
Panting 
Pot belly
109
Q

What breed does Masticatory Myositis occur in?

A

large breed under 4 years old

110
Q

What are the clinical signs of Masticatory Myositis?

A

Swollen painful muscles
pain upon opening of the mouth
severe atrophy of the masticatory muscles

111
Q

Diagnosis of Masticatory Myositis?

A

serology or immunohistochemistry of muscle biopsies

112
Q

Treatment of Masticatory Myositis?

A

Prednisone

Azathioprine used with Prednisone for steroid sparing effect

113
Q

What breed is Extraocular myositis common in?

A

Golden Retrievers

114
Q

Extraocular myositis

A

myositis causing bilateral exophthalmus

115
Q

Treatment of Extraocular myositis?

A

Corticosteroid therapy

Prednisone

116
Q

What breed is exertional myopathy common in?

A

Grey hounds

117
Q

Diagnosis for exertional myopathy

A

elevated serum CK levels

118
Q

What is common of animal with exertional myopathy to die from?

A

Renal Failure

119
Q

What species is Hypokalemic myopathy common in?

A

Older Cats with renal disease

120
Q

What causes Hypokalemic myopathy?

A

diets deficient in potassium
acidifying diets
cats with hyperthyroidism
polyuria

121
Q

Clinical signs of Hypokalemic myopathy?

A

persistent ventroflexion of the neck

122
Q

Treatment of Hypokalemic myopathy

A

Oral potassium supplementation

123
Q

Clinical signs of Feline Idiopathic inflammatory myopathy

A

pronounced cervical ventroflexion
painful muscles
weakness

124
Q

Treatment of Feline Idiopathic inflammatory myopathy

A

Prednisone

125
Q

Limber Tail

A

Pointers, Labs, and other working breeds develop flaccid tail after a history of cage rest and a hard workout the day before or exposure to wet or cold weather

126
Q

Clinical signs of Dystrophic myopathies

A

bunny hopping
marked muscle atrophy with fibrosis
contracture of the tarsus at 6 weeks of age or earlier
kyphosis or lordosis
Progressive signs over the first 6 months of life

127
Q

What animals do you see Dystrophic myopathies in

A

young puppies - inherited disease

128
Q

Clincal signs of Exercise Intolerance and collapse (EIC) of Laboradors

A

Collapse after intense work/play
ataxia
rocking horse gait
collapse
Dog returns to normal after 5-25 mins of rest
Patellar reflexes are absent but return to normal

129
Q

What gene is Exercise Intolerance and collapse (EIC) of Laboradors associated with

130
Q

Myotonia Congenita

A

sustained depolarization of muscle fibers

131
Q

Clinical Signs of Myotonia Congenita

A 
Dimpling of the muscle after percussion 
Stiff gait 
walk with difficulty 
CP responses are slow 
Clonic reflexes
132
Q

What breeds are Myotonia Congenita common in?

A

Chow Chow
Westies
Great Danes
Domestic Cats

133
Q

Dermatomyositis

A

inflammatory disease of the capillary walls in the skin

134
Q

Clinical signs of Dermatomyositis

A

Facial dermatitis
mild weakness
megaesophagus
Chronic waxing/waning course of clinical signs

135
Q

Treatment of Dermatomyositis

A

Pentoxyifylline

Topical treatment of dermatitis

136
Q

Feline hyperesthesia Syndrome

A

Intermittent rippling and twitching of the skin in cats

137
Q

Clinical signs of Feline hyperesthesia Syndrome

A 
excessive grooming
licking 
biting of areas 
vocalization 
growling 
hissing 
exaggerated tail motion 
frantic running and attacking inanimate objects and people
138
Q

Treatment of Feline hyperesthesia Syndrome

A

Prednisone

Phenobarbitone

139
Q

Congenital Myasthenia Gravis

A

motor end plate nicotinic acetylcholine receptors are decreased

140
Q

Acquired Myasthenia Gravis

A

autoantibodies are produced against the Acetylcholine receptors

141
Q

Clinical Signs of Myasthenia Gravis

A

Muscle weakness
megaesophagus
facial, pharyngeal or laryngeal muscle weakness

142
Q

2 forms of Generalized Myasthenia Gravis

A

Acute fulminating generalized MG

Chronic fulminating generalized MG

143
Q

Clinical signs of Acute fulminating generalized MG

A

regurgitation due to megaesophagus
muscle weakness
respiratory distress
respiratory failure

144
Q

Clinical Signs of Chronic fulminating generalized MG

A

Megaesophagus

muscle weakness induced by exercise

145
Q

What do many cats with Myasthenia Gravis also have?

146
Q

What test is used to detect Myasthenia Gravis?

A

Tensilon test

147
Q

What is the tensilon test used to diagnose?

A

Myasthenia Gravis

148
Q

What anticholinesterase agent is used to diagnose Myasthenia Gravis?

A

Edrophonium

149
Q

What is the treatment for Myasthenia Gravis?

A

anticholinesterase drugs: pyridostigmine or neostigmine

150
Q

What do dogs with Myasthenia Gravis usually die from?

A

Aspiration pneumonia

151
Q

Which type of Myasthenia Gravis has a poor prognosis?

A

Progressive Myasthenia Gravis

Acute fulminating Myasthenia Gravis

152
Q

Botulism

A

caused by ingestion of food contaminated with exotoxins from Clostridium botulinum which blocks acetylcholine release from presynaptic membranes at somatic and autonomic muscular junctions

153
Q

Clinical signs of Botulism

A

Hypo- or areflexia
hypotonia
megaesophagus
Repiratory paralysis

154
Q

What is a definitive diagnosis of Botulism?

A

exotoxin in the feces or serum

155
Q

What is the treatment for Botulism?

A

Supportive therapy

Neostigmine/Pyridostigmine

156
Q

What are the problems with using Botulism polvalent antisera?

A

very expensive and dangerous due to anaphylaxis

157
Q

Tick paralysis

A

blocking of conduction impulses along distal protions of motor nerves or inhibition of presynaptic release of acetylcholine at motor end plates

158
Q

Clinical signs of Tick Paralysis

A

mild paresis
tetraplegia
LMN signs

159
Q

When does recovery from Tick Paralysis begin?

A

8-12 hours after tick removal

160
Q

Tetanus

A

neurotoxin of Clostridium tetani migrates from peripheral nerves to the brain where it blocks inhibitory interneurons on spinal motor neurons

161
Q

Clinical signs of Tetanus

A 
Wrinkling of skin between the ears
pricking of ears
enophthalmos 
sardonic grin 
"saw" horse stance 
recumbent 
asphyxiate
162
Q

Treatment of Tetanus

A 
Penicillin 
Valium 
acepromazine 
Clean wounds with peroxide 
pentobarbital
163
Q

Coon hound paralysis (acute idiopathic polyradiculoneuritis)

A

raccoon bites causing changes in nerve antigenicity that results in inflammation, degeneration and demyelination of the ventral nerve roots

164
Q

Clinical signs of coon hound paralysis

A

ascending LMN paralysis

tetraplegia

165
Q

Diagnosis of Coonhound paralysis

A

clinical signs

EMG findings

166
Q

What two organisms cause Protozoal polyradiculoneuritis?

A

Toxoplasma

Neospora

167
Q

Clinical signs of Protozoal polyradiculoneuritis?

A

progressive posterior paralysis

168
Q

Diagnosis of Protozoal polyradiculoneuritis?

A

Serology

Histopathology of muscle biopsies

169
Q

Treatment of Protozoal polyradiculoneuritis?

A

pyrimethamine

Trimethaprim-sulfadiazine

RUSVM Small Animal Medicine I 2016 (9 decks)

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