Unit 2 - Neuro 2 Flashcards
What is the pathophysiology of cervical vertebral stenotic myelopathy?
Compression of the spinal cord due to impingement from the vertebrae narrowing the vertebral canal
When can impingement in patients with cervical vertebral stenotic myelopathy occur?
It can be static (at rest) or dynamic (when the neck is flexed/extended)
What horses are typically affected by cervical stenotic myelopathy?
Big and young horses (CVSM type 1) or older and arthritic (CVSM type 2)
What clinical signs are associated with cervical vertebral stenotic myelopathy?
Normal physical exam, normal mentation, normal cranial nerve exam, and ataxia affecting all four limbs (hindlimbs may be 1-2 grades worse than forelimbs)
How is cervical vertebral stenotic myelopathy diagnosed?
radiographs or myelogram
What are the cons to using radiographs to diagnose cervical vertebral stenotic myelopathy?
It is a 2D image of a 3D structure - you need to get really good laterals
What are the pros to using a myelogram to diagnose cervical vertebral stenotic myelopathy?
Current gold standard for static and dynamic compression
What are cons to using a myelogram to diagnose cervical vertebral stenotic myelopathy?
More expensive, requires general anesthesia, and the horse may wake up from general anesteshia 1-2 grades worse than before (temporary)
How is Cervical vertebral stenotic myelopathy treated?
Basket’ surgery, time and decrease caloric intake if the horse is still growing, retirement, or euthanasia
What is the goal with basket surgery for cervical vertebral stenotic myelopathy?
To prevent them from doing worse and get 1-2 grades better within the next year
What etiologic agent causes equine protozoal myeloencephalitis?
Sarcocystis neurona
How do horses get S. neurona?
by eating opossum feces
Where does S. neurona travel?
wherever it wants to go
In practice, what clinical signs can equine protozoal myeloencephalitis have?
anything it wants to be
Accorind to the NAVLE, what clinical signs does equine protozoal myeloencephalitis have?
Asymptomatic, hind limb ataxia and atrophy
How is equine protozoal myeloencephalitis diagnosed?
serology, CSF antibody titres, and necropsy
When is serology for equine protozoal myeloencephalopathy valuable?
When you get a negative test. Serology tests for exposure which 90% of horses have, so if you get a negative test it means they havent been exposed.
What is the gold-standard for diagnosis for EPM?
necropsy to find the parasite