Quiz #8 neuro Flashcards
How is the nervous system divided? What is included in each division?
- Central nervous system (CNS): Brain and spinal cord
* Peripheral nervous system (PNS): Cranial nerves, peripheral nerves
How do we “rank” levels of mentation?
• Alert> depressed/obtunded> stuporous> comatose
o Depressed = difficult to arouse but has a normal reaction to different stimuli
o Stuporous = pet can only be aroused by a strong stimulus (ie pain)
o Comatose = pet cannot be aroused at all
What are some of the different postures we see in veterinary medicine? Where is the lesion for each of these postures?
- Decerebrate posture: Extreme rigidity of all 4 legs, Possible opisthotonous, Animal stuporous/comatose, Grave prognosis = disconnect between forebrain and brainstem
- Decerebellate posture: Rigid forelimbs and flexed hindlimbs or all 4 rigid, Cerebellar injury, Usually normal mentation
- Schiff-Sherrington posture: Rigid forelimbs and flaccid hindlimbs (but normal spinal pelvic reflexes), Normal mentation, T3-L3 lesion
Spinal reflexes
o Patellar: Gently tap the patellar tendon; quadriceps contracts; stifle should extend
o Flexor (withdrawal) : With fingers, pinch skin of toe web; Normal response = animal flexes all joints of the limb, Does not necessarily mean the animal feels it
o Perineal reflex: Touch perineal area; normal response is flexion of the tail and contraction of the anal sphincter, Evaluated on both sides
o Cutaneous trunci reflex (panniculus), Gently pinch the skin lateral to the spine from caudal to cranial, Stimulation of one side should result in bilateral contraction of the cutaneous trunci muscles, Usually used to help localize disc disease,
Postural reflexes
o Knuckling: Tests conscious proprioception – might notice with gait – place paw on dorsal surface and see if animal corrects it – if not generally indicates neuro dz o Visual and tactile placing o Hopping o Hemiwalking o Wheelbarrowing o Extensor postural thrust
Levels of pain/how to test for them
- Superficial pain: pinch the skin of the toes
- Deep pain: clamp down on third phalanx with hemostat
- Pain = animal notices the painful stimulus (turns, cries, tries to bite..)
What are the phases of seizures? What is status epilepticus?
- Pre-ictal/aura: precedes seizure activity; animal may be restless, agitated, whine, etc. as if it knows what will happen; seconds to hours
- Ictal phase: actual seizure event; seconds to minutes; may lose consciousness or change in mental awareness; status epilepticus = seizure that lasts longer than 5 minutes (EMERGENCY)
- Post-ictal phase: period immediately after the end of a seizure; generally includes confusion/disorientation/restlenessness; minutes to hours
What will a tonic-clonic or grand mal seizure look like?
Symmetric throughout body, Tonic phase (rigid extension), Clonic phase (paddling, running), Chewing, facial movements, urination/defecation/salivation, Consciousness impaired, Typical form of idiopathic epileptic seizures
What about an absence seizure?
Little movement, Stare blankly but do little else, Rare in pets
Partial/focal seizure?
Involves specific parts of the brain, May be unilateral, May be facial twitching/repetitive limb movement, Conscious awareness usually maintained
Psychomotor seizure?
affect part of the brain that is responsible for emotions and behavior – often have bizarre behavior
When is it necessary to treat a seizure? What do we use initially to treat them?
- Critical with status epilepticus or cluster seizures (multiple seizures within a short period of time)
- Diazepam (Valium®) drug of choice for status epilepticus
What can an owner do if their pet is having a seizure?
• They can’t do much!- Average less than 2 minutes
• Remove objects that may injure pet
• Time the seizure
o Bring pet immediately if it lasts longer than 5 minutes or if having cluster seizures
• If could be diabetic crisis or other reason to suspect hypoglycemia, can apply honey or Karo syrup to gums
o Do NOT place hands in mouth!!!
• Owner can take video
How do we diagnose idiopathic epilepsy? What age range do we usually see diagnose this in?
- Rule out other causes – use DAMN IT!
- History
- CBC/Chem panel
- Bile Acids
- CT/MRI
- CSF tap
- Dogs, 1- 5 years; not as common in cats
What are clinical signs of idiopathic vestibular disease?
- Sudden onset – owners think pet has had a stroke
- Incapacitating loss of balance
- Head tilt (usually towards lesion)
- Nystagmus (fast phase away from lesion)
- Disorientation, ataxia
- Circling (usually towards lesion)
- Vomiting, anorexia
