Neurology diagnostic tests

Question 1

What should be done with a neuro consult?

Answer 1

• Thorough history
• Perform physical + neurological examination
• Localise lesion
• VITAMIN D
• Formulate diagnostic plan

Question 2

What diagnostic investigations can be done?

Answer 2

(VITAMIN D)
* Blood work = rule out Metabolic disease
* MRI = Vascular
-Inflammatory
-Trauma
-Anomalous
-Neoplastic
-Degenerative
* CSF = rule out Inflammatory disease

Question 3

With focal + lateralised lesion what is more likely?

Answer 3

• Neoplasia
• Vascular
  (inflammatory, infectious, trauma, anomalous)

Question 4

With multifocal lesion what is more likely?

Answer 4

• Inflammatory / infectious
  (neoplasia, vascular, trauma, degenerative)

Question 5

With diffuse + symmetrical lesion, what is more likely?

Answer 5

• Metabolic
• Toxic
  (anomalous, degenerative, inflammatory/infectious, trauma)

Question 6

With T2-WI MRI, what does fluid + fat show as?

Answer 6

• Both bright = oedema = bright

Question 7

What occurs with forebrain lesions?

Answer 7

• Contralateral proprioception

Question 8

Where are CSF taps done in pets?

Answer 8

• cervical CSF tap - always go caudal to lesion

Question 9

What are contraindications for doing a CSF tap?

Answer 9

• Increased intracranial pressure
• Clotting problems
• Chiari-like malformation
• AA instability or trauma

Question 10

what is normal CSF analysis?

Answer 10

• <5WBC/ul
• no RBCs
• Protein <30(C) - 45(L) mg/dl

Question 11

Where are locations for CSF tap?

Answer 11

• Cervical = cerebellomedullary cistern
• Lumbar = lumbar subarachnoid space

Question 12

Depending on different predominant cells, what are the most likely differentials?

Answer 12

• Neutrophilic = Sterile Responsive Meningitis Arthritis - bacterial
• Mononuclear = MUOs
• Mixed = MUOs
• Eosinophilic = Eosinophilic ME, Fungal, protozoal, parasitic

Question 13

What are infectious diseases of the brain of dogs / cats?

Answer 13

• Dogs =
  -Neospora
  -Toxoplasma
  -CDV
  -Cryptococcus
  -Tick-borne diseases
• Cats =
  -FIV
  -FeLV
  -FIP
  -Toxoplasma
  -Cryptococcus

Question 14

What is myelography?

Answer 14

• Administration of contrast agent into subarachnoid space
• Useful for intravertebral disk disease - to guide surgery

Question 15

What are possible complications of myelography?

Answer 15

• Neurological deterioration
• Seizures
• Infection
• Difficult technique

Question 16

What are benefits of CT?

Answer 16

• Very good for trauma = better bony detail than MRI

Question 17

What are acetylcholine receptor antibodies titres useful for?

Answer 17

• Diagnosing acquired Myasthenia Gravis (Ach recept antibodies blocking at post-synaptic membrane)

Question 18

What is Type IIM antibodies titres useful for?

Answer 18

• Diagnosing Masticatory Muscle Myositis

Question 19

What tests can be used for myasthenia gravis?

Answer 19

• Edrophonium test
• Neostigmine test
  = injection post collapse = animal able to walk properly again

Question 20

What are different electrodiagnostics + what are they used for?

Answer 20

• 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