Neurology
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Neurology

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Questions and Answers

What is the expected pupillary response when lesions affect CN3?

  • Constriction only in the affected eye
  • Constriction in both eyes when one eye is illuminated
  • No constriction in both eyes regardless of illumination
  • Loss of constriction in the affected eye, with constriction in the unaffected eye (correct)

    • Which type of lesions typically result in ataxia?

  • Peripheral nerve lesions
  • Brainstem lesions
  • Cerebral lesions
  • Cerebellar lesions (correct)

    • In the presence of a lesion affecting CN6, what ocular condition is likely to occur?

  • Alternating strabismus
  • Vertical strabismus
  • Lateral strabismus
  • Medial strabismus (correct)

    • What does an abnormal pupillary light reflex (PLR) indicate concerning CN3?

    <p>The large pupil is denervated</p> Signup and view all the answers

    What causes circling to occur after a brain lesion?

    <p>The side of the lesion is usually the same as the circling direction</p> Signup and view all the answers

    What indicates the loss of sympathetic tone affecting pupil size?

    <p>Presence of small pupils</p> Signup and view all the answers

    Which brain lesions show opposite side postural deficits?

    <p>Cerebral lesions</p> Signup and view all the answers

    When examining ocular motility, which cranial nerves are involved in voluntary eye movement?

    <p>CN3, CN4, and CN6</p> Signup and view all the answers

    What condition is indicated by eosinophilic inflammation related to immune-mediated encephalitis?

    <p>Fungal infections</p> Signup and view all the answers

    Which of the following signs may indicate forebrain lesions?

    <p>Drowsiness and confusion</p> Signup and view all the answers

    Which condition is characterized by the presence of tumor cells or organisms in a sample?

    <p>Erythrophagocytosis</p> Signup and view all the answers

    What conclusion can be drawn about increased red blood cells (RBCs) in CSF analysis?

    <p>Can result from contamination or trauma</p> Signup and view all the answers

    What is a common symptom of systemic metabolic alterations?

    <p>Seizures</p> Signup and view all the answers

    What indicates the presence of a central nervous system (CNS) lesion when associated with seizures or altered consciousness?

    <p>A CNS lesion</p> Signup and view all the answers

    Which of the following treatments is specifically used for edema related to meningioma?

    <p>Corticosteroids</p> Signup and view all the answers

    Which reflex tests the integrity of cranial nerves CN5 and CN6?

    <p>Retractor oculi reflex</p> Signup and view all the answers

    In the presence of diffuse weakness and diminished reflexes without postural deficits, where is the lesion most likely located?

    <p>In the peripheral nervous system</p> Signup and view all the answers

    Which type of lesions can lead to symptoms such as lethargy and altered mentation?

    <p>Focal diencephalic lesions</p> Signup and view all the answers

    What is likely to occur with both diffuse and focal disorders affecting the brain?

    <p>Absence of pain response</p> Signup and view all the answers

    If the clinical signs manifest only in the limbs, where is the lesion likely to be found?

    <p>Below the foramen magnum</p> Signup and view all the answers

    What is the primary method to assess the corneal reflex?

    <p>Touching the cornea</p> Signup and view all the answers

    What does the presence of CN deficits and limb signs typically suggest about the lesion's location?

    <p>It is in the CNS</p> Signup and view all the answers

    What feature indicates injury to the cranial nerve 12 (CN12) or brainstem lesions?

    <p>Tongue atrophy</p> Signup and view all the answers

    Which option represents a crucial alteration in biochemical tests related to nerve system function?

    <p>Calcium levels</p> Signup and view all the answers

    Which breeds are primarily affected by canine idiopathic vestibular disease?

    <p>Cairn terrier, Kerry blue terrier, miniature poodle</p> Signup and view all the answers

    What is the typical age range for the onset of signs in canine idiopathic vestibular disease?

    <p>4 to 16 weeks</p> Signup and view all the answers

    What are common clinical signs associated with canine idiopathic vestibular disease?

    <p>Head tilt, circling, falling, nystagmus, anorexia</p> Signup and view all the answers

    How is canine idiopathic vestibular disease diagnosed?

    <p>By ruling out other causes of clinical signs</p> Signup and view all the answers

    What is the treatment approach for canine idiopathic vestibular disease?

    <p>Supportive treatment until clinical signs resolve</p> Signup and view all the answers

    Which condition is mentioned as a differential diagnosis for canine idiopathic vestibular disease?

    <p>Neoplasia</p> Signup and view all the answers

    Which breed is NOT commonly associated with multisystem neuroaxonal dystrophy?

    <p>Cocker spaniel</p> Signup and view all the answers

    What unique clinical signs are observed in affected miniature poodles?

    <p>Cerebellovestibular signs</p> Signup and view all the answers

    What characterizes an epileptic seizure?

    <p>It results from abnormal activity in the cerebral cortex.</p> Signup and view all the answers

    Which age group in dogs is most likely associated with idiopathic seizures?

    <p>Dogs between 1 and 5 years.</p> Signup and view all the answers

    What is status epilepticus?

    <p>A continuous seizure lasting more than 30 minutes.</p> Signup and view all the answers

    Which statement is true regarding cats and idiopathic epilepsy?

    <p>Almost all cats have an underlying cause for seizures.</p> Signup and view all the answers

    Which sequence of events indicates the postictal phase of a seizure?

    <p>The experience of altered behavior immediately after a seizure.</p> Signup and view all the answers

    What is a likely indication of secondary epilepsy in dogs?

    <p>First seizure symptoms are focal.</p> Signup and view all the answers

    Which of the following is a common type of seizure in dogs?

    <p>Generalized convulsions.</p> Signup and view all the answers

    What factor might suggest idiopathic epilepsy in a dog?

    <p>The dog is a large breed and has more than 4 weeks between seizures.</p> Signup and view all the answers

    Which reflex test evaluates the integrity of the musculocutaneous nerve?

    <p>Biceps reflex</p> Signup and view all the answers

    What does an exaggerated patellar reflex indicate?

    <p>Upper motor neuron lesion</p> Signup and view all the answers

    Which reflex is tested by assessing spinal cord segments L6 to S2?

    <p>Pelvic limb flexor reflex</p> Signup and view all the answers

    A positive Babinski reflex suggests the presence of which type of disease?

    <p>Upper motor neuron disease</p> Signup and view all the answers

    What does the loss of nociceptive spinal reflexes indicate?

    <p>Lower motor neuron lesion</p> Signup and view all the answers

    Which test is warranted if inflammatory disease is suspected?

    <p>Ophthalmologic examination</p> Signup and view all the answers

    Which condition may produce changes in urinalysis due to its impact on the nervous system?

    <p>Diabetes</p> Signup and view all the answers

    Which examination can be used to identify certain viral diseases?

    <p>Serology</p> Signup and view all the answers

    What is the typical response of the unaffected eye when a lesion affects CN3?

    <p>Constricts without changes in the affected eye</p> Signup and view all the answers

    Which cranial nerve injury is most likely to result in medial strabismus?

    <p>CN6</p> Signup and view all the answers

    What does pupillary asymmetry indicate when assessing ocular integrity?

    <p>Possible damage to sympathetic and CN3</p> Signup and view all the answers

    Which of the following conditions is associated with cerebellar lesions?

    <p>Contralateral postural deficits</p> Signup and view all the answers

    What effect does a lesion in the brainstem usually have on postural reactions?

    <p>Leads to bilateral deficits worse on the same side</p> Signup and view all the answers

    In terms of ocular motility, which cranial nerve primarily controls the elevation of the eye?

    <p>CN3</p> Signup and view all the answers

    How does ataxia typically present when caused by cerebellar lesions?

    <p>Severe ataxia with asymmetrical stance</p> Signup and view all the answers

    Which description accurately characterizes the role of CN3 regarding pupil size?

    <p>Largely unaffected when sympathetic nerve is impaired</p> Signup and view all the answers

    Which condition is characterized by nonprogressive clinical signs such as ataxia and an absent menace response?

    <p>Trigeminal neuritis</p> Signup and view all the answers

    Which statement accurately describes cerebellar abiotrophies?

    <p>Clinical signs manifest between 4 to 10 weeks of age.</p> Signup and view all the answers

    What is a common clinical sign of idiopathic facial paralysis?

    <p>Unilateral facial droop</p> Signup and view all the answers

    In which breed is there an increased incidence of idiopathic facial paralysis?

    <p>Cocker spaniel</p> Signup and view all the answers

    What is a significant characteristic of multiple neuronal abiotrophies?

    <p>Cell loss in specific brain areas</p> Signup and view all the answers

    What is the treatment approach for cerebellar abiotrophies?

    <p>Supportive care is the only available option</p> Signup and view all the answers

    Which sign might indicate a degenerate condition rather than a disease of inflammatory origin?

    <p>Progressive ataxia and tremors</p> Signup and view all the answers

    When diagnosing idiopathic facial paralysis, what must be ruled out?

    <p>Other causes of facial paralysis</p> Signup and view all the answers

    What clinical signs are typically associated with CN8 neoplasia?

    <p>Vestibular signs, Horner syndrome, and cranial neuropathies</p> Signup and view all the answers

    Which diagnostic method is preferred for evaluating suspected CN8 neoplasia?

    <p>Magnetic resonance imaging (MRI)</p> Signup and view all the answers

    What is a common characteristic of congenital sensorineural deafness in dogs?

    <p>Associated with cochlear hair cell degeneration</p> Signup and view all the answers

    What type of tumor is associated with CN8 and can lead to vestibular signs?

    <p>Neurofibromas and meningiomas</p> Signup and view all the answers

    Which statement accurately describes the management of neurological tumors involving CN8?

    <p>Radiation therapy may slow progression when surgery is not viable.</p> Signup and view all the answers

    In cases of seizures in dogs, which information is critical to obtain for accurate diagnosis?

    <p>Details of the seizure episodes, including duration and frequency</p> Signup and view all the answers

    What is a key clinical sign indicating cognitive dysfunction in dogs?

    <p>Altered behavior or orientation alongside motor activity changes</p> Signup and view all the answers

    What primarily causes seizures in dogs younger than one year?

    <p>Developmental or metabolic disorders</p> Signup and view all the answers

    Which of the following breeds is NOT associated with hypertonicity syndrome?

    <p>Miniature Schnauzer</p> Signup and view all the answers

    What is the primary clinical sign of mitochondrial myopathy in affected breeds?

    <p>Exercise intolerance with metabolic acidosis</p> Signup and view all the answers

    Which of the following can be considered a possible diagnostic test for motor unit disorders?

    <p>Electrodiagnostics</p> Signup and view all the answers

    In patients with ischemic disorders, which of the following clinical signs is the least likely?

    <p>Localized regurgitation</p> Signup and view all the answers

    Which biochemical change is most closely associated with mitochondrial myopathy?

    <p>Increased lactate levels</p> Signup and view all the answers

    Which canine breed typically shows clinical signs of congenital myasthenia gravis?

    <p>Cavalier King Charles Spaniel</p> Signup and view all the answers

    Which treatment is most commonly indicated for hypertonicity syndrome in dogs?

    <p>Clonazepam</p> Signup and view all the answers

    What is the most significant aspect of diagnosing neurological conditions according to the clinical signs presented?

    <p>History and physical examination</p> Signup and view all the answers

    What approach should be taken when performing a neurologic examination?

    <p>Start with a general examination before moving to specific tests</p> Signup and view all the answers

    Which of the following best evaluates the conscious proprioception in an animal?

    <p>Hemihopping</p> Signup and view all the answers

    What does a head tilt in an animal typically indicate?

    <p>A vestibular injury</p> Signup and view all the answers

    In the context of neurologic examination, what is the primary significance of assessing the mental status?

    <p>It provides insight into brainstem and cerebral function</p> Signup and view all the answers

    What does a normal hopping response during hemihopping indicate?

    <p>Intact conscious proprioception and sufficient strength</p> Signup and view all the answers

    Which of the following procedures is NOT part of the neurologic examination process?

    <p>Immediate surgical intervention</p> Signup and view all the answers

    What does the menace response test evaluate during a neurologic examination?

    <p>Function of cranial nerves CN2 and CN7</p> Signup and view all the answers

    Which evaluation focuses on the animal's conscious awareness of limb placement?

    <p>Proprioceptive positioning</p> Signup and view all the answers

    What type of imaging provides excellent visualization of brain and spinal cord structures?

    <p>Magnetic resonance imaging (MRI)</p> Signup and view all the answers

    What is a major disadvantage of myelography?

    <p>Does not provide information on the cause</p> Signup and view all the answers

    Which test is useful for assessing motor unit innervation?

    <p>Needle electromyography (EMG)</p> Signup and view all the answers

    In which situation is cerebrospinal fluid (CSF) collection contraindicated?

    <p>Elevated intracranial pressure</p> Signup and view all the answers

    What characterizes the brainstem auditory evoked response tests?

    <p>Evaluates cortical lesions</p> Signup and view all the answers

    What is the primary use of nerve conduction studies?

    <p>To gauge action potential conduction velocity</p> Signup and view all the answers

    What condition can be evaluated by testing cerebrospinal fluid (CSF) for antibodies?

    <p>Infectious agent activity</p> Signup and view all the answers

    Which factor is essential during the administration of a cerebrospinal fluid collection?

    <p>General anesthesia</p> Signup and view all the answers

    Which type of nystagmus is most likely to indicate central vestibular disease?

    <p>Vertical nystagmus</p> Signup and view all the answers

    What does the crossed extensor reflex indicate in cases of upper motor neuron disease?

    <p>Stimulated limb flexes and contralateral limb extends</p> Signup and view all the answers

    Which of the following reflexes assesses cranial nerves CN5 and CN7?

    <p>Palpebral reflex</p> Signup and view all the answers

    What does increased sensitivity to pain typically signify in a neurological assessment?

    <p>Central nervous system lesion</p> Signup and view all the answers

    Which characteristic is associated with nociceptive evaluation?

    <p>Decreased pain perception</p> Signup and view all the answers

    What does positional nystagmus suggest when the head is in an abnormal position?

    <p>Central vestibular lesions</p> Signup and view all the answers

    Which observation typically points to a cerebral lesion when assessing facial symmetry?

    <p>Contralateral facial asymmetry</p> Signup and view all the answers

    What type of nystagmus suggests peripheral vestibular disease but can also occur with central lesions?

    <p>Resting nystagmus</p> Signup and view all the answers

    What is a common clinical feature of necrotizing encephalitis?

    <p>Cavitating lesions</p> Signup and view all the answers

    Which imaging technique is most useful for defining tumors in neurologic disorders?

    <p>CT and MRI</p> Signup and view all the answers

    What might CSF analysis help distinguish when assessing neurological conditions?

    <p>Inflammation from neoplasia</p> Signup and view all the answers

    In which age group is generalized idiopathic tremors most commonly observed?

    <p>Younger than 6 years</p> Signup and view all the answers

    What is expected as a consequence of brain trauma related to increased intracranial pressure?

    <p>Bradycardia</p> Signup and view all the answers

    In diagnosing necrotizing encephalitis, which condition must be excluded?

    <p>GME</p> Signup and view all the answers

    Which condition is characterized by seizures, dementia, and neck pain in toy breeds?

    <p>Necrotizing encephalitis</p> Signup and view all the answers

    What might the prognosis for necrotizing encephalitis generally be?

    <p>Poor</p> Signup and view all the answers

    What is the prognosis for methylxanthine toxicosis if treatment is initiated promptly?

    <p>Fair</p> Signup and view all the answers

    Which of the following clinical signs is NOT commonly associated with methylxanthine toxicosis?

    <p>Hyperactivity</p> Signup and view all the answers

    In cases of organophosphate poisoning, what effect does acetylcholinesterase inhibition have on acetylcholine?

    <p>Causes excessive accumulation</p> Signup and view all the answers

    Which of the following breeds is commonly affected by congenital hydrocephalus?

    <p>Toy Poodle</p> Signup and view all the answers

    What is the recommended treatment within 2 hours after ingestion of methylxanthines?

    <p>Induce vomiting</p> Signup and view all the answers

    Which clinical sign is an indicator of ethylene glycol poisoning?

    <p>Ataxia</p> Signup and view all the answers

    Which statement is accurate regarding the treatment of organophosphate poisoning?

    <p>Anticonvulsants should be administered if necessary</p> Signup and view all the answers

    What type of poisoning is characterized by clinical signs such as salivation, vomiting, and muscle tremors?

    <p>Organophosphate poisoning</p> Signup and view all the answers

    What is the significance of eosinophilic inflammation in the context of encephalitis?

    <p>It suggests an allergic reaction to parasites.</p> Signup and view all the answers

    Which condition would most likely result in increased protein concentration in CSF?

    <p>Acute bacterial encephalitis.</p> Signup and view all the answers

    How does the presence of increased red blood cells (RBCs) in CSF typically present?

    <p>Can be due to contamination during CSF tap.</p> Signup and view all the answers

    What is a common clinical manifestation of forebrain lesions in animals?

    <p>Personality changes or seizures.</p> Signup and view all the answers

    Which of the following would typically NOT be a consequence of focal brain lesions?

    <p>Generalized ataxia.</p> Signup and view all the answers

    What does the presence of opisthotonus imply in neurological assessments?

    <p>Potential involvement of vestibular signs.</p> Signup and view all the answers

    In cases of systemic metabolic alterations, which symptom is least likely to be observed?

    <p>Localized pain response.</p> Signup and view all the answers

    How might mental status be affected in cases of diffuse neurological disorders?

    <p>May present with stupor or coma.</p> Signup and view all the answers

    What is the expected outcome in pupil constriction when a lesion affects cranial nerve 2 (CN2)?

    <p>Loss of constriction in both pupils when the affected eye is illuminated</p> Signup and view all the answers

    Which of the following scenarios would indicate an abnormal pupillary light reflex (PLR) associated with cranial nerve 3 (CN3)?

    <p>Large pupil with absent PLR</p> Signup and view all the answers

    How does a lesion affecting the cerebellum typically present in terms of gait?

    <p>Increased wobbliness and loss of coordination</p> Signup and view all the answers

    In the context of pupillary response, what does a smaller pupil indicate?

    <p>Damage to the sympathetic nerve with normal PLR</p> Signup and view all the answers

    Which type of cranial nerve lesion commonly results in ventrolateral strabismus?

    <p>Injury to either CN3 or CN8</p> Signup and view all the answers

    What clinical finding confirms the presence of ataxia due to a cerebral lesion?

    <p>Postural deficit on the opposite side of the body</p> Signup and view all the answers

    What does a bilateral postural deficit indicate about the location of a brain lesion?

    <p>A brainstem lesion with deficits worse on the ipsilateral side</p> Signup and view all the answers

    Which cranial nerves are essential for voluntary eye movement?

    <p>CN3, CN4, and CN6</p> Signup and view all the answers

    What is the preferred imaging technique when evaluating bony lesions after a fracture?

    <p>CT scan</p> Signup and view all the answers

    Which type of lesions tend to have a poorer prognosis in spinal cord conditions?

    <p>Intramedullary lesions</p> Signup and view all the answers

    In spinal cord trauma, what treatment is recommended immediately after injury?

    <p>Large doses of glucocorticosteroids</p> Signup and view all the answers

    What is the prognosis for infections related to the neurological system when the cause is unknown?

    <p>Guarded prognosis unless the cause is identified</p> Signup and view all the answers

    Which condition is characterized by inflammation of peripheral nerves and is commonly seen in hunting dogs?

    <p>Acute polyradiculoneuritis</p> Signup and view all the answers

    Which inflammatory condition has a good prognosis when treated appropriately?

    <p>Immune-mediated meningitis</p> Signup and view all the answers

    What factor primarily influences the prognosis of vascular disorders in the nervous system?

    <p>Severity of the neurologic deficits</p> Signup and view all the answers

    What is primarily associated with nemaline rod myopathy in affected animals?

    <p>Progressive muscle atrophy</p> Signup and view all the answers

    Which breed is specifically mentioned as being affected by familial canine dermatomyositis?

    <p>Collies</p> Signup and view all the answers

    Which of the following is NOT a known metabolic disorder related to muscle disease?

    <p>Myotonia congenital</p> Signup and view all the answers

    What is a common clinical manifestation of generalized inflammatory myopathy?

    <p>Episodes of body tremors and collapse</p> Signup and view all the answers

    Which of the following is likely to be a contributing factor in glycolysis-related muscle disorders?

    <p>Deficient glycogen storage</p> Signup and view all the answers

    Which condition is associated with malignancies and may result in inflammatory muscle disease?

    <p>Familial canine dermatomyositis</p> Signup and view all the answers

    In which context are nemaline rods present within myofibers observed?

    <p>Nemaline rod myopathy</p> Signup and view all the answers

    What is a recognized cause of body tremors and muscle weakness in certain dogs?

    <p>Excitement-induced stress</p> Signup and view all the answers

    What type of injury typically results in weakness in limbs at the level of the injury?

    <p>Lower Motor Neuron (LMN) injury</p> Signup and view all the answers

    Which type of sensory loss is associated with injury to ascending nociceptive tracts in the spinal cord?

    <p>Loss of deep pain sensation</p> Signup and view all the answers

    What is the primary goal of surgical treatment in spinal cord injury cases?

    <p>To stabilize the vertebral column and decompress the spinal cord</p> Signup and view all the answers

    What is indicated by the absence of deep pain sensation in a patient?

    <p>Severe spinal cord injury</p> Signup and view all the answers

    Which of the following describes the progression of clinical signs as spinal cord lesions worsen?

    <p>CP loss occurs first, followed by UP, UMN, and nociceptive loss</p> Signup and view all the answers

    Which class of antibiotics is commonly associated with treating discspondylitis caused by Staphylococcus?

    <p>Penicillins</p> Signup and view all the answers

    How does UMN injury affect muscle tone when an animal is recumbent?

    <p>Increased extensor muscle tone</p> Signup and view all the answers

    What is the role of immunosuppressive agents in treating immune-mediated disorders?

    <p>To decrease the body's immune response</p> Signup and view all the answers

    What is one of the primary clinical signs of neuropathy?

    <p>Muscle atrophy</p> Signup and view all the answers

    Which condition is NOT included in the differential diagnosis for polyneuropathy?

    <p>Sepsis</p> Signup and view all the answers

    Which diagnostic method is used to record activity in skeletal muscle?

    <p>Needle Electromyography (EMG)</p> Signup and view all the answers

    What is a common cause of weakness in animals with neuropathy?

    <p>Traumatic injury</p> Signup and view all the answers

    What treatment approach is necessary to maintain nutrition in animals with neuropathy?

    <p>Balanced nutritional support</p> Signup and view all the answers

    What does an elevation in aspartate aminotransferase indicate regarding muscle disorders?

    <p>It is a sign of muscle damage</p> Signup and view all the answers

    What is the primary disadvantage of myelography?

    <p>It provides no information regarding cause</p> Signup and view all the answers

    What underlying condition is associated with self-mutilation in animals with neuropathy?

    <p>Severe pain and discomfort</p> Signup and view all the answers

    Which statement is true regarding the prognosis of nerve injuries?

    <p>Prognosis is worse for injuries distant from the muscle</p> Signup and view all the answers

    When is cerebrospinal fluid (CSF) analysis contraindicated?

    <p>When intracranial pressure is elevated</p> Signup and view all the answers

    What type of imaging is particularly effective for evaluating bony structures?

    <p>Computed tomography (CT)</p> Signup and view all the answers

    Which statement is true regarding the electrodiagnostic examination of the motor unit?

    <p>Needle electromyography provides insight into muscle membrane ion conductance</p> Signup and view all the answers

    What does the brainstem auditory evoked response test assess?

    <p>Hearing pathways</p> Signup and view all the answers

    What is usually required during the electroencephalography (EEG) procedure to minimize movement?

    <p>Sedation</p> Signup and view all the answers

    What condition is indicated by the presence of antibodies in cerebrospinal fluid (CSF)?

    <p>Autoimmune disease</p> Signup and view all the answers

    Which imaging technique provides valuable information for identifying extradural or intradural lesions causing spinal cord compression?

    <p>Myelography</p> Signup and view all the answers

    What is the consequence of ingesting 1 ounce of baker’s chocolate per kilogram of body weight?

    <p>It may be lethal in some cases.</p> Signup and view all the answers

    Which clinical sign is NOT typically associated with methylxanthine toxicosis?

    <p>Skin rash</p> Signup and view all the answers

    What is an essential treatment step for methyxanthine toxicosis if less than 2 hours have passed since ingestion?

    <p>Induce vomiting and provide activated charcoal.</p> Signup and view all the answers

    Which breed is NOT commonly affected by congenital hydrocephalus?

    <p>Rottweiler</p> Signup and view all the answers

    What is the prognosis for an animal treated early for ethylene glycol poisoning?

    <p>Fair</p> Signup and view all the answers

    Which is a clinical sign of organophosphate and carbamate poisoning?

    <p>Miosis</p> Signup and view all the answers

    What indicates a congenital disorder characterized by accumulation of CSF within the brain?

    <p>Hydrocephalus</p> Signup and view all the answers

    Which of the following clinical signs is most likely to be associated with a puppy infected with organophosphate poisoning?

    <p>Muscle tremors</p> Signup and view all the answers

    Which breed is predisposed to canine dystrophin-deficient muscular dystrophy?

    <p>German shepherd dog</p> Signup and view all the answers

    What is a clinical sign associated with glycogen storage disease in Norwegian Forest cats?

    <p>Severe muscle atrophy</p> Signup and view all the answers

    Which of the following conditions is characterized by a deficiency of $\beta$-galactocerebrosidase?

    <p>Globoid cell leukodystrophy</p> Signup and view all the answers

    What clinical sign is most pronounced in pelvic limbs due to diabetes mellitus?

    <p>Marked weakness</p> Signup and view all the answers

    Which disorder is described as a lethal condition in young male cats?

    <p>Feline dystrophin-deficient muscular dystrophy</p> Signup and view all the answers

    Which metabolic disorder can be linked to muscle weakness in dogs?

    <p>Diabetes mellitus</p> Signup and view all the answers

    What is the common diagnostic finding in conditions such as canine dystrophin-deficient muscular dystrophy?

    <p>Elevated serum creatine kinase levels</p> Signup and view all the answers

    Which of the following breeds is NOT typically associated with inherited peripheral nerve diseases?

    <p>Yorkshire terrier</p> Signup and view all the answers

    Which treatment is indicated for spinal cord trauma to enhance recovery?

    <p>High doses of glucocorticosteroids administered immediately</p> Signup and view all the answers

    What is the prognosis for patients with granulomatous encephalitis?

    <p>Guarded to poor prognosis regardless of treatment</p> Signup and view all the answers

    Which of the following infections has a guarded prognosis unless a specific cause is identified?

    <p>Meningitis</p> Signup and view all the answers

    What is the preferred imaging technique for evaluating bony lesions?

    <p>Computed Tomography (CT)</p> Signup and view all the answers

    Which type of lesions is associated with a better prognosis?

    <p>Extramedullary compressive lesions</p> Signup and view all the answers

    What dosage of glucocorticosteroids is recommended for degenerative disorders causing spinal cord compression?

    <p>High anti-inflammatory doses</p> Signup and view all the answers

    Which statement is true regarding the management of immune-mediated meningitis?

    <p>It usually has a good prognosis if treated appropriately</p> Signup and view all the answers

    The prognosis for vascular disorders primarily depends on what factor?

    <p>The severity of neurologic deficits</p> Signup and view all the answers

    What does an exaggerated response in the patellar reflex typically suggest?

    <p>Upper motor neuron lesion</p> Signup and view all the answers

    Which reflex assesses the integrity of the spinal cord segments C6 to T2?

    <p>Thoracic limb flexor reflex</p> Signup and view all the answers

    What does a positive Babinski reflex indicate?

    <p>Upper motor neuron disease</p> Signup and view all the answers

    What is a notable clinical sign of metronidazole toxicity in dogs and cats?

    <p>Opisthotonus</p> Signup and view all the answers

    Which test is used to identify changes in urine due to metabolic diseases impacting the nervous system?

    <p>Urinalysis</p> Signup and view all the answers

    The loss of nociceptive spinal reflexes suggests which type of lesion?

    <p>Lower motor neuron lesion</p> Signup and view all the answers

    Which method is used to diagnose cystic accumulation of CSF in the subarachnoid space?

    <p>MRI or CT</p> Signup and view all the answers

    What is the primary purpose of the cranial tibialis reflex test?

    <p>To assess the peroneal branch of the sciatic nerve</p> Signup and view all the answers

    Which of the following is NOT a clinical sign of cerebellar hypoplasia in cats?

    <p>Hyperactivity</p> Signup and view all the answers

    What is the typical treatment method for cystic formations causing compression of neural tissue?

    <p>Surgical fenestration of the cyst wall</p> Signup and view all the answers

    Which condition is most likely to produce neurologic signs related to uremia?

    <p>Renal failure</p> Signup and view all the answers

    In cats with cerebellar hypoplasia, what clinical signs are observed at the onset of walking?

    <p>Severe ataxia and intention tremors</p> Signup and view all the answers

    What diagnostic approach is warranted in cases of suspected inflammatory or neoplastic disease?

    <p>Thoracic radiographs and abdominal ultrasound</p> Signup and view all the answers

    Which neurotransmitters are observed at decreased levels in the frontal cortex of older dogs experiencing cognitive loss?

    <p>Norepinephrine and dopamine</p> Signup and view all the answers

    What is the primary cause of cerebellar hypoplasia in cats?

    <p>Panleukopenia infection during gestation</p> Signup and view all the answers

    What characterizes the clinical signs of decreased social interaction in older dogs?

    <p>Loss of house training</p> Signup and view all the answers

    What is the purpose of myelography in the evaluation of spinal cord conditions?

    <p>To detect intradural lesions causing spinal cord compression</p> Signup and view all the answers

    What does a cerebrospinal fluid (CSF) analysis typically indicate when inflammation is suspected?

    <p>CSF analysis can provide valuable information for inflammatory conditions</p> Signup and view all the answers

    Which imaging modality provides the best visualization of bony structures in the diagnosis of spine disorders?

    <p>Computed tomography (CT)</p> Signup and view all the answers

    What is a significant disadvantage of electroencephalography (EEG) in diagnosing brain lesions?

    <p>It is unable to determine the exact location of lesions</p> Signup and view all the answers

    What does needle electromyography (EMG) assess in neurological evaluations?

    <p>The innervation of motor units and muscle response</p> Signup and view all the answers

    In which condition is cerebrospinal fluid (CSF) collection contraindicated?

    <p>Elevated intracranial pressure</p> Signup and view all the answers

    What information is NOT typically provided by a myelogram?

    <p>The exact cause of spinal cord compression</p> Signup and view all the answers

    Which test is appropriate for measuring action potential conduction velocity in a motor nerve?

    <p>Nerve conduction studies</p> Signup and view all the answers

    What is a key factor that influences the decision to proceed with surgery for spinal lesions?

    <p>The likelihood that surgery will be beneficial</p> Signup and view all the answers

    Which diagnostic procedure is useful for evaluating spinal cord imaging but is known for requiring longer anesthesia times?

    <p>Myelography</p> Signup and view all the answers

    What nursing care practice is NOT typically considered beneficial for patients with spinal cord conditions?

    <p>Administration of anti-inflammatory drugs</p> Signup and view all the answers

    What does the minimum database for assessing overall health in patients with spinal lesions include?

    <p>CBC, biochemistry profile, and urinalysis</p> Signup and view all the answers

    Which type of lesions typically leads to clinical signs that are not symmetrical?

    <p>Extramedullary lesions</p> Signup and view all the answers

    Which imaging technique provides the best information for evaluating spinal cord compression?

    <p>Magnetic resonance imaging (MRI)</p> Signup and view all the answers

    In assessing prognosis based on clinical signs, which statement is accurate?

    <p>More severe clinical signs correlate with a poorer prognosis</p> Signup and view all the answers

    Which factor negatively affects the prognosis of a spinal cord injury?

    <p>Severity of the clinical signs</p> Signup and view all the answers

    What indicates that a patient may have epilepsy based on seizure history?

    <p>Two or more seizures within 6 months or cluster seizures within 12 months</p> Signup and view all the answers

    Which drug is noted for causing hepatotoxicity and has a rapid elimination rate?

    <p>Phenytoin</p> Signup and view all the answers

    When should emergency therapy for seizures be administered?

    <p>If there are more than three seizures per hour</p> Signup and view all the answers

    What is the recommended method for monitoring serum phenobarbital levels during treatment?

    <p>After reaching a steady state, then periodically at specified intervals</p> Signup and view all the answers

    Which new antiepileptic drug is specifically noted for use in dogs with hepatic disease?

    <p>Gabapentin</p> Signup and view all the answers

    What should be done if a patient is experiencing status epilepticus?

    <p>Use diazepam to stop seizure activity first</p> Signup and view all the answers

    What characterizes the absorption timing of phenobarbital post-oral administration?

    <p>Maximal absorption happens within 4 to 8 hours</p> Signup and view all the answers

    What is a common characteristic of diazepam when used for seizures?

    <p>Tolerance develops quickly with prolonged use</p> Signup and view all the answers

    What is the primary differential diagnosis when considering a case of suspected ivermectin toxicity?

    <p>Hepatic encephalopathy</p> Signup and view all the answers

    What is a common cause of feline ischemic encephalopathy?

    <p>Cerebral infarction of the middle cerebral artery</p> Signup and view all the answers

    Which of the following best describes the clinical signs of lissencephaly?

    <p>Behavior changes, dementia, and seizures</p> Signup and view all the answers

    Which clinical signs are associated with thiamine deficiency in cats?

    <p>Seizures and sudden death</p> Signup and view all the answers

    What treatment is indicated for a patient exhibiting seizures due to ivermectin toxicity?

    <p>Anticonvulsants if necessary</p> Signup and view all the answers

    Which action is recommended if a patient ingests a toxic substance within 2 hours and exhibits no clinical signs?

    <p>Induce vomiting immediately</p> Signup and view all the answers

    Which breed is most commonly affected by necrotizing vasculitis?

    <p>Beagle</p> Signup and view all the answers

    What is the prognosis for a patient with ivermectin toxicity if treated early?

    <p>Good with no expected complications</p> Signup and view all the answers

    What is the recommended treatment for thiamine deficiency in cats?

    <p>Parenteral thiamine and B vitamin supplements</p> Signup and view all the answers

    Which of the following describes a clinical sign of feline ischemic encephalopathy?

    <p>Cerebral edema</p> Signup and view all the answers

    In the case of lissencephaly, when do clinical signs typically present?

    <p>Immediately after birth or within the first year of life</p> Signup and view all the answers

    Which of the following breeds are specifically mentioned as having a defect allowing ivermectin to enter the CNS?

    <p>Collie and Shetland Sheepdog</p> Signup and view all the answers

    What is a likely outcome if treatment for thiamine deficiency is initiated early?

    <p>Good prognosis</p> Signup and view all the answers

    What type of condition is lead poisoning categorized under?

    <p>Neurotoxic condition</p> Signup and view all the answers

    What is a key component of supportive treatment for a patient with elevated intracranial pressure?

    <p>Administration of mannitol</p> Signup and view all the answers

    Which of the following is true regarding the clinical signs of necrotizing vasculitis?

    <p>Commonly exhibits fever and neck stiffness</p> Signup and view all the answers

    What is the primary cause of globoid cell leukodystrophy?

    <p>Deficiency of $\beta$-galactocerebrosidase</p> Signup and view all the answers

    Which breed is NOT commonly associated with canine dystrophin-deficient muscular dystrophy?

    <p>Alaskan malamute</p> Signup and view all the answers

    What is a typical clinical sign of glycogen storage disease in Norwegian Forest cats?

    <p>Muscle atrophy</p> Signup and view all the answers

    Which condition in cats is classified as a lethal disorder affecting young males?

    <p>Feline dystrophin-deficient muscular dystrophy</p> Signup and view all the answers

    What effect does diabetes mellitus have on muscle strength?

    <p>Limb weakness, primarily in pelvic limbs</p> Signup and view all the answers

    Which storage disease is associated with peripheral nerve issues in felines?

    <p>Niemann-Pick disease</p> Signup and view all the answers

    What is a common symptom of hypothyroidism related to neuromuscular function?

    <p>Limb weakness</p> Signup and view all the answers

    Which breed is predisposed to conditions resulting from deficiency in a glycogen branching enzyme?

    <p>Norwegian Forest cats</p> Signup and view all the answers

    What typically characterizes the clinical signs of cerebellar abiotrophies?

    <p>Intention tremor and progressive ataxia</p> Signup and view all the answers

    What is the most important feature of idiopathic facial paralysis?

    <p>Diagnosis is based on ruling out other causes of facial paralysis</p> Signup and view all the answers

    What indicates a poor prognosis in cases of cerebellar disorders?

    <p>No current treatment available for affected dogs</p> Signup and view all the answers

    What is a common misconception regarding the onset of clinical signs in multiple neuronal abiotrophies?

    <p>Clinical signs begin at birth and worsen with age</p> Signup and view all the answers

    Which breed has an increased incidence of idiopathic facial paralysis?

    <p>Cocker Spaniel</p> Signup and view all the answers

    In cases of trigeminal neuritis, what is a notable clinical sign that affects affected dogs?

    <p>Inability to chew and inability to close the mouth</p> Signup and view all the answers

    What is a key characteristic of the prognosis for dogs with cerebellar disorders?

    <p>The prognosis is generally poor with no effective treatments</p> Signup and view all the answers

    Which primary characteristic defines multiple neuronal abiotrophies?

    <p>Cell loss or chromatolytic changes in multiple brain areas</p> Signup and view all the answers

    What is a critical time frame that indicates a predisposition for epilepsy in a patient?

    <p>More than one cluster seizure within 12 months</p> Signup and view all the answers

    What is an important pharmacokinetic characteristic of phenobarbital after oral administration?

    <p>Maximal absorption occurs within 4 to 8 hours</p> Signup and view all the answers

    Which statement regarding diazepam is true in the context of its use for seizure management?

    <p>It can lead to withdrawal seizures when discontinued</p> Signup and view all the answers

    What constitutes the criteria for administering emergency therapy for seizures?

    <p>More than three seizures in a single day</p> Signup and view all the answers

    When should serum monitoring of phenobarbital concentrations begin after initiating treatment?

    <p>Two weeks, followed by intermittent assessments</p> Signup and view all the answers

    Which factor may decrease phenobarbital's elimination half-life in a dog?

    <p>Induction of the hepatic P450 system</p> Signup and view all the answers

    What indicates a situation that requires immediate emergency treatment for seizures?

    <p>Single seizure lasting more than 5 minutes</p> Signup and view all the answers

    What is true regarding the use of gabapentin in veterinary medicine?

    <p>Indicated in dogs with hepatic disease and in cats</p> Signup and view all the answers

    What is the primary differential diagnosis when considering a case of ivermectin toxicity?

    <p>Hepatic encephalopathy</p> Signup and view all the answers

    In cases of ivermectin toxicity, which breed-related defect allows the drug to enter the central nervous system?

    <p>P-glycoprotein pump defect</p> Signup and view all the answers

    What clinical sign is typically NOT associated with ivermectin toxicity?

    <p>Vocalization changes</p> Signup and view all the answers

    What is the recommended supportive treatment in cases of ivermectin toxicity?

    <p>Providing IV fluids and nutritional support</p> Signup and view all the answers

    Which clinical sign is most indicative of lissencephaly in affected breeds?

    <p>Seizures</p> Signup and view all the answers

    What is the key component in the initial diagnostic approach for identifying congenital arachnoid cysts?

    <p>Imaging studies like MRI or CT scan</p> Signup and view all the answers

    Which treatment approach is NOT recommended for managing lissencephaly?

    <p>Surgical intervention to correct brain structure</p> Signup and view all the answers

    What is a notable clinical strategy for treating seizures in a patient experiencing ivermectin toxicity?

    <p>Administration of anticonvulsants</p> Signup and view all the answers

    Which imaging method provides excellent imagery of the brain and spinal cord?

    <p>Magnetic resonance imaging (MRI)</p> Signup and view all the answers

    What is a significant disadvantage of myelography?

    <p>No information is gathered regarding cause.</p> Signup and view all the answers

    When is cerebrospinal fluid (CSF) analysis contraindicated?

    <p>If intracranial pressure is elevated.</p> Signup and view all the answers

    Which test is used to measure the action potential conduction velocity in a motor nerve?

    <p>Nerve conduction studies</p> Signup and view all the answers

    Which of the following statements about electroencephalography (EEG) is true?

    <p>EEG is useful with corticocerebral lesions.</p> Signup and view all the answers

    What is the purpose of a Tension or edrophonium chloride test?

    <p>To transiently alleviate symptoms in neuromuscular junction diseases.</p> Signup and view all the answers

    What is a primary use of needle electromyography (EMG)?

    <p>To gather information about motor unit innervation.</p> Signup and view all the answers

    What type of lesions can myelography effectively visualize?

    <p>Extradural or intradural lesions causing spinal cord compression</p> Signup and view all the answers

    What does a yellow-orange color in CSF analysis indicate?

    <p>Breakdown of hemoglobin</p> Signup and view all the answers

    Which of the following is a typical characteristic of suppurative meningitis in CSF analysis?

    <p>Increase in neutrophils</p> Signup and view all the answers

    Which clinical sign is associated with cerebellar lesions?

    <p>Incoordination during voluntary movements</p> Signup and view all the answers

    What type of inflammation does an increase in a mixed population of cells in CSF suggest?

    <p>Nonsuppurative inflammation</p> Signup and view all the answers

    Which clinical sign is commonly associated with brainstem lesions?

    <p>Altered cranial nerve function</p> Signup and view all the answers

    What does a turbid appearance of CSF usually suggest?

    <p>Infection or inflammation</p> Signup and view all the answers

    What is a common outcome of severe brainstem lesions?

    <p>Respiratory regulation effects</p> Signup and view all the answers

    An increase in CSF protein indicates which of the following?

    <p>Possible inflammatory response</p> Signup and view all the answers

    Which clinical sign is NOT typically associated with CN8 neoplasia?

    <p>Unilateral deafness</p> Signup and view all the answers

    What is the primary diagnostic method for suspected cases of CN8 neoplasia?

    <p>MRI</p> Signup and view all the answers

    Which of the following correctly describes the typical progression of a neurodegenerative disorder of the forebrain?

    <p>Gradual onset and progression</p> Signup and view all the answers

    In cases of congenital sensorineural deafness in dogs, what is the underlying cause?

    <p>Degeneration of cochlear hair cells</p> Signup and view all the answers

    What type of tumors are most likely to affect CN8?

    <p>Neurofibromas and meningiomas</p> Signup and view all the answers

    Which statement is true regarding the treatment options for tumors affecting CN8?

    <p>Radiation therapy is indicated to slow progression</p> Signup and view all the answers

    Which of the following is NOT a behavioral change associated with cognitive dysfunction disorders?

    <p>Increased activity levels</p> Signup and view all the answers

    What is a common source of information necessary for diagnosing seizures in dogs?

    <p>Vaccination status and medical history</p> Signup and view all the answers

    What is a reason that bromide therapy is not recommended in cats?

    <p>High prevalence of respiratory problems</p> Signup and view all the answers

    What clinical sign is associated with immune-mediated disorders in young dogs?

    <p>Neck stiffness and hyperesthesia</p> Signup and view all the answers

    What does the presence of tumors such as astrocytoma indicate?

    <p>Neoplastic causes of central nervous system issues</p> Signup and view all the answers

    Which protozoal infection is known to affect dogs and is mentioned in relation to neurological disorders?

    <p>Neospora caninum</p> Signup and view all the answers

    What is a key indicator for monitoring bromide therapy effectiveness in dogs?

    <p>Bromide levels at specific intervals</p> Signup and view all the answers

    Which condition is linked to rickettsial causes in dogs?

    <p>Ehrlichiosis and Rocky Mountain spotted fever</p> Signup and view all the answers

    In which situation can bromide be used independently of phenobarbital?

    <p>If seizures have been absent for more than a year and quality of life is questionable</p> Signup and view all the answers

    What characterizes hyperpathia, which can occur due to spinal cord issues?

    <p>Exaggerated response to a painful stimulus</p> Signup and view all the answers

    Study Notes

    Cranial Nerves

    • Cranial Nerve (CN) 2 lesions cause loss of pupillary constriction in both pupils when the affected eye is illuminated.
    • CN3 lesions cause loss of pupillary constriction in the affected eye only, while the unaffected eye still constricts.
    • Pupillary symmetry evaluates both CN3 and the sympathetic nerve to the eye.
    • CN3 damage results in a larger pupil with no pupillary light reflex (PLR).
    • Sympathetic nerve damage results in a smaller pupil but normal PLR in both eyes.
    • Pupillary size reflects both CN3 and sympathetic nerve integrity.
    • Large pupils can be due to CN3 paralysis, while small pupils can result from loss of sympathetic tone.
    • Ocular position is influenced by CN3, CN4, CN6, and CN8
    • CN6 injury leads to medial strabismus.
    • CN3 or CN8 injury causes ventrolateral strabismus.
    • Voluntary eye movement involves cerebral, CN3, CN4, and CN6 activity.
    • A cerebral lesion affects voluntary eye movement.
    • A normal blink reflex tests CN5 and CN7.
    • A normal retractor oculi reflex tests CN5 and CN6.
    • Facial sensory examination tests CN5, stimulating the nasal mucosa should elicit an avoidance response.
    • The gag reflex tests CN9, CN10, and the brainstem.
    • A lack of swallowing reflex suggests either a brainstem or CN injury.
    • Tongue atrophy indicates either a brainstem or CN12 lesion.
    • Tongue deviation can be caused by cerebral injuries.

    Lesion Location

    • Limbs signs only suggest a lesion below the foramen magnum.
    • CN deficits, seizures, altered consciousness, or abnormal head posture indicate a lesion above the foramen magnum.

    General Diagnostics

    • Hematology usually shows minimal changes.
    • Biochemical tests may reveal alterations in blood glucose, calcium, potassium, and sodium, which can affect nervous system function.
    • Cerebrospinal fluid (CSF) analysis can be used to determine the cause of neurological signs.
    • Increase in CSF protein suggests encephalitis, meningitis, neoplasia, chronic neurodegenerative conditions, or trauma.
    • Increased white blood cells (WBCs) in CSF can result from inflammatory disorders.
    • Increased Red blood cells (RBCs) can be due to contamination during CSF tap or hemorrhage.

    Forebrain Lesions

    • Seizures, personality changes, and dementia can occur with both diffuse and focal disorders.
    • Diffuse disorders can cause generalized ataxia, bilateral miosis, and conscious proprioceptive deficits.
    • Focal lesions can cause circling, contralateral conscious proprioceptive deficits, and contralateral facial sensory deficits and weakness.
    • Diencephalic lesions can lead to lethargy, altered mentation, or circling.
    • Head and neck pain can result from structural lesions.

    Vestibular Disease

    • Canine idiopathic vestibular disease can affect older dogs and young adult cats.
    • Clinical signs include head tilt, circling, falling, nystagmus, and anorexia.
    • There is no specific treatment for canine idiopathic vestibular disease.
    • Hypothyroidism can cause vestibular signs, CN7 and CN10 dysfunction.
    • Hypothyroidism treatment involves thyroid supplementation.

    Neoplasia

    • CN5 neoplasms (neurofibromas or schwannomas) are common in middle-aged to older dogs.
    • Seizures in dogs between 1 to 5 years of age are usually idiopathic, but may have a congenital origin.
    • Seizures in dogs older than 5 years are often due to structural disorders (brain tumors) or metabolic diseases.
    • Idiopathic epilepsy is more likely if seizures are infrequent (greater than 4 weeks between episodes).
    • Idiopathic epilepsy is more likely in large breed dogs, with onset between 1 and 5 years of age.
    • Secondary epilepsy is more likely if seizures are frequent (less than 4 weeks between episodes).
    • Secondary epilepsy is more likely if the first seizure is focal, if it occurs before 1 year or after 7 years of age, or if there are other neurological abnormalities.

    Neurological Examination

    • Pupillary size and symmetry should be evaluated, as this can indicate cranial nerve damage
    • CN2 lesions cause loss of constriction in both pupils when the affected eye is examined.
    • CN3 lesions cause loss of constriction in the affected eye, with constriction in the unaffected eye
    • CN3 and sympathetic nerve integrity are reflected in pupillary size. Large pupils could be due to CN3 paralysis, whereas small pupils can be due to a loss of sympathetic tone.
    • CN3, CN4, CN6 and CN8 play a role in determining the ocular position
    • CN6 injury causes medial strabismus
    • CN3 or CN8 injury causes ventrolateral strabismus
    • CN8 can be affected by neurofibromas or meningiomas, leading to vestibular signs, horner syndrome, and other cranial neuropathies.

    Gait and Stance

    • A normal gait requires integration of the entire nervous system
    • Ataxia is rarely caused by cerebral of peripheral nerve lesions
    • Cerebellar lesions typically cause ataxia
    • Cerebral lesions may produce mild weakness
    • More pronounced weakness is caused by injury to the brainstem, spinal cord, or peripheral spinal nerves
    • Abnormal stance may be caused by decreased proprioception, weakness or pain

    Postural Reactions

    • Cerebral lesions: Postural deficit is on the opposite side of the body (contralateral)
    • Brainstem lesions: Postural deficits are bilateral, but worse on the same side as the lesion (ipsilateral)
    • Extensor carpi radialis reflex also evaluates C7 to T2; normally the carpus extends
    • Biceps reflex evaluates the musculocutaneous nerve (from C6 to C7)
    • Patellar reflex tests femoral nerve and L4 to L6; an exaggerated response suggests an upper motor neuron (UMN) lesion
    • Cranial tibialis reflex tests the peroneal branch of the sciatic nerve from L6 to S2
    • Nociceptive spinal reflexes are initiated by a painful stimulus. Loss of the reflex suggests lower motor neuron (LMN) lesion
    • Thoracic limb flexor reflex tests spinal cord segments C6 to T2
    • Pelvic limb flexor reflex tests segments L6 to S2
    • Perineal reflex tests S1 to S3
    • Babinski reflex: Stroking the plantar aspect of the metatarsus in the hind limbs should cause slight flexion of the toes, or no response. A positive Babinski reflex signifies UMN disease, and the toes spread apart and elevate.

    Degenerative Brain Disease

    • Cerebellar abiotrophies
      • The cerebellum develops normally, but is followed by premature degeneration and cell death. It is autosomal recessive in some breeds.
      • Clinical signs include intention tremor and progressive ataxia. Dogs are normal at birth, but clinical signs start between 4 and 10 weeks of age.
      • Rule out other causes of progressive cerebellar disease
      • There is no treatment, and the prognosis is poor.
    • Multiple neuronal abiotrophies
      • Cell loss or chromatolytic changes in multiple areas of the brain. Breeds affected include the Jack Russel Terrier, the pug, and the border collie.
      • Clinical signs resemble those of cerebellar abiotrophies, but signs appear later in life than with cerebellar abiotrophies - usually after 6-10 months of age.
      • There is no treatment.
    • Cerebral Cortical Degeneration (CCD)
      • Neurodegenerative disorder of the forebrain with gradual onset and progression of behavioral and/or motor activity, followed by changes in behavior and/or orientation.
      • Affects older dogs primarily, but can occur in young animals (< 1 year)
      • Typically occurs in dogs over 10 (but can occur in dogs 6 years old and older)
      • There is no treatment available
    • Cognitive Dysfunction
      • Neurodegenerative disorder of the forebrain with gradual onset and progression of behavioral and/or motor activity, followed by changes in behavior and/or orientation.
      • Affects older dogs primarily, but can occur in young animals (< 1 year)
      • Typically occurs in dogs over 10 (but can occur in dogs 6 years old and older)
      • There is no treatment available

    Cranial Nerve Disorders

    • Trigeminal Neuritis

      • Etiology is unknown. Affects middle-aged dogs.
      • Clinical signs include inability to close the mouth and difficulty chewing food.
      • Diagnosis is based on history of acute mandibular paralysis.
      • Treatment is supportive, corticosteroid therapy is not beneficial.

    • Idiopathic Facial Paralysis or Palsy

      • Causes are unknown.
      • Clinical signs include a unilateral facial droop, decreased tear production, and inability to blink. Food, water, and saliva fall out of the mouth.
      • Cocker spaniels have an increased incidence.
      • Diagnosis is by ruling out other causes of facial paralysis.
      • There is no treatment.

    Seizures

    • These are a clinical sign of disease affecting the brain.
    • Diagnosis
      • Obtain a thorough history, including vaccination status, pedigree, travel history, medications given, and previous medical and surgical problems.
      • Obtain as much information as possible about seizure episodes, including duration, time between seizures, type of seizures (e.g., generalized tonic-clonic, absence, focal) and behaviors surrounding the seizure.
      • Evaluate current behaviors and document changes.
    • Dogs
      • Seizures in dogs younger than 1 year are usually secondary to developmental, metabolic, or infectious disorders.
      • In dogs older than 1 year, seizures are more often caused by structural lesions.
    • Common causes of seizures in dogs (including but not limited to)
      • Developmental/Metabolic
        • Hypoglycemia: Low blood sugar
        • Hypocalcemia: Low blood calcium
        • Hypomagnesemia:: Low blood magnesium
        • Portosystemic shunt: Abnormal connection between the portal vein and systemic circulation, causing liver dysfunction
        • Meningitis: Inflammation of the meninges
        • Encephalitis: Inflammation of the brain
        • Toxicity: Ingestion of toxins such as lead, pesticides, or medications
        • Infectious diseases: Including distemper, rabies, and canine herpesvirus
    • Structural
      • Brain tumors: Can cause seizures particularly in older dogs
      • Trauma: Head injuries
      • Stroke: Impaired blood flow to the brain
      • Idiopathic: Unknown cause
    • Treatment
      • Treatment for seizures will vary depending on the underlying cause and severity of the seizures. This may include medications to control seizures, supportive care, or surgical intervention, if needed.

    Motor Unit Disorders

    • Most common clinical sign is muscle weakness
    • Other clinical signs include gait abnormalities, paralysis or paresis, and localized signs such as regurgitation, dysphagia, dysphonia, and dyspnea.
    • Diagnosis:
      • History and physical examination are most important. Proprioception and pain are usually intact in motor unit disorders.
      • Perform routine laboratory tests to identify underlying disorders. Other tests such as lactate, thyroid hormone concentrations, adrenal function tests, ANA titer, and serologic tests may be indicated.
      • Specialized tests such as edrophonium chloride challenge test, electrodiagnostics, muscle biopsy, and carnitine quantification may be helpful.
      • Radiography should be performed to rule out underlying disorders such as megaesophagus, neoplasia, or other conditions.
    • Different types of motor unit disorders in dogs (including but not limited to)
      • Myasthenia gravis
        • Causes
          • An autoimmune disorder in which the body's immune system attacks the acetylcholine receptors at the neuromuscular junction, leading to muscle weakness.
          • Causes can include infections, immune-mediated disorders, or inherited conditions.
        • Clinical signs:
          • Muscle weakness, particularly in the facial muscles and limbs.
          • Weakness often worsens with exercise and improves with rest.
          • Some dogs may show signs of megaesophagus.
        • Diagnosis
          • Blood test for anti-acetylcholine receptor antibodies.
          • Response to edrophonium chloride challenge test.
          • Muscle biopsy.
        • Treatment
          • Cholinesterase inhibitors such as pyridostigmine bromide.
          • Immunosuppressive drugs may be used to suppress the immune system.
      • Polymyositis
        • Causes:
          • An immune-mediated disease in which the body's immune system attacks the muscles.
          • May be associated with other autoimmune diseases.
        • Clinical signs:
          • Muscle weakness, pain, and atrophy.
          • May affect various muscle groups.
        • Diagnosis:
          • Muscle biopsy.
          • Blood tests to identify elevated muscle enzymes (e.g., creatine kinase).
        • Treatment:
          • Immunosuppressive drugs such as corticosteroids.
      • Myopathies
        • Causes:
          • Inherited disorders that affect muscle fiber function.
          • Can be caused by genetic mutations.
        • Clinical signs:
          • Muscle weakness, atrophy, and stiffness.
          • May affect specific muscle groups.
        • Diagnosis:
          • Muscle biopsy.
          • DNA testing may assist in diagnosis.
        • Treatment:
          • Treatment is often supportive, and focuses on managing symptoms.
          • May include pain medications, physiotherapy, and dietary changes.

    Neurological Testing

    • A neurological examination can assist in pinpointing the location and type of the neurological problem
    • Urinalysis
      • Helps to identify metabolic diseases that impact the nervous system (e.g., diabetes, renal disease, liver disease).
    • Ophthalmologic Examination
      • Warranted if there is inflammatory disease
    • Blood Pressure Measurement
      • Warranted as hypertension can predispose to CNS vascular disease
    • Thoracic Radiographs and Abdominal Ultrasound:
      • Useful if inflammatory or neoplastic disease is suspected.
    • Fecal Analysis:
      • Parasites can cause CNS disease in young animals.
    • Serology for Viral or Rickettsial Diseases:
      • May be indicated
    • Immunofluorescence
      • Can be used to identify some viral diseases.
    • Toxicology
      • May be utilized to identify certain toxins
    • Neuroradiography and Special Imaging
      • Magnetic resonance imaging (MRI) can show brain lesions, tumors, and other neurological abnormalities
      • Computed tomography (CT) can help to visualize the brain and spinal cord.
      • Electroencephalogram (EEG) can help detect abnormal brain activity associated with seizures or other neurological conditions.

    Prognosis

    • The prognosis for neurological diseases varies depending on the underlying cause, severity, and responsiveness to treatment.
    • In some cases, with appropriate treatment, a dog may recover to some degree.
    • Other neurological conditions are progressive and ultimately fatal.
    • Regular veterinary checkups and proper management are essential for dogs with neurological diseases.

    Prevention

    • Vaccination against certain infectious diseases (e.g., distemper, rabies) can help prevent neurological complications.
    • Avoiding exposure to toxins and maintaining a healthy lifestyle can also help reduce the risk of neurological problems.
    • Early diagnosis and appropriate treatment can improve the outcome of neurological diseases.

    General Examination

    • Evaluate the animal's mental status, behavior, and coordination of head movements.
    • Assess the level of consciousness (alert, depressed, stuporous, comatose) and behaviors such as dementia.
    • Dementia can indicate disruptions in the cerebral function.
    • Determine if the animal is leaning or falling towards one side, which could indicate a vestibular injury.

    Specific Examination

    • Evaluate the animal's gait, including the presence of ataxia (lack of coordination), paresis (weakness), or paralysis (complete loss of function).
    • Assess the animal's strength by testing its ability to bear weight and use limbs for movement.
    • Evaluate the animal's proprioception by observing its response to a variety of tests like toe pinch, paw placement, hemihopping, and wheelbarrowing.

    Cranial Nerve Examination

    • Evaluate for a menace response, which tests cranial nerves 2 (optic) and 7 (facial), by observing the animal's response to a menacing gesture.
    • Examine the pupillary light reflex, which tests cranial nerves 2 and 3 (oculomotor), by observing the pupils' constriction to light.
    • Evaluate the animal's head posture, as it reflects the vestibular system. A head tilt can suggest a vestibular injury.
    • Assess for nystagmus (involuntary eye movements), noting direction and potential causes.

    Spinal Reflexes

    • Test patellar, tibial, and gastrocnemius reflexes for symmetry and hyperreflexia.
    • Observe the animal's response to pain by applying a non-painful stimulus down the spine.

    Diagnostic Tests

    • Use radiography to identify bony lesions and changes in intervertebral disc spaces.
    • Perform myelography to visualize extradural or intradural lesions causing spinal cord compression by injecting contrast material into the subarachnoid space.
    • Utilize computed tomography (CT) for detailed imaging of bony structures.
    • Conduct magnetic resonance imaging (MRI) to visualize the brain and spinal cord.

    Cerebrospinal Fluid Analysis

    • Collect CSF for analysis when inflammation is suspected.
    • Avoid collecting CSF if intracranial pressure is elevated.
    • Conduct laboratory CSF testing to rule out infectious agents and differentiate between inflammation and neoplasia.

    Cranial Nerve 2

    • Lesions of CN2 cause loss of constriction in both pupils when the affected eye is examined

    Cranial Nerve 3

    • Lesions of CN3 cause loss of constriction in the affected eye, with constriction in the unaffected eye

    Pupillary Symmetry

    • Evaluates CN3 and the sympathetic nerve to the eye
    • If CN3 is abnormal, the large pupil is denervated, and the pupillary light reflex (PLR) is absent.
    • If the sympathetic nerve is damaged, the smaller pupil is abnormal, but the PLR is normal in both eyes

    Pupillary Size

    • Reflects the integrity of CN3 and the sympathetic nerve.
    • Large pupils can be due to CN3 paralysis.
    • Small pupils may be due to loss of sympathetic tone.

    Ocular Position

    • Determined by CN3, CN4, CN6, and CN8
    • Injury to CN6 causes medial strabismus
    • Injury to CN3 or CN8 causes ventrolateral strabismus

    Ocular Motility

    • Voluntary eye movement requires cerebral, CN3, CN4, and CN6 activity.
    • With a cerebral infection, some viral infections, mild pupil dilation may be present ipsilaterally.

    Vestibular Signs

    • Vestibular signs and opisthotonus may be present

    Mental Status

    • Mental status is usually normal

    Forebrain Lesions

    • Seizures, personality changes, and dementia can occur with both diffuse and focal disorders
    • Diffuse disorders may cause conscious proprioceptive deficits, stupor, coma, absent response to pain, generalized ataxia, and bilateral miosis
    • Focal disorders may cause circling, contralateral conscious proprioceptive deficits, contralateral facial sensory deficits and weakness

    Diencephalic Lesions

    • Focal diencephalic lesions can cause lethargy, altered mentation, or circling
    • Head and neck pain can result from structural lesions

    Systemic Metabolic Alterations

    • Signs are usually diffuse, with alteration of mental status
    • Seizures may also be seen

    Spinal Cord Disease

    • Proprioceptive deficits and ataxia occur early in spinal cord disease
    • Injury to CP tracts causes knuckling
    • Injury to unconscious proprioception (UP) tracts causes ataxia in limbs caudal to the lesion

    Paresis

    • Paresis (weakness) can result from injury to UMN or LMN tracts
    • UMN injury causes weakness in limbs caudal to the lesion, and LMN injury causes weakness in limbs at the level of the injury
    • UMN injury causes increased extensor muscle tone when recumbent
    • LMN injury causes decreased spinal reflexes, decreased muscle tone, and muscle atrophy

    Nociceptive Loss

    • Injury to ascending nociceptive tracts in the spinal cord results in depressed or absent pain from stimuli caudal to the injury
    • Lack of deep pain sensation indicates severe spinal cord injury

    Spinal Cord Lesions

    • CP loss occurs first, followed by UP loss, UMN, then nociceptive loss as lesions worsen
    • With fractures, if the spinal cord is intact, surgery can be beneficial if performed within a few hours of injury
    • CT is preferred if bony lesions are being evaluated

    CSF Analysis

    • CSF analysis is the test of choice for diagnosing inflammatory spinal cord disease.
    • Protein concentration is normally low in CSF.
    • Disorders that increase CSF protein include encephalitis, meningitis, neoplasia, chronic neurodegenerative conditions, and trauma.
    • Other cells or organisms identified include tumor cells, cryptococcal or fungal organisms, distemper inclusions, bacteria, or rickettsial organisms.
    • Increased red blood cells (RBCs) may be due to contamination during the CSF tap but can also be due to hemorrhage due to trauma. Erythrophagocytosis is an indication of previous hemorrhage

    Spinal Cord Treatment

    • Medical treatment includes the use of corticosteroids, mannitol, antibiotics, and immunosuppressive agents
    • Surgical treatment is primarily aimed at decompressing the spinal cord and stabilizing the vertebral column
    • The prognosis for spinal cord disorders varies depending on the cause, severity, and location of the lesion.

    Peripheral Nerve Disorders

    • Toxoplasma gondii and Neospora caninum can cause inflammation of peripheral nerves
    • Acute polyradiculoneuritis (coonhound paralysis) is a common peripheral nerve disorder
    • Frequently observed in hunting dogs 1 to 2 weeks after exposure to a raccoon
    • Generalized inflammatory myopathy as a result of cell-mediated immunity
    • Associated with malignancies, systemic lupus erythematosus, and immune-mediated arthritis

    Metabolic Disorders

    • Lipid storage myopathy, malignant hyperthermia syndrome, electrolyte imbalances, endocrine disorders, neoplasia, parasitic disorders, and viral disorders can all contribute to peripheral nerve disorders
    • Toxic or drug-induced disorders can occur due to neurotoxins from ticks, Clostridium botulinum toxin, organophosphate insecticides.

    Spine Radiographs

    • Used to identify bony lesions and changes in intervertebral disc spaces
    • Provide limited information regarding spinal cord compression

    Myelography

    • Contrast material is injected into the subarachnoid space
    • Used for viewing extradural or intradural lesions causing spinal cord compression

    Skull Radiography

    • Can identify fractures, foramen magnum problems, and tumors

    Computed Tomography (CT)

    • Provides excellent imaging of bony structures

    Magnetic Resonance Imaging (MRI)

    • Provides excellent imaging of brain and spinal cord

    Cerebrospinal Fluid (CSF) Collection and Analysis

    • Indicated when inflammation is suspected
    • Contraindicated when intracranial pressure is elevated
    • Performed under general anesthesia

    Electroencephalography (EEG)

    • Useful with corticocerebral lesions
    • Sedation is usually required to minimize movement

    Brainstem Auditory Evoked Response Tests

    • Used to assess auditory function

    Electrodiagnostic Examination of the Motor Unit

    • Needle electromyography (EMG) provides information about motor unit innervation and muscle membrane ion conductance
    • Nerve conduction studies measure the action potential conduction velocity between points along a motor nerve
    • Repetitive nerve stimulation is useful in neuromuscular junction diseases

    Methylxanthine Toxicosis

    • Ingestion of as little as 1 ounce of baker’s chocolate per kilogram of body weight may be lethal
    • Clinical signs include tachycardia, cardiac arrhythmias, vomiting, polyuria, polydipsia, respiratory paralysis, cyanosis, seizures, muscle tremors, ataxia, and coma
    • Treat with activated charcoal, promote diuresis, treat cardiac arrhythmias and seizures.

    Organophosphate and Carbamate Poisoning

    • Acetylcholinesterase is inhibited, so acetylcholine is not broken down at muscarinic and nicotinic sites.
    • Clinical signs include salivation, vomiting, diarrhea, miosis, bradycardia, muscle tremors, weakness, exercise intolerance, respiratory paralysis, hyperactivity, and seizures
    • Treatment involves inducing vomiting and giving activated charcoal within 2 hours of ingestion.

    Ethylene Glycol Poisoning

    • Diagnosis is based on history and clinical signs
    • Treat by inducing vomiting; give activated charcoal if less than 2 hours after ingestion. Provide supportive care, and give anticonvulsants if needed

    Congenital Malformations and Anomalies

    • Hydrocephalus
      • Congenital disorder characterized by an accumulation of CSF within the brain.
      • Clinical signs include head pressing, dementia, changes in behavior, seizures, altered consciousness, ataxia, and visual deficits.
      • Signs are usually seen in dogs less than 1 year old.
      • Prognosis is guarded unless a specific cause can be identified and treated.
    • Spinal Cord Trauma
      • Prognosis is better with fractures if the spinal cord is intact.
      • Extramedullary compressive lesions have a better prognosis than intramedullary lesions.
      • Surgery is beneficial if performed within a few hours of the injury.
    • Discospondylitis
      • Has a fair to good prognosis if treatment is instituted early.
    • Meningitis and Myelitis
      • Immune-mediated meningitis has a good prognosis if treated appropriately.
      • Granulomatous encephalitis has a guarded to poor prognosis.
    • Vascular disorders
      • Prognosis depends on the severity of the neurologic deficits.
    • Neoplasia
      • Associated with a poor prognosis overall

    Peripheral Nerve Disorders

    • Neuropathy refers to functional disturbances in the peripheral nervous system.
    • Polyneuropathy refers to involvement of several nerves.
    • Common clinical signs include weakness and muscle atrophy, and self-mutilation.
    • Diagnosis involves history and physical examination, elevated creatine phosphokinase, lactic dehydrogenase, and aspartate aminotransferase.
    • Treatment is typically supportive.

    Anomalous, Inherited, and Congenital Disorders

    • These are typically noted prior to 1 year of age.
    • Diagnosis is based on clinical signs and signalment.
    • Specific breeds that may be affected include German shepherd dogs, Tibetan mastiffs, boxers, pointers, longhaired dachshunds, Brittanys, rottweilers, Leonberger dogs, Alaskan malamutes, dalmatians, golden retrievers, Birman cats, and Norwegian Forest cats.

    Metabolic and Endocrine Disorders

    • Diabetes mellitus can cause limb weakness.
    • Hypothyroidism can be associated with weakness.

    Inflammatory and Immune-Mediated Disorders

    • Toxoplasma gondii and Neospora caninum can cause inflammation of peripheral nerves.
    • Acute Polyradiculoneuritis (coonhound paralysis) is a common peripheral nerve disorder.
    • It is usually observed in hunting dogs 1 to 2 weeks after exposure to a raccoon.
    • Response to pain is often exaggerated.
    • Differential diagnosis includes botulism, tick paralysis, myasthenia gravis, and protozoal infection.
    • Treat with supportive care.

    Idiopathic Disorders

    • Can affect any breed of dog or cat, causing insidious or acute onset of weakness.

    Traumatic Injury

    • A common cause of weakness.
    • Prognosis is better when the nerve is injured close to the muscle it innervates.
    • Brachial plexus avulsion is common in road traffic injuries or when animals jump from moving vehicles.
    • Treat with physical therapy to prevent muscle contraction and prevent abrasions.
    • Regrowth of injured nerves may take months.
    • Amputation should be considered if there is self-mutilation or little return to function after 6 months.

    Muscle and Neuromuscular Junction Disorders

    • Hereditary disorders
      • Canine dystrophin-deficient muscular dystrophy
        • Similar to Duchenne muscular dystrophy in humans.
        • Most commonly in males.
        • Breeds predisposed include golden retriever, Irish terrier, Samoyed, rottweiler, Japanese spitz, and Labrador retriever.
        • Evident by about 10 to 12 weeks of age.
        • Clinical signs include stunted growth, weakness, muscle atrophy.
        • Serum creatine kinase levels are markedly elevated.
      • Feline dystrophin-deficient muscular dystrophy
        • A lethal condition of young male cats.
        • Clinical signs include skeletal muscle hypertrophy, glossal hypertrophy and dysfunction, and excess salivation.
        • No treatment is available.

    Neurological Examination

    • Reflex testing can help evaluate the nervous system.
    • Extensor carpi radialis reflex evaluates C7 to T2.
    • Biceps reflex evaluates the musculocutaneous nerve (from C6 to C7).
    • Patellar reflex tests the femoral nerve and L4 to L6. An exaggerated response suggests an upper motor neuron (UMN) lesion.
    • Cranial tibialis reflex tests the peroneal branch of the sciatic nerve from L6 to S2.

    Nociceptive Spinal Reflexes

    • Nociceptive spinal reflexes are initiated by a painful stimulus.
    • Loss of the reflex suggests a lower motor neuron (LMN) lesion.
    • Thoracic limb flexor reflex tests spinal cord segments C6 to T2.
    • Pelvic limb flexor reflex tests segments L6 to S2.
    • Perineal reflex tests S1 to S3.

    Special Reflexes

    • Babinski reflex is in the hindlimbs. Stroking the plantar aspect of the metatarsus should cause slight flexion of the toes, or no response. A positive Babinski reflex signifies UMN disease, and the toes spread apart and elevate.

    Diagnostic Procedures

    • Urinalysis can identify metabolic diseases that impact the nervous system.
    • Ophthalmologic examination is warranted if there is inflammatory disease.
    • Blood pressure measurement is warranted as hypertension can predispose to CNS vascular disease.
    • Thoracic radiographs and abdominal ultrasound are useful if inflammatory or neoplastic disease is suspected.
    • Fecal analysis can identify parasites that can cause CNS disease in young animals.
    • Serology for viral or rickettsial diseases may be indicated.
    • Immunofluorescence can be used to identify some viral diseases.
    • Toxicology may be utilized to identify certain toxins.

    Neuroradiography and Special Imaging

    • Radiographs of the spine can identify bony lesions, changes in intervertebral disc spaces, and provide minimal information regarding spinal cord compression.
    • Myelography involves injecting contrast material into the subarachnoid space and is useful for viewing extradural or intradural lesions causing spinal cord compression.
    • Radiographs of the skull can identify fractures, foramen magnum problems, and tumors.
    • Computed tomography (CT) provides excellent imaging of bony structures.
    • Magnetic resonance imaging (MRI) provides excellent imaging of brain and spinal cord.

    Cerebrospinal Fluid (CSF) Collection and Analysis

    • CSF analysis is indicated if inflammation is suspected.
    • CSF analysis is contraindicated if intracranial pressure is elevated.
    • CSF collection is performed under general anesthesia.

    Electroencephalography (EEG)

    • An EEG is useful with corticocerebral lesions.
    • Sedation is usually required to minimize movement.
    • No information regarding cause is gathered.

    Brainstem Auditory Evoked Response Tests

    • This test evaluates the brainstem and auditory pathways.

    Electrodiagnostic Examination of the Motor Unit

    • Needle electromyography (EMG) gives information about motor unit innervation and muscle membrane ion conductance.
    • Nerve conduction studies measure the action potential conduction velocity between points along a motor nerve.
    • Repetitive nerve stimulation is useful in neuromuscular junction diseases.
    • Tensilon or edrophonium chloride test: Intravenous (IV) administration transiently alleviates muscle weakness but recovery can take weeks.

    Other Conditions

    • Spinal Cord Tumors:
      • Intramedullary lesions cause symmetrical clinical signs.
      • Extramedullary lesions cause asymmetrical signs that are usually ipsilateral to the lesion.
      • The decision to perform surgery is based on the progression of clinical signs and the likelihood that surgery will be beneficial.
      • Surgery is most beneficial if it is performed early in the course of the disease.
      • Nursing care is very important and includes thermal applications of cold and hot packs, muscle massage, limb manipulations, hydrotherapy, frequent evacuation of the bladder, padded bedding, and daily baths.
    • Cerebellar Hypoplasia in Cats:
      • Caused by exposure of kittens in utero to panleukopenia infection.
      • Clinical signs including severe ataxia, intention tremors, falling, head bobbing, and loss of menace response are observed as soon as kittens start to walk.
      • Diagnosis is based on clinical signs.
      • There is no treatment.
    • Cerebellar Hypoplasia in Dogs:
      • May be secondary to postnatal herpesvirus infection, but most cases have a genetic base.
      • Clinical Signs: Severe ataxia, intention tremors, falling, head bobbing, and loss of menace response.
    • Neurological Disorders in Old Dogs:
      • Often caused by cognitive loss in older dogs (greater than 11 years of age).
      • Cortical atrophy and amyloid plaques are common. Decreased levels of norepinephrine and dopamine have been observed in the frontal cortex.
      • Clinical signs include decreased social interaction, staring, wandering, getting lost, loss of house training, and altered sleep cycles.
      • Diagnosis is based on history and clinical signs.
      • Treat with selegiline, which inhibits the breakdown of dopamine and norepinephrine. Modify the home environment.

    Seizures

    • Epileptic seizure:
      • Suspected if there is an incident of a sudden onset of abnormal behavior that lasts less than 5 minutes.
    • Criteria for diagnosis:
      • Two or more seizures within 6 months.
      • Two or more cluster seizures within 12 months.
      • An episode of status epilepticus.
      • A seizure has occurred within one week of trauma.

    Antiepileptic Drugs

    • Phenobarbital:
      • Maximal absorption occurs within 4 to 8 hours after oral administration.
      • Most is metabolized by the liver.
      • Phenobarbital induces the hepatic P450 system in the dog but not the cat. This will decrease the elimination half-life in the dog.
      • IV treatment can achieve therapeutic concentrations rapidly.
      • Serum monitoring is essential.
    • Other Antiepileptic drugs:
      • Potassium bromide.
      • Zonisamide.
      • Felbamate: used alone.
      • Gabapentin: used in dogs with hepatic disease. Also used in cats.
    • Drugs not used for routine therapy in the dog:
      • Phenytoin (Dilantin): causes hepatotoxicity and has very rapid elimination.
      • Diazepam (Valium): can cause withdrawal seizures, and tolerance develops very quickly.

    Emergency Seizure Management

    • Hospital Emergency Treatment:
      • Emergency therapy should be given if status epilepticus is present, if a single seizure lasts more than 5 minutes, if there is more than one seizure per hour, or more than 3 seizures per day.
      • Use diazepam to stop seizure activity and a long-acting drug to prevent further seizures.
    • At Home Emergency Treatment:
      • Diazepam is rapidly absorbed when given rectally.

    Prognosis for Spinal Cord Injury

    • Prognosis depends on the severity of the clinical signs, the duration of the injury, and the underlying cause.

    Prognosis for Spinal Cord Injury

    • The more severe the clinical signs, and the longer the duration of spinal cord injury, the poorer the prognosis.
    • Anomalies have a nonprogressive course.
    • Degenerative disorders have a guarded or poor prognosis.
    • Trauma: Prognosis is variable and depends on the extent of injury.

    Cerebral Dysfunction

    • Feline Ischemic Encephalopathy occurs in young to middle-aged cats, with a higher incidence in late summer, caused by a cerebral infarction of the middle cerebral artery
    • Clinical Signs: Seizures, cerebral dysfunction. Improvement may take several months
    • Diagnosis: Rule out other vascular diseases and cerebral diseases, MRI may show cerebral edema
    • Treatment: Anticonvulsants may be needed. Prednisone isn't effective
    • Necrotizing Vasculitis primarily affects young beagles, Bernese mountain dogs, and German shorthaired pointers. Likely immune-mediated
    • Clinical Signs: Meningitis symptoms such as neck pain, stiffness, and fever are common
    • Diagnosis: CSF analysis shows increased neutrophils. Diagnosis based on history and clinical signs
    • Treatment: Induce vomiting within 2 hours of ingestion if no clinical signs. Give anticonvulsants if necessary, bathe if exposure is on the skin. Give atropine and pralidoxime chloride. Provide IV fluids, nutritional support, and padded bedding.

    Neurological Disorders

    • IvermectinToxicity: Normally, the blood-brain barrier prevents ivermectin from entering the CNS. A P-glycoprotein pump defect in collies, Shetland sheepdogs, Australian shepherds, and Old English sheepdogs allows ivermectin to enter the brain
    • Clinical Signs: Ataxia, muscle tremors, tetraparesis, and coma
    • Diagnosis: Based on history, breed, and clinical signs
    • Treatment: Supportive care; prognosis is good, but severe cases can be fatal
    • Thiamine Deficiency: Caused by improperly formulated diets (especially all fish diets) or prolonged anorexia, cats are more frequently affected
    • Clinical Signs: Weight loss, head and neck ventroflexion, ataxia, extensor rigidity, opisthotonus, coma, mydriasis, blindness, seizures, and sudden death
    • Diagnosis: Rule out other causes
    • Treatment: Parenteral thiamine. Supplement with B vitamins for at least 2 weeks. Prognosis is good with early treatment
    • Neurotoxins:
      • Lead poisoning is caused by ingestion of lead-containing materials. Chronic exposure can lead to chronic toxicity
      • Clinical Signs: Seizures, behavior changes, dementia, visual deficits
      • Diagnosis: Rule out hepatic encephalopathy, encephalitis, and other toxins
      • Treatment: Induce vomiting within 2 hours of ingestion, anticonvulsants for seizures, corticosteroids, and mannitol if intracranial pressure is elevated

    Congenital Brain Diseases

    • Lissencephaly: Absence of cerebral cortex convolutions and thinned white matter. Inherited in Lhasa apsos, wirehaired fox terriers, and Irish setters. Some may have cerebellar hypoplasia
    • Clinical Signs: Behavior changes, dementia, seizures, and visual deficits. Present at birth or within the first year of life
    • Treatment: No specific treatment. Anticonvulsants may be needed
    • Congenital Arachnoid Cysts: Cysts in the brain, often causing seizures
    • Clinical Signs: Vary based on cyst location and size.
    • Treatment: May need surgery to remove or reduce the cyst

    Degenerative Brain Disease

    • Cerebellar Abiotrophies: Cerebellum develops normally but undergoes premature degeneration and cell death. Autosomal recessive in some breeds
    • Clinical Signs: Intention tremor and progressive ataxia. Dogs are normal at birth, but signs start between 4 and 10 weeks of age
    • Diagnosis: Rule out other causes of progressive cerebellar disease
    • Treatment: No treatment. Prognosis is poor
    • Multiple Neuronal Abiotrophies: Cell loss or chromatolytic changes in multiple areas of the brain. Affects certain breeds including German shepherd dogs, Tibetan mastiffs, boxers, pointers, longhaired dachshunds, Brittanys, rottweilers, Leonberger dogs, Alaskan malamutes, dalmatians, golden retrievers, Birman cats, and Norwegian Forest cats.
    • Clinical Signs: Vary depending on the affected brain area.
    • Treatment: No specific treatment. Supportive care may help manage symptoms.

    Seizures

    • Epileptic Seizures: Suspect if there have been two or more seizures within 6 months, two or more cluster seizures within 12 months, an episode of status epilepticus, evidence of intracranial disease, or a seizure within a week of trauma.
    • Treatment:
      • Phenobarbital: Maximal absorption within 4-8 hours after oral administration. Most metabolized by the liver. Induces hepatic P450 system in dogs but not cats (lowers elimination half-life in dogs)
      • Monitoring: Trough concentrations should be monitored after reaching a steady state.
      • New Antiepileptic Drugs:
        • Felbamate: Used alone.
        • Gabapentin: Used in dogs with hepatic disease, also used in cats
      • Drugs Not Used Routinely:
        • Phenytoin (Dilantin): Causes hepatotoxicity and has rapid elimination.
        • Diazepam (Valium): Can cause withdrawal seizures, and tolerance develops quickly
      • Hospital Emergency Treatment:
        • Administer emergency therapy if status epilepticus is present, single seizure lasts longer than 5 minutes, more than one seizure per hour, or more than 3 seizures per day.
        • Use diazepam to stop seizure activity and a long-acting drug to prevent further seizures.
      • At Home Emergency Treatment: Diazepam is rapidly absorbed when given rectally.

    Muscle and Neuromuscular Junction Disorders

    • Hereditary Disorders:
      • Canine Dystrophin-Deficient Muscular Dystrophy: Similar to Duchenne muscular dystrophy in humans. Most common in males. Breeds include golden retriever, Irish terrier, Samoyed, rottweiler, Japanese spitz, and Labrador retriever. Evident by 10-12 weeks of age.
      • Clinical Signs: Stunted growth, weakness, muscle atrophy, elevated serum creatine kinase levels
      • Feline Dystrophin-Deficient Muscular Dystrophy: Lethal condition in young male cats.
      • Clinical Signs: Skeletal muscle hypertrophy, glossal hypertrophy and dysfunction, excess salivation

    Peripheral Nerve Disease

    • Clinical Signs: Weakness, paralysis, atrophy, decreased reflexes, pain, ataxia, gait abnormalities.
    • Diagnosis: Based on clinical signs, history, breed, and signalment. Inherited/congenital should be suspected in young animals with peripheral nerve disease signs.
    • Breeds Affected: German shepherd dogs, Tibetan mastiffs, boxers, pointers, longhaired dachshunds, Brittanys, rottweilers, Leonberger dogs, Alaskan malamutes, dalmatians, golden retrievers, Birman cats, and Norwegian Forest cats.
    • Specific Disorders:
      • Globoid Cell Leukodystrophy: Deficiency of -galactocerebrosidase.
      • Glycogen Storage Disease: Deficiency in a glycogen branching enzyme in Norwegian Forest cats.
      • Other Storage Diseases: Hyperchylomicronemia in cats, Niemann-Pick disease, and GM2-gangliosidosis

    Metabolic and Endocrine Disorders

    • Diabetes Mellitus: Can cause limb weakness (more pronounced in pelvic limbs).
    • Hypothyroidism: May be associated with limb weakness.
    • Treatment: Address the underlying disorder.

    Cranial Nerve Disorders

    • Idiopathic Disorders: Unclear cause
      • Trigeminal Neuritis: Affects middle-aged dogs.
      • Clinical Signs: Inability to close the mouth, difficulty chewing food.
      • Diagnosis: Based on history of acute mandibular paralysis
      • Treatment: Supportive care; corticosteroids not beneficial.
      • Idiopathic facial paralysis or palsy: Causes unknown
      • Clinical Signs: Unilateral facial droop, decreased tear production, inability to blink, food, water and saliva fall out of the mouth. Cocker spaniels have an increased incidence.
      • Diagnosis: Ruling out other causes of facial paralysis.
      • Treatment: No treatment.

    Radiographs of the Spine

    • Used to identify bony lesions, changes in intervertebral disc spaces
    • Provide minimal information regarding spinal cord compression

    Myelography

    • Contrast material is injected into the subarachnoid space
    • Useful for viewing extradural or intradural lesions causing spinal cord compression

    Radiographs of the Skull

    • Can identify fractures, foramen magnum problems, and tumors

    Computed Tomography (CT)

    • Provides excellent imaging of bony structures

    Magnetic Resonance Imaging (MRI)

    • Provides excellent imaging of the brain and spinal cord

    Cerebrospinal Fluid (CSF) Collection and Analysis

    • CSF analysis is indicated if inflammation is suspected
    • CSF analysis is contraindicated if intracranial pressure is elevated
    • CSF collection is performed under general anesthesia
    • For brain disorders, CSF is collected at the cerebellomedullary cistern
    • For spinal cord disorders, CSF is collected at the lumbar space
    • Gross examination:
      • CSF should normally be clear and colorless
      • CSF is turbid in inflammation
      • Pink color indicates blood contamination
      • Yellow-orange color indicates breakdown of hemoglobin from previous hemorrhage or severe elevation in CSF protein
    • Cytology
      • Suppurative meningitis is characterized by an increase in neutrophils and indicates bacterial encephalitis, meningioma, vasculitis in young dogs, or feline infectious peritonitis (FIP) in cats
      • Mixed inflammation is characterized by an increase in a mixed population of cells and usually indicates fungal, protozoal, or idiopathic encephalitis. It may be seen in chronic bacterial infections
      • Nonsuppurative inflammation is indicative of immune-mediated encephalitis, rickettsial, metabolic, or toxic disorders

    Electroencephalography (EEG)

    • Useful with corticocerebral lesions
    • Sedation is usually required to minimize movement
    • Does not provide information regarding the cause of the lesion

    Brainstem Auditory Evoked Response Tests

    • Measure the electrical activity of the auditory pathway in response to sound
    • Used to evaluate hearing

    Electrodiagnostic Examination of the Motor Unit

    • Needle electromyography (EMG) gives information about motor unit innervation and muscle membrane ion conductance
    • Nerve conduction studies measure the action potential conduction velocity between points along a motor nerve
    • Repetitive nerve stimulation is useful in neuromuscular junction diseases
    • Tensilon or edrophonium chloride test: Intravenous (IV) administration transiently alleviates signs of myasthenia gravis

    Brain and Cranial Nerve Disorders

    • Common clinical signs of brainstem lesions:
      • Cranial nerve dysfunction (CN3-CN12)
      • Clinical signs involving facial expression (CN7) and mastication (CN5)
      • Head tilt, circling, and falling
      • Ascending white matter tract injury causes ipsilateral conscious proprioceptive deficits
      • Descending UMN injury causes tetraparesis or paralysis
      • Severe brainstem lesions result in altered consciousness and can affect cardiovascular and respiratory regulation
    • Common clinical signs of cerebellar lesions:
      • Incoordination during voluntary movements
      • Truncal swaying and a wide-based stance
      • Intention tremor of the head

    Canine Seizures

    • The most common neurologic problem in dogs
    • Seizures can be caused by a variety of factors, including:
      • Developmental defects
      • Metabolic disorders
      • Toxin exposure
      • Inflammatory or infectious diseases
      • Neoplasia
      • Trauma
    • Diagnosis:
      • Obtain a thorough history, including vaccination status, pedigree, travel history, medications given, and previous medical and surgical problems
      • Obtain as much data about the seizure episodes as possible, including duration, time between seizures, type of seizures, and behaviors surrounding the seizure
      • Evaluate current behaviors and document changes

    Canine Encephalitis

    • Causes:
      • Idiopathic
      • Infections (bacterial, viral, fungal, protozoal)
      • Immune-mediated disorders
    • Clinical Signs:
      • Seizures
      • Behavioral changes
      • Altered mental status
      • Signs of brainstem dysfunction
      • Blindness
      • Paralysis

    Treatment of Canine Seizures

    • Anticonvulsant Therapy:
      • Phenobarbital
        • Most commonly used anticonvulsant for dogs
        • Typically given orally, once or twice daily
        • Side effects can include sedation, lethargy, polydipsia, polyphagia, and weight gain
      • Potassium Bromide
        • Used in combination with phenobarbital to improve seizure control
        • Can be used alone if phenobarbital is not tolerated or effective
        • Side effects can include sedation, lethargy, anorexia, and vomiting
      • Other anticonvulsants:
        • Gabapentin
        • Levetiracetam
        • Zonisamide
    • Supportive Care:
      • Monitor for signs of infection
      • Provide hydration
      • Manage seizures with medications
    • Prognosis:
      • Varies depending on the underlying cause of the seizures
      • Treatment can be difficult and time-consuming
      • Many dogs can live long and productive lives with appropriate treatment and management

    Ivermectin Toxicity

    • Normally the blood-brain barrier prevents ivermectin from entering the CNS
    • A P-glycoprotein pump defect in some collies, Shetland sheepdogs, Australian shepherds, and Old English sheepdogs allows ivermectin to enter the brain
    • Single oral dose can be neurotoxic if this defect is present
    • Clinical signs include ataxia, muscle tremors, tetraparesis, and coma
    • Treatment is supportive
    • Prognosis is good

    Cognitive Dysfunction

    • Neurodegenerative disorder of the forebrain with gradual onset and progression of behavioral and/or motor activity, followed by a change in behavior or orientation

    Lissencephaly

    • Absence of cerebral cortex convolutions and thinned white matter
    • Inherited in the Lhasa apso, wire-haired fox terrier, and Irish setter
    • Some may have concurrent cerebellar hypoplasia
    • Clinical signs include behavior changes, dementia, seizures, and visual deficits
    • Clinical signs are present at birth or within the first year of life
    • No specific treatment; treat with anticonvulsants if needed

    Congenital Arachnoid Cysts

    • Slow progression of temporal and masseter muscle atrophy followed by facial sensory loss is observed
    • MRI is the diagnostic method of choice
    • Surgery is difficult; radiation therapy may slow progression

    CN VIII Neoplasia

    • Neurofibromas or meningiomas may affect CN8
    • Other tumors may extend into or invade the nerve
    • Clinical signs include vestibular signs, Horner syndrome, and other cranial neuropathies
    • MRI is the diagnostic method of choice
    • Usually not possible to remove the tumor

    Congenital Sensorineural Deafness

    • Caused by postnatal cochlear hair cell and spiral ganglion degeneration; occurs in many dog breeds
    • Also occurs in white cats with blue eyes
    • Clinical signs include unilateral or bilateral deafness in very young puppies

    Bromide Therapy

    • Oral bromide is used in addition to phenobarbital and decreases the number and severity of seizures in many dogs
    • Monitor bromide levels at 1 month, 3 months, and 6 months after starting therapy
    • Monitor bromide levels every 6 months after that
    • Bromide can be used without phenobarbital if there is hepatic disease, if there have been no seizures for more than a year, or the quality of life is unacceptable on both phenobarbital and bromide, and there have been no seizures for more than 3 months
    • Bromide therapy is not recommended in cats due to a high prevalence of respiratory problems

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