Neurology Problem-Based Studies Part II

Question 1

what is the stride length like with general proprioceptive ataxia?

Answer 1

dysmetria
long stride length: no GP information, so onset of protraction of limb delayed

Question 2

does the continuous or intermittent tail pull better assess weakness?

Answer 2

continuous tail pull

Question 3

what is the walking tail pull response like with general proprioceptive deficits?

Answer 3

ataxic response

Question 4

in what lesions would you see general proprioceptive deficits in all four limbs?

Answer 4

C1-5
C6-T2

Question 5

what diseases are associated with focal spinal ataxia?

Answer 5

cervical vertebral malformation
trauma

Question 6

is there a fever in cervical vertebral stenotic myelopathy?

Answer 6

no

Question 7

what minimum sagittal diameter is considered normal in thoroughbreds?

Answer 7

> 0.5

Question 8

what view in contrast myelography is best for assessing static compression?

Answer 8

neutral position

Question 9

what are the aims with intervertebral fusion?

Answer 9

dynamic: avoid further compression
static: atrophy of hypertrophied areas (remodeling and atrophy of articular processes)

Question 10

what is equine protozoal myelitis caused by?

Answer 10

intracellular protozoa: Sarcocystis neurona, less commonly Neospora hughesi

Question 11

is there a fever with equine protozoal myelitis?

Answer 11

not usually

Question 12

what are the diagnostic testing options for equine protozoal myelitis?

Answer 12

PCR: tissue
western blot
IFAT (indirect fluorescent antibody test)
ELISAs: surface antigens

Question 13

how is equine herpesvirus-1 myeloencephalopathy transmitted?

Answer 13

respiratory
endogenous reactivation

Question 14

what are the clinical signs with equine herpesvirus-1 myeloencephalopathy?

Answer 14

ataxia
+/- fever, respiratory signs, abortion
bladder dysfunction
cranial nerve deficits, central depression, behavior changes possible
perineal sensory deficits

Question 15

how can you diagnose equine herpesvirus-1 myeloencephalopathy?

Answer 15

nasal, blood, CSF PCR

Question 16

what is the average survival for rabies in horses?

Answer 16

5 days
most dead by 10 days

Question 16

when is the peak prevalence of west nile virus?

Answer 16

september and october
fall

Question 17

what percentage of horses with west nile virus show a fever?

Answer 17

25%

Question 18

how is west nile virus diagnosed?

Answer 18

IgM for acute infection: ELISA
post mortem PCR or IHC on CNS tissue

Question 19

what is the mortality of west nile virus?

Answer 19

20-40%

Question 20

what does neural invasion in eastern equine encephalitis occur secondary to?

Answer 20

likely to vascular infection or invasion through olfactory epithelium

Question 21

how can you manage eastern equine encephalitis?

Answer 21

vaccination with killed equine vaccine
mosquito control
not stable in environment

Question 22

what are the common clinical signs with Anaplasma phagocytophila?

Answer 22

fever
anorexia
icterus
edema
petechiae

Question 23

how can you treat Anaplasma phagocytophila?

Answer 23

tetracycline
minocycline
doxycycline

Question 24

what is lyme disease caused by?

Answer 24

Borrelia burgdorferi

Question 25

how can you treat Borrelia?

Answer 25

minocycline or doxycycline ceftiofur steroids

Question 26

what happens in equine degenerative myeloencephalopathy?

Answer 26

diffuse non-compressive spinal cord disease degeneration of neurons in white matter of spinal cord

Question 27

what vitamin plays a significant roll in equine degenerative myeloencephalopathy?

Answer 27

deficiencies in vitamin E

Question 28

what is the common stride length with GP deficits?

Answer 28

long

Question 29

what causes diffuse spinal ataxia?

Answer 29

EDM

Question 30

what causes multifocal spinal ataxia?

Answer 30

EPM viral encephalitis tick-borne

Question 31

what are the two types of cervical vertebral stenotic myelopathy?

Answer 31

developmental disease in young horses spinal cord compression due to osteoarthritic enlargement of articular processes in older horses

Question 32

how is minimum sagittal diameter determined?

Answer 32

smallest diameter of cranial aspect of cervical canal divided by widest diameter of cranial aspect of vertebral body of same vertebra

Question 33

how can you manage cervical vertebral stenotic myelopathy in a youngster?

Answer 33

can try dietary management moderate to severe calorie restriction

Question 34

what is the definitive host of Sarcocystis neurona?

Answer 34

opossum

Question 35

what is the best test for equine protozoal myelitis?

Answer 35

ELISA of IgG response to unique surface antigens serum:CSF titer ratio

Question 36

what can you use to treat equine protozoal myelitis?

Answer 36

marguis/ponazuril protazil/diclazuril rebalance

Question 37

what is the pathogenesis of equine herpesvirus-1?

Answer 37

multifocal vasculitis with ischemia direct viral infection of vascular endothelial cells

Question 38

has vaccination been shown to prevent the neurologic form of equine herpesvirus-1?

Answer 38

no

Question 39

what are the classic form of rabies?

Answer 39

dumb: progressive depression furious: progressive aggression

Question 40

what can be seen in CSF with rabies?

Answer 40

increased protein and lymphocyes may be normal

Question 41

is west nile virus spread horse to horse?

Answer 41

no- viremia is too low

Question 42

are there pathognomonic signs that distinguish west nile virus from other CNS diseases?

Answer 42

no

Question 43

if a horse with west nile virus significantly improves within __________, then full recovery is expected within 1-6 months in 90%

Answer 43

3-7

Question 44

is there a vaccine available for west nile virus?

Answer 44

yes, safe

Question 45

what is the most important amplifier of virus activity in VEE?

Answer 45

horses

Question 46

when does encephalitis occur with EEE?

Answer 46

after neuronal or hematogenous spread

Question 47

what can be seen in CSF with EEE?

Answer 47

neutrophilia in acute stages

Question 48

what fraction of horses that survive EEE have residual neurologic deficits?

Answer 48

2/3

Question 49

how stable is EEE in the environment?

Answer 49

not stable

Question 50

how can you diagnose Anaplasma phagocytophila?

Answer 50

PCR inclusion bodies: 10-18 days post infection

Question 51

what can be seen in horses with lyme?

Answer 51

ataxia, paresis, weight loss neck stiffness, behavior cranial or peripheral neuropathies concurrent conjunctivitis and uveitis, fever

Question 52

what are the clinical signs with equine degenerativee myeloencephalopathy?

Answer 52

age <2years acute or slowly progressive symmetric proprioceptive ataxia all limbs no fever