Clin Med IV: Neuro Dz. Review

IVDD:

Extrusion of the nucleus pulposus (inner portion of disk) from the interverebral disk.

Describe Type I IVDD:

• Acute rupture

• C/S: back pain, hunched posture, paresis + paralysis.

• MRI is the modality of CHOICE.

• Tx with med management or sx treatment

  • Hemilaminectomy (throaco-lumbar)

  • Ventral slot

Describe Type II IVDD:

• Degeneration of nucleus pulposus

• Slowly progressing

• Older dogs— 8-10 years

• Doberman Pinschers are predisposed

• C/S: Neck pain, stiff gait, lowered head, paresis/paralysis

• Pts with loss of deep pain more than 24hrs has a guarded-poor porgnosis.

Side effects of steroids:

• Decreased wound healing

• Decreased immunity

• V/D

• Melena

• PU/PD/PP

Atloantaxial Subluxation:

• AA instability

• Cranial part of the axis is displaced.

• Toy/mini breeds

• C/S: neck pain, reluctance to move/turn head, tetraparesis, sudden death (brain stem)

• Dx— radiographs

• Tx— medical management or sx

  • Dorsal approach

  • Ventral approach

  • Neck brace

Cervical Spondylmyelopathy (Wobbler’s):

• Compression due to malformation of C5 and C7

• Larger breed dogs (Great danes and dobermans).

• C/S: ataxia and neck pain

• Tx medical and surgical (dorsal or ventral approach)

• GUARDED PROGNOSIS

Degenerative Myelopathy:

• Degeneration of white matter

• SLOW PROGRESSION

• Most common in MIDDLE-OLD AGE GSD

• C/S: can progress into hind-limb paresis and ataxia

• dx: rule out other dz

• Tx: PT— NO CURE

Organophosphate Toxicity:

• Pesticides, herbicides, insecticides.

• C/S: S-salivation, L-lacrimation, U-urination, D- defecation, E-emesis

• Tx: atropine, 2-Pam, decontamination, activated charcoal.

Idiopathic Vestibular Disease:

• Acute dz inv. loss of balance and nystagmus.

• C/S: NYSTAGMUS, circling with head tilt

• Dx: rule out, otic exam (inner ear)

• Tx: supportive care— full recovery in 3-6 weeks.

Laryngeal Paralysis (Lar Par):

• Hereditary vs. Acquired vs. Idiopathic

• C/S: inspiratory stridor, heat stroke— can’t pant correctly.

• Tx: medical or sx

Brain trauma:

• Primary event— direct injury to nervous tissues

• Secondary event— increased intracranial pressure, edema, hypoxia, seizurea

• Tx: goal is to prevent/decrease secondary effects; osmotic agents decrease cerebral edema

• Animals in a coma longer than 48 hours usually don’t survive

Neoplasia of the brain:

• Primary tumors— meningioma— MC in cats

• Secondary tumors— metastasis

• C/S: seizures, vest. dz, tremors/ataxia, circling

• Dx: CBC/chem, MRI/CT

• Tx: Sx, radiation, + / - chemo, treat c/s.

Megaesophagus:

• Lack of effective esophageal peristalsis, regurgitation

• Prognosis— poor to guarded

• C/S: regurgitation, respiratory signs

• Tx: NO CURE, provide elevated feeding chair (Bailey chair)