Neurology diagnostic tests Flashcards
What should be done with a neuro consult?
- Thorough history
- Perform physical + neurological examination
- Localise lesion
- VITAMIN D
- Formulate diagnostic plan
What diagnostic investigations can be done?
(VITAMIN D)
* Blood work = rule out Metabolic disease
* MRI = Vascular
-Inflammatory
-Trauma
-Anomalous
-Neoplastic
-Degenerative
* CSF = rule out Inflammatory disease
With focal + lateralised lesion what is more likely?
- Neoplasia
- Vascular
(inflammatory, infectious, trauma, anomalous)
With multifocal lesion what is more likely?
- Inflammatory / infectious
(neoplasia, vascular, trauma, degenerative)
With diffuse + symmetrical lesion, what is more likely?
- Metabolic
- Toxic
(anomalous, degenerative, inflammatory/infectious, trauma)
With T2-WI MRI, what does fluid + fat show as?
- Both bright = oedema = bright
What occurs with forebrain lesions?
- Contralateral proprioception
Where are CSF taps done in pets?
- cervical CSF tap - always go caudal to lesion
What are contraindications for doing a CSF tap?
- Increased intracranial pressure
- Clotting problems
- Chiari-like malformation
- AA instability or trauma
what is normal CSF analysis?
- <5WBC/ul
- no RBCs
- Protein <30(C) - 45(L) mg/dl
Where are locations for CSF tap?
- Cervical = cerebellomedullary cistern
- Lumbar = lumbar subarachnoid space
Depending on different predominant cells, what are the most likely differentials?
- Neutrophilic = Sterile Responsive Meningitis Arthritis - bacterial
- Mononuclear = MUOs
- Mixed = MUOs
- Eosinophilic = Eosinophilic ME, Fungal, protozoal, parasitic
What are infectious diseases of the brain of dogs / cats?
- Dogs =
-Neospora
-Toxoplasma
-CDV
-Cryptococcus
-Tick-borne diseases - Cats =
-FIV
-FeLV
-FIP
-Toxoplasma
-Cryptococcus
What is myelography?
- Administration of contrast agent into subarachnoid space
- Useful for intravertebral disk disease - to guide surgery
What are possible complications of myelography?
- Neurological deterioration
- Seizures
- Infection
- Difficult technique
What are benefits of CT?
- Very good for trauma = better bony detail than MRI
What are acetylcholine receptor antibodies titres useful for?
- Diagnosing acquired Myasthenia Gravis (Ach recept antibodies blocking at post-synaptic membrane)
What is Type IIM antibodies titres useful for?
- Diagnosing Masticatory Muscle Myositis
What tests can be used for myasthenia gravis?
- Edrophonium test
- Neostigmine test
= injection post collapse = animal able to walk properly again
What are different electrodiagnostics + what are they used for?
- Electromyography = identify denervated / damaged muscles
- Nerve conduction velocities = evaluates peripheral nerve function
- Repetitive nerve stimulation = evaluate N-M junction (M.gravis)
- Electroencephalography = detects seizures + localises seizures
