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Medicine 1 VCS860 > Peripheral Neuropathies > Flashcards

Peripheral Neuropathies Flashcards

1
Q

Neuropathic Syndrome

A

Neurogenic Muscle Atrophy

Flaccid paresis / paralysis

Reduced or absent reflexes

Decreased Pain response

Proprioceptive Deficits

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2
Q

Peripheral Neuropathies

A

Motor and sensory nerves

Mono- or Polyneuropathies

Variable Etiologies

*degenerative, neoplastic, metabolic

*nutritional, inflammatory, infectios

*Traumatic

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3
Q

Classification of Peripheral Neuropathies

Degenerative

A

giant axonal neuropathy

Hypertrophic neuropathy

Birman cat distal neuropathy

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4
Q

Classification of peripheral neuropathies

metabolic

A

Diabetic Neuropathy

Hyperchylomicronemia

Hypothyroidism

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5
Q

Classification of Peripheral Neuropathies

Neoplastic

A

Nerve Sheath Tumor

Leukemia

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6
Q

Classification of peripheral neuropathies

Infection

A

Botulism, Tetanus

Tick Paralysis

Toxoplasma, Neospora

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7
Q

Classification of peripheral neuropathies

Inflammatory

A

Coonhound paralysis

Idiopathic polyradiculoneuritis

Idiopathic , immune-mediated

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8
Q

Diagnostic pathway for Peripheral Neuropathy

A

Accurate localization based on examination

Reference access

Clinical features and characteristics alone

Electromyography and Nerve Conduction Velocity studes

MRI

Nerve and Muscle Biopsy

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9
Q

Traumatic Neuropathy

A

Monoparesis

Traction, compression, missile, bite, Injection, surgical, ischemia,

LMN signs

Variable return to function: axon intact, axon disrupted, support intact, severed axon and support

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10
Q

Traumatic Neuropathy

Diagnosis

A

History,

Clinical signs

EMG
and NCV

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11
Q

Traumatic Neuropathy

Treatment

A

Surgical

Conservative care

Amputate if non-functional or no improvement

*4-6 weeks in most

*Rare recovery after 4 months

*Axons regrow at 1-4 mm/day

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12
Q

Facial Nerve Paralysis

A

Mononeuropathy

Etiology: Otiis media, Hypothyroidism, Trauma, Idiopathic

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13
Q

Facial Nerve Paralysis

Diagnosis

A

clinical

Eliminate differentials

EMG

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14
Q

Facial nerve Paralysis

Prognosis

A

poor for recovery

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15
Q

Facial Nerve Paralysis

Treatment

A

Supportive

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16
Q
A

Facial Nerve Paralysis

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17
Q

Trigeminal Neuritis

A

Idiopathic, bilateral

Acute onset jaw paralysis

Some clients will present the dog for polydipsia

Concurrent neuropathy: CN7, Sensory of 5, Horner’s

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18
Q

Trigeminal Neuritis

Diagnosis

A

Clinical

19
Q

Trigeminal Neuritis

Therapy

A

supportive

20
Q

Trigeminal Neuritis

Pronosis

A

Good

21
Q

Trigeminal Neuritis

Differential Diagnosis

A

Leukemia / mononuclear cell neoplasia, rabies

22
Q
A

Trigeminal Neuritis

23
Q

Coonhound Paralysis / Idiopathic Polyradiculoneuritis

A

Hunting dogs (CP), any breed (IP)

Common polyneuropathy

24
Q

Coonhound Paralysis / Idiopathic Polyradiculoneuritis

Clinical Presentation

A

onset 7-11 days post-exposure

progressive over 12 hours or up to 10 days

LMN signs

Normal form Neck up

Persists up to 3 months

Sensory Pathways still intact

25
Q

Coonhound Paralysis / Idiopathic Polyradiculoneuritis

Level of effect

A

Severe

affect facial nerve, voice, breathing

26
Q

Coonhound Paralysis / Idiopathic Polyradiculoneuritis

Diagnosis

A

Clinical

EMG/MNCV: both may be normal

CBC/Chemistry: normal

27
Q

Coonhound Paralysis / Idiopathic Polyradiculoneuritis

Therapy

A

supportive care

Mechanical ventilation in some cases

28
Q
A

Cat with idiopathic polyradiculoneuritis

29
Q

Tick paralysis

A

A N-M juction disorder

5-9 days post attachement

Progressive over 1-3 days

30
Q

Tick paralysis

Clinical Signs

A

Diffuse LMN signs

Voice change, cough, dysphagia

Normal cranial nerves

Respiratory paralysis

31
Q

Tick Paralysis

Therapy

A

Tick removal - rapid recovery

32
Q

Tick Pralysis

Prevention

A

Isoxazolone preventives are most effective at preventing disease

33
Q

Botulism

A

A N-M junction disease (Type C Toxin Only)

Progressive ascending LMN paralysis

Additional Findings:

*Megaesophagus

*KCS

*Dysphagia

*cranial nerve dysfunction

Uncommon in dogs and cats

34
Q

Botulism

Treatment

A

mostly supportive

No C Antitoxin

14-24 days for spontaneous recovery

35
Q

Infectious Polyradiculoneurits

A

Protozoal Disease

Neospora Caninum

Toxoplasma Gondii

Puppies < 3 months

36
Q

Infectious Polyradiculoneuritis

Clinical Sings

A

Extensor Rigidity of pelvic limbs

Meningoencephalomyelitis, myositis

37
Q

Infectious Polyradiculoneuritis

Diagnosis

A

Serology

cytology

Histopathology

38
Q

Infectious Polyrradiculoneuritis

Treatment

A

Clindamycin, TMS, Primethamine

Ponazuril, Toltrazuril

39
Q

Chronic Inflammatory Demyelinating Polyneuropathy

Chronic Relapsing Polyneuropathy

Idiopathic Unclassified Demyelinating Polyneuropathy

A

poorly classified and spontaneous

Variable onset of symptoms and peripheral nerve dysfunction

Paresis or paralysis involving all 4 limbs is the expected

Recovery is spontaneous in many

Immunosuppression helps with some forms

40
Q

Tetanus

A

Tetanospasmin from C. tetani

Inhibits Glycine and GABA release, protected from anti-toxin in neuron

Generalized muscle stiffness, sardonic grin, laryngeal spasm

Infected wounds or surgery sites

Develop over 2-7 days

Takes 30-45 days to resolve

41
Q

Tetanus

Managment

A

Penicillin or metronidazole (latter preferred)

Musle relaxant:

*Acepromazine and methocarbamol: commonly recommend protocol, may need to administer methocarbamol hourly and ace every 4 hrs

*Phenobarbital, diazepam, midazolam, magnesium: more effective, especially in more severe cases

*Gabapentin: May help inhibit extensor tone

Nutritional support

Tetanus anti-toxin is not effective

42
Q

Sensory Neuropathies

Hereditary or idiopathic

A

longhairded dachshunds

English Pointer

43
Q

Sensory Neuropathies

Sensory and or sensorimotor

A

Border collie, Rottweiler, Golden Retriever

44
Q

Sensory Neuropathies

A

Proprioceptive loss, loss of pain perception, self-mutilation, megaesophagus

Medicine 1 VCS860 (13 decks)

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