Drugs
Name the four anti-seizure medications (maintenance drugs).
Phenobarbital
Zonisamide
Potassium Bromide
Keppra
A patient has a head tilt to the left and nystagmus. What is their neurolocalization?
Left vestibular
We scan a 2yr Lab with a history of seizures, normal neurologic exam, and normal bloodwork, and find that the MRI is normal and CSF is also normal. What disease do we diagnose?
Idiopathic epilepsy
What two dogs require bladder expression?
-Dog who is non-ambulatory paraparetic
-Dog who is paraplegic with deep pain intact
-Dog who is paraplegic with deep pain absent
-Dog who is ambulatory tetraparetic
Paraplegic deep pain intact
Paraplegic deep pain absent
What brain disease is most likely?
3mo puppy who presents for seizures and myoclonic jerks. 2 weeks ago, had some diarrhea when adopted and on exam (owners think might be stress), has clear nasal discharge (owners think might be allergies).
Distemper
Name 3 side effects of phenobarbital.
Polyphagia
Polyuria/Polydipsia
Sedation
Incoordination
Bone marrow suppression
Increased liver values
A patient cannot move their back legs at all but tries to bite when hemostats are clamped down on the bones of the toes. How would you describe their neurologic status?
Paraplegic deep pain positive
What is the name of the disease where the immune system attacks the brain and subsequently causes inflammation in the brain and meninges (lining of brain)?
MUO (meningoencephalitis of unknown origin)
aka: inflammatory brain disease
aka: auto-immune encephalitis
What is the official name for a 'missile disc herniation'? And is this a surgical problem?
ANNPE - acute non-compressive nucleus pulposus extrusion
No, not surgical (nothing to remove)
Myelomalacia, the softening and dying of the spinal cord, only applies to dogs with what neurologic status? Bonus: what percentage of these dogs will develop myelomalacia?
Paraplegic deep pain negative dogs
10-15%
We typically use three drugs to treat MUO. Prednisone is given initially and then what are two common long-term options?
Cyclosporine
Cytarabine (Cytosar)
Azathioprine
Leflunomide
Mycophenolate
What part of the brain does a 'truncal sway' and hypermetria localize to?
Cerebellum
Strokes in dogs most commonly cause what kind of neurologic signs?
Vestibular (and cerebellar)
You find a panniculus/cutaneous truncii cut-off at L2. Where in the spinal cord is the problem?
T13 or L1 (1-2 sites in front of the cut-off)
What is the term for a neurologic lameness? (example: a dog presents to Laurent for a right front leg lameness but then he comes to neuro because he can't find anything wrong with the muscles, joints, etc). We find a nerve sheath tumor on MRI.
Nerve root signature
A 4.2kg dog starts having a seizure. What medication do you draw up to stop the seizure and how many mL do you draw up?
What are the four categories of thoracolumbar spinal cord dysfunction? (Using terms like paresis and plegia)
Ambulatory paraparetic
Non-ambulatory paraparetic
Paraplegic SPP
Paraplegic DPP/DPN
The vestibular system can be peripheral and central. What is the difference and what do we use on our exam to tell if central vs. peripheral causes are more likely?
Peripheral - middle and inner ear compartments
Central - brain
Proprioceptive deficits
What is the name for the following disease:
-Infection of the intervertebral disc that spreads to the neighboring vertebra
-Can be caused most commonly by a UTI or blood infection; sometimes can be fungal
-Patients typically are large breed dogs who present for spinal pain
Discospondylitis
A patient has a herniated disc at C5-6 and is tetraplegic. Why is the patient hypoventilating?
Phrenic nerve paralysis - C5,6,7
What electrolyte will be elevated in patients that are receiving potassium bromide (and it is normal and not concerning)
Chloride
A patient has the following exam abnormalities:
-Circles to right
-Menace absent on left, normal on right
-Does not correct knuckling on left limbs, but is normal on right limbs
Where is the problem?
Right forebrain
What is the name of the congenital back-of-the-skull abnormality that can cause fluid pockets in the spinal cord? Hint: Cavalier King Charles Spaniels are poster children for this.
COMS; caudal occipital malformation syndrome
What is the name for fluid pockets in the spinal cord that develop secondary to an abnormality in the back of the skull?
A patient has a brain tumor on MRI and your doctor sees herniation.
What collection of cardiovascular abnormalities might you see on your anesthesia monitoring and what is this phenomenon called?
Cushings reflex
Hypertension and then Bradycardia