Use of steroids in neurology

Question 1

How can steroids be used for brain tumours?

Answer 1

Can reduce oedema associated with them - normally see an improvement in 24 hours but can take 48 hours to decrease ICP
N.B does not work for other types of cerebral oedema!
Can also have anti tumour effects - e.g. lymphoma/ glioma

Question 2

Outline SRMA

Answer 2

Fever, neck/spinal pain
Often don't have other neuro signs unless been going on a long time
NSDTR, beagle, Burmese mountain dog
Young, large breed most common
Ideally imaging, CSF analysis, C+S

Question 3

Outline MUO

Answer 3

Typically affected dogs are small, middle-aged, and female, but many types and ages of dog can be affected
Variable clinical signs
Diagnosis depends on imaging and CSF analysis, but it can be difficult to definitively rule out some differential diagnoses without examination of histopathological specimens
Tx with immunosuppressive steroids +/- additionals

Question 4

What are the main types of immune mediated myositis?

Answer 4

masticatory muscle myositis (in which the masticatory muscles are the only group clinically affected), extraocular myositis (a rare condition causing abnormal eye movements in dogs), dermatomyositis (in which immune-mediated disease of both muscle and skin occur concurrently; most commonly seen in collie dogs)
generalized myositis, which can have an acute, waxing and waning, or chronic course

Question 5

How can you diagnose myositis?

Answer 5

evaluation of CK levels in the blood can be a useful aid to diagnosis, although because of the short half-life of this enzyme, a normal level does not rule out muscle disease.
Muscle biopsy
Masticatory muscle myositis can be diagnosed by blood samples demonstrating a raised level of the type 2M antibodies that are specific for this condition
Electrodiagnostics