Neurology Diagnostics Flashcards
What specific testing can you perform to diagnose myasthenia gravis?
Acetyl choline receptor antibodies
The gold standard
What specific diagnostic test can you perform in cases of masticatory myositis?
Type II M antibodies
How can you make a definitive diagnosis of myasthenia gravis?
Eprodphonium test - anti-cholinesterase
Allows acetyl choline to build up at the synaptic cleft
What are the symptoms of a cholinergic crisis associated with edrophonium administration?
Defaecation Urination Miosis Bradycardia Bronchochonstriction Emesis Lacrimation Salivation
How can you treat a cholinergic crisis?
Atropine
Where should you collect a CSF sample in relation to the lesion?
Caudal to it
What are some contraindications for CSF sampling?
High intracranial pressure Chiari like malformation Coagulopathies Post-contrast study Atlanto-axial instability
What should you analyse in a CSF sample?
Differential count Cytology Protein RBC PCRs
What two locations can you sample CSF at?
Cerebromedullary cistern - too deep = risk of tetraparesis or death
Lumbar subarachnoid space - safer
L5-L6 in dogs
L6-L7 in cats
What are some differentials for neutrophillic pleocytosis in a CSF sample?
SRMA
MUO - GME & NE
Bacterial meningitis
FIP
What are some causes of mononuclear pleocytosis in a CSF sample?
GME NE CNS lymphoma Canine distemper virus Chronic SRMA
Was is CT good for investigating in neurology?
Trauma Haemorrhage Middle ear disease Hydrocephalus Large masses - iodinated contrast agent Bony lesions
What can MRI show us?
Everything! Also very useful for the spine
Best image contrast of any modality
What can electromyelography tell us?
Identifies denervated or damaged muscles but can’t differentiate between muscle or nerve pathology
What can nerve conduction velocities tell us?
About peripheral nerve function
- tell us velocity (myelination) and amplitude (axon)
What does repetitive nerve stimulation tell us?
Evaluates the activity of the neuromuscular junction
What does F wave tell us?
The function of nerve root and proximal peripheral nerves
What does electroencephalography tell us?
Records spontaneous electrical activity in the cortex
Detecting and localising seizure focus
What does brainstem auditory evoked response tell us?
Can screen for congenital sensorineural deafness
Assess for brain death
What muscles are commonly biopsied?
Cranial tibial Biceps femoral Gastrocnemius Temporal Vastus lateralis
What nerve is commonly biopsied?
Peroneal n. - motor and sensory fibres
What should you assess on a spinal radiograph?
Width of the spinal canal
Subluxations
Displacement
Malformation
What structures are normal but commonly mistaken for pathology?
Lumbar intumescence - vertical canal widens, then narrows
Bony prominences on ventral L3 and L4 where the diaphragm attaches
Lumbosacral disks are wider
What are common incidental findings on spinal radiographs?
Disk mineralisation in chondrodystrophic dogs
Dural ossification
Asymptomatic spondylitis deformans
Facet OA
