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Neurology (SA) > Neuromuscular diseases > Flashcards

Neuromuscular diseases Flashcards

1
Q

Name the 3 classic clinical signs of motor dysfunction (R-A-T)

A

Reduced reflexes
Muscle atrophy
Reduced tone

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2
Q

What causes botulism and how is it diagnosed?

A

Clostiridum botulinum exotoxins

Electrophysiology, exotoxins in feed/faeces/serum

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3
Q

Which ACH synapse receptors do junctionopathies affect? Name 1 clinical sign seen with this

A

Nicotinic ACH synapses

Tetraparesis or CN dysfuncton

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4
Q

Which ACH synapse receptors does dysautonomia affect? Name 3 clinical signs seen with this

A

Muscarinic ACH synapses

Urinary dysfunction, GI dysmotility, mydriasis, reduced tear production

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5
Q

Brachial plexus avulsions can be caused by RTAs and other trauma. Which nerves are affected?

A

C6-T2

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6
Q

An animal presents with monoparesis, an ipsilateral absent cutaneous trunci reflex, and signs of Horner’s following a recent history of trauma. What is your must likely diagnosis and which nerves are affected?

A

Brachial plexus avulsion

C6-T2

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7
Q

Give an example of a brachial plexus tumour

A

Malignant peripheral nerve sheath tumour

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8
Q

What are the clinical signs of a brachial plexus tumour (malignant peripheral nerve sheath tumour)?

A

Chronic progressive forelimb lameness
Pain
Muscle atrophy
WITH PALPABLE MASS

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9
Q

How are brachial plexus tumours treated? What is the prognosis?

A

Surgical removal

Poor if spinal involvement

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10
Q

Immune mediated polymyositis is usually idiopathic. Which dog breeds are affected?

A 
Large breeds:
Newfoundland
Boxer
German Shepherd
Labrador
Golden Retriever
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11
Q

A German Shepherd presents with pyrexia, stiffness, reluctance to move, lowered head carriage, muscle swelling, general weakness and fatigue and episodes of regurgitation. Give your most likely diagnosis

A

Immune mediated polymyositis

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12
Q

How is immune mediated polymyositis diagnosed?

A

Muscle biopsy

Electrodiagnostics

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13
Q

Give 1 haematological change and 1 biochemical change seen with immune mediated polymyositis

A

Inflammatory leukogram

Elevated CK/AST (severe)

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14
Q

What is the treatment for immune-mediated polymyositis?

A

Immunosuppression

prednisolone, ciclosporin, azathioprine, mycophenalate

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15
Q

What is overlap syndrome?

A

Immune mediated polymyositis

+ masticatory muscle myositis

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16
Q

What are the 2 causes of myasthenia gravis?

A

Congenital (autosomal recessive)

Acquired (immune mediated or paraneoplastic)

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17
Q

Myasthenia gravis can be acquired as a paraneoplastic syndrome. This is commonly see with which tumour?

A

Thymoma

Up to 50% of cats with myasthenia have thymoma

18
Q

What is the gold standard test for diagnosing myasthenia gravis?

A

Nicotonic acetylcholine receptor antibody test

nAChRAb

19
Q

What is the treatment for myasthenia gravis?

A

Anti-cholinesterase drugs- neostigmine or pyridostigmine
Immunosuppression if immune-mediated
Thymectomy if thymoma

20
Q

Myasthenia gravis may be self-limiting in some dogs, but has a general prognosis of ‘guarded to poor’. Why?

A

Risk of aspiration pneumonia

fulminant form - severe and sudden onset

21
Q

Myasthenia gravis can be fulminant or focal. Give examples of focal MG

A

Facial
Laryngeal
Pharyngeal
Oesophageal - megaoesophagus

22
Q

What breed of cats are predisposed to myasthenia gravis?

A

Abysinnian

23
Q

Masticatory myositis is in dogs with antibodies to the 2M myosin isoform. Which breed is predisposed to juvenile MM?

A

CKCS

24
Q

A CKCS presents with swollen, painful mucus membranes, exopthalmus, trismus (lockjaw) and localised muscle atrophy. What is your most likely diagnosis?

A

Masticatory muscle myositis

Juvenile form

25
Q

How is masticatory muscle myositis diagnosed?

A

Imaging of TMJ
Elevated CK
2M antibodies
Electromyography

26
Q

How is masticatory muscle myositis treated?

A

Immunosuppressive drugs - prednisolone

Physiotherapy - Kong

27
Q

Myositis can be a paraneoplastic syndrome associated with which 2 tumours?

A

Thymoma

Lymphoma

28
Q

Name 2 infectious causes of myositis

A

Neospora caninum

Toxoplasma gondii

29
Q

What is polyradiculoneuritis?

A

Inflammation of nerves and their roots

30
Q

What cat breed is predisposed to polyradiculoneuritis?

A

Bengal

31
Q

Polyradiculoneuritis has an acute onset and is rapidly progressive. Which spine roots are mostly affected, and does this cause mostly motor or sensory deficits?

A

Ventral spinal roots

Motor deficits

32
Q

How can polyradiculoneuritis be treated?

A

Supportive - physiotherapy, ventilation

Plasmapheresis

33
Q

Polyradiculoneuritis can be idiopathic, but can also have other causes. Name 3 examples of other causes

A

Rabies vaccine
Campylobacter (raw feeding)
Contact with racoons
Severe axon damage (demyelination)

34
Q

Define neuropraxia. What is the prognosis?

A

Temporary nerve damage
Conduction block due to pressure
Prognosis good: function returns in days

35
Q

Define axonotmesis. What is the prognosis?

A

Disruption of axon but intact basal laminae and myelin sheath
Due to trauma
Prognosis: variable

36
Q

Define neurotmesis. What is the prognosis?

A

Partial or complete nerve transection
Due to trauma
Prognosis guarded/poor: complete recovery unlikely

37
Q

Name the 3 traumatic neuropathies

A

Neuropraxia
Axonotmesis
Neurotmesis

38
Q

Trigeminal neuritis is inflammation of the trigeminal nerves, including the bilateral ganglia. What are the symptos?

A

‘Dropped jaw’ - acute onset of masticatory muscle paresis/plegia
Masticatory muscle atrophy
Horner’s, facial paralysis
Sensory deficits

39
Q

What is the treatment for trigeminal neuritis?

A

Supportive - self-resolves within 3 weeks

40
Q

How is trigeminal neuritis diagnosed?

A

MRI - shows inflammed nerve

41
Q

What causes half of all unilateral temporal muscle atrophy cases?

A

Trigeminal nerve sheath tumour

42
Q

How is unilateral temporal muscle atrophy due to a trigeminal nerve sheath tumour treated?

A

Radiotherapy
Prednisolone
(palliative)

Neurology (SA) (8 decks)

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