Neuromuscular Disease Flashcards
What is the difference between a Neuropathy, Junctionopathy and Myopathy?
Neuro- affecting the nerves (multiple nerves= polyneuropathy)
Junction- affecting the Neuromuscular junction
Myopathy- affecting the muscles
Neuromuscular Disease presents neurologically as ___________ without ___________
What is this dissimilar to?
weakness without ataxia
(unlike cerebellar disease which is ataxia without weakness or spinal disease which is both)
Weakness in Neuromuscular Disease can present as…
short strides
stiff/ stilted gait
‘floppy’- reduced reflexes
What is a sign of Neuromuscular disease specific to cats and why is this not present in other domestic species such as the dog?
Cervical ventroflexion (like a hunched head)- not seen in dogs as they have passive support from the nuchal ligament which isn’t present in cats
What are some common signs associated with Neuromuscular Disease apart from weakness? (4)
Regurgitation
Dysphonia
Palmigrade/ Plantigrade posture adopted
Muscle Atrophy
How is proprioception affected in Neuromuscular disease?
Should be unaffected- patient despite showing weakness should still be aware of where its limbs are
How are spinal reflexes such as the patella reflex affected in Neuromuscular Disease?
Reduced- the signal goes to the brain but cannot reach the effector
What will present on a blood test and urinalysis of a patient with Myopathy?
Increased CK, AST and ALT
Urinalysis will show myoglobinuria
How does Electromyography work in the diagnosis of Neuromuscular disease?
Under general anaesthetic, needles are attached into the muscles and electric signals read- at rest the machine is silent but if the machine shows spontaneous electrical activity then it is suggestive of neuropathy/ myopathy
How do nerve conduction studies work?
General anaesthetic & needle into the muscle- stimulate the nerve to check how strong the signal is that reaches the muscle- this checks how strong the nerve itself is and distinguishes Neuropathies
In nerve conduction studies, how can we differentiate from axonal disease neuropathy and myelin disease neuropathy?
axonal disease will show decreased amplitude of signals
myelin disease will present as slowed conduction velocity
How can we diagnose Myasthenia Gravis with nerve conduction studies?
Myasthenia Gravis is a junctionopathy that causes progressive weakness- analyse the strength of the response after repeated nerve stimulation
What diagnostic testing should we perform to rule out other pathological possibilities that cause symptoms similar to Neuromuscular disease?
For Endocrine disease- ACTH stimulation test, also check T4 & TSH levels
For systemic disease- look at Thoracic/ Abdominal imaging
How can we provide support for patients with Neuromuscular Disease? (3)
Bladder management for recumbent patients
Ventilatory support for those with severe muscle weakness
Physiotherapy/ Hydrotherapy to maintain muscle mass and prevent atrophy
