Term
| What three things can we determine by evaluating CSF? |
|
Definition
-type of injury/lesion
-location of lesion
-stage of disease |
|
|
Term
| Describe how CSF can tell us the type of injury. |
|
Definition
-can show us etiologic agent (bacteria, virus)
-not all lesions can have abnormal CSF (hydrocephaly has normal CSF) |
|
|
Term
| Describe how CSF can tell us the location of the lesion. |
|
Definition
| meningeal and paraventricular lesions produce greater CSF changes |
|
|
Term
| Describe how CSF can tell us the stage of the disease. |
|
Definition
| acute diseases are more likely to have abnormal CSF |
|
|
Term
| What should you avoid testing CSF? |
|
Definition
-recent trauma
-increased intracranial pressure (cuz we don't want to cause herniation) |
|
|
Term
| What are some pros and cons to evaluating CSF? |
|
Definition
pros: cheap, safe, can get good info
cons: general anesthesia, sample needs to be processed immediately, risk of complications (blood contamination, brain herniation) |
|
|
Term
| Describe the flow of CSF. |
|
Definition
-produced by cells of choroid plexus
-flows thru ventricular sys to bathe brain and spinal cord
-reabsorbed into subarachnoid space |
|
|
Term
| What is the function of CSF? |
|
Definition
-shock absorber
-regulate pressure and volume within CNS
-transports nutrients, metabolites, waste, nrotransmitters
-acts as chemical buffer to maintain pH and appropriate ionic concentrations |
|
|
Term
| What are the three places you can get CSF from? |
|
Definition
-atlantooccipital puncture (all)
-cisternal puncture (dogs)
-lumbosacral interpsace (cats, large animals) |
|
|
Term
| What are the three C's of CSF analysis? |
|
Definition
-color
-clarity
-clot formation (shouldn't have if you put into EDTA tube) |
|
|
Term
| Describe normal/abnormal CSF color. |
|
Definition
Normal: colorless
Pink = traumatic tapp, recent hemmorhage
Brown = old hemmorhage
yellow/orange = Xanthochromia = release of bilirubin from Macs that have engulfed RBCs; OR hyperbilirubinemia |
|
|
Term
| Describe normal/abnormal CSF clarity. |
|
Definition
Normal: clear
Turbid = increased cell number |
|
|
Term
| Describe normal/abnormal CSF clot formation. |
|
Definition
Normal: doesn't clot because in EDTA tube
-Clotting may occur with inflammation or blood contamination |
|
|
Term
| What is the most common change seen in CSF? |
|
Definition
|
|
Term
| What proteins are seen in CSF? |
|
Definition
-low protein levels
-mostly albumin, also some IgG
-most protein comes from the plasma |
|
|
Term
| What does increased protein in CSF suggest? |
|
Definition
-traumatic tap
-disruption of BBB
-inflammation
-increased intrathecal antibody production |
|
|
Term
| What does cell count in CSF tell us? |
|
Definition
-cell count is low cuz of the low protein, therefore count using hemocytometer
-Pleocytosis is term for increased cells in CSF, usually without increased protein |
|
|
Term
|
Definition
-could be due to traumatic tap or pathologic hemmorhage
-usually eaten by Macs within 2-12 hrs cuz of lack of proteins in CSF to support them |
|
|
Term
| When would we see neutrophilic pleocytosis? |
|
Definition
-occurs when there's more than 50% neutrophils present
-usually due to bacterial infections, sometimes fungal, neoplasms, or trauma |
|
|
Term
| When would we see mononuclear pleocytosis or lymphocytic pleocytosis? |
|
Definition
-occurs when there's more than 75% mononuclear cells or lymphocytes present
-seen in viral, fungal, granulomatous diseases |
|
|
Term
| When would we see eiosinophilic pleocytosis? |
|
Definition
-occurs when there's more than 20% eiosinophils
-seen in parasitic infections |
|
|
Term
| When would we see neoplastic cells in the CSF? |
|
Definition
| -RARE, except in CNS lymphoma |
|
|
Term
| What is the most common fungal infection in CSF? |
|
Definition
|
|
Term
| Is it easier to try to visualize bacteria in CSF or do PCR? |
|
Definition
|
|
Term
| What are CSF changes associated with bacterial meningoencephalitis? |
|
Definition
-increase WBC, protein
-neutrophils
-can culture or PCR to find agent |
|
|
Term
| What are CSF changes associated with fungal infection? |
|
Definition
-mixed, neutrophilic, mononuclear, or eiosinophilic pleocytosis
-increased protein
-organisms visualized in 90% cases |
|
|
Term
| What are CSF changes associated with granulomatous meningoencephalomyelitis? |
|
Definition
-idiopathic inflamm disease of CNS
-increased WBC, protein |
|
|
Term
| What are the CSF changes associated with necrotizing meningoencephalitis of toy breeds? |
|
Definition
-non-suppurative inflamm of cerebrum and meninges
-increased WBCs (lymphocytes) and protein |
|
|
Term
| What are the CSF change associated with steroid responsive suppurative meningitis/arteritis? |
|
Definition
-etiology unknown, possibly immune
-increased WBC (neutrophils), protein (IgA) |
|
|
Term
| What are the CSF changes associated with canine distemper |
|
Definition
Acute: normal, mild to moderate mixed pleocytosis
Chronic: mononuclear pleocytosis |
|
|
Term
| What are the CSF changes associated with Equine protozoal myeloencephalomyelitis? |
|
Definition
| -increased protein, antibodies, mononuclear pleocytosis |
|
|
Term
| What are the CSF changes associated with Parelophostrongylus infection? |
|
Definition
-seen in llamas and alpacas
-eiosinophilic pleocytosis |
|
|
Term
| What is the primary goal of a neurological examination? |
|
Definition
|
|
Term
| What are the etiologic categories for neural damage? |
|
Definition
*VITAMIND*
Vascular
Inflammatory
Trauma/Toxin
Anamolous
Metabolic
Immune/Idiopathic
Neoplastic/Nutritional
Degenerative |
|
|
Term
| What are the two functions you need to check in order to determine mental status? |
|
Definition
-level of consciousness
-behavior (evaluates thalamocortical function) |
|
|
Term
| Describe the levels of consciousness. |
|
Definition
-normal
-delirium
-somnolence (depression)
-stupor (sleeping, takes a LOT to rouse)
-coma |
|
|
Term
|
Definition
| saddlebagging, where the back is curved down |
|
|
Term
|
Definition
-sign of pain
-back is curves upward |
|
|
Term
|
Definition
| -lateral deviation of the spine |
|
|
Term
| What is the most important part of the neurological exam? |
|
Definition
|
|
Term
| What are the three types of ataxia? |
|
Definition
-vestibular
-cerebellar
-proprioceptive |
|
|
Term
| What is a major sign of vestibular ataxia? |
|
Definition
|
|
Term
| What is the major sign of cerebellar ataxia? |
|
Definition
-dysmetria/hypermetria
-tremors |
|
|
Term
| What is usually associated with proprioceptive ataxia? |
|
Definition
-paresis
-common with spinal compression/lesions |
|
|
Term
| What makes the patellar reflex unique? |
|
Definition
|
|
Term
| What cranial nerves does the menace response test? |
|
Definition
-CN II
-CN VII
-thalamocortex
-cerebellum |
|
|
Term
| What cranial nerves does the pupillary light reflex test assess? |
|
Definition
Parasympathetic
-CN II
-CN III |
|
|
Term
| What is Horner's Syndrome? |
|
Definition
Anisocoria = two difference pupil sizes
-miosis (small pupil)
-ptosis (droopy eyelid)
-enophthalmus (sunken eye)
-protrusion of 3rd eyelid |
|
|
Term
| What is the area that is affected in Horner's Syndrome? |
|
Definition
| Tectotegmentospinal Tract (sympathetic) |
|
|
Term
| What does the oculocephalic reflex test (physiological nystagmus) assess? |
|
Definition
-CN III
-CN IV
-CN VI
-CN VIII |
|
|
Term
| What does vertical nystagmus indicate? |
|
Definition
|
|
Term
| What are the three branches of the trigeminal nerve? |
|
Definition
-ophthalmic
-maxillary
-mandibular |
|
|
Term
| What are the three tests that assess the trigeminal nerve? |
|
Definition
-palpebral reflex (checks all 3 branches)
-nasal sensation (CN V sensory, thalamocortex test)
-muscles of mastication (look at size/symmetry) |
|
|
Term
| What does the palpebral reflex test assess? |
|
Definition
|
|
Term
| What does the nasal sensation test assess? |
|
Definition
-CN V sens
-CN VII
-thalamocortex |
|
|
Term
| By assessing the size and symmetry of the muscles of mastication, which cranial nerve function are you assessing? |
|
Definition
|
|
Term
| By assessing the size and symmetry of the muscles of the face, which cranial nerve function are you assessing? |
|
Definition
|
|
Term
| If there's facial assymetry (one side is droopy), which cranial nerve may be damaged? |
|
Definition
|
|
Term
| What is a clinical sign associated with a lesion in CN VIII? |
|
Definition
vestibulocochlear nerve
-head tilt
-ataxia, disequilibrium, nystagmus |
|
|
Term
| What are the clinical signs associated with a lesion in Cn IX or CN X? |
|
Definition
glossopharyngel and vagus nerves
-dysphoria
-dysphagia
-inspiratory dyspnea
-stertorous breathing
very uncommon to see these problems |
|
|
Term
| Which nerve are we assessing when we look at tongue symmetry? |
|
Definition
|
|
Term
| What are the three most important postural reaction tests to detect neurological deficits? |
|
Definition
-proprioception (sensitive)
-hopping (good to detect mild asymmetry)
-tactile positioning (cats, small dogs) |
|
|
Term
| Are PRs (postural reactions) a replacement for a gait exam? |
|
Definition
|
|
Term
| Thoracic limb extensor tone reflex tests assess which spinal nerves? |
|
Definition
|
|
Term
| Thoracic limb flexor tone reflex tests assess which spinal nerves? |
|
Definition
all nerves of the brachial plexus (C6-T2)
-musculocutaneous (C6-8) is a very important contribution |
|
|
Term
| The perineal reflex test assesses which nerves? |
|
Definition
|
|
Term
| Pelvic limb extensor tone reflex tests assess which spinal nerves? |
|
Definition
|
|
Term
| Pelvic limb patellar reflex tests assess which spinal nerves? |
|
Definition
|
|
Term
| Pelvic limb flexor of the lateral digit reflex tests assess which spinal nerves? |
|
Definition
|
|
Term
| Pelvic limb flexor of the medial digit reflex tests assess which spinal nerves? |
|
Definition
femoral n (S1-S3)
-sensory |
|
|
Term
| The cutaneous trunci reflex (panniculus) assesses which spinal nerves? |
|
Definition
| lateral thoracic n (C8-T1) |
|
|
Term
| When and how do you test nociception? |
|
Definition
-nociception = deep pain
-test only in paralyzed animals
-squeeze digits with hemastats |
|
|
Term
| Describe how to do a spinal palpation. |
|
Definition
-pressure over the dorsal root ganglia
-move in a cranio-caudal direction
-look for painful responses to the pressure |
|
|
Term
| What are some signs associated with compressive spinal cord lesions, in order of appearance? |
|
Definition
-proprioceptive ataxia, mild paresis
-ataxia, severe paresis
-paralysis
-urinary incontinence
-loss of nociception |
|
|
Term
| What are the functions of the upper motor neurons? |
|
Definition
-initiate voluntary movement
-postural adjustment
-maintenance of muscle tone (facilitate flexors, inhibit extensors) |
|
|
Term
| What are signs associated with upper motor neuron dysfunction? |
|
Definition
-paresis/paralysis
-normal to increased muscle tone and reflexes
-mild muscular atrophy, late onset |
|
|
Term
| What are the functions of the lower motor neurons? |
|
Definition
| -manifest motor activity (reflexes and voluntary movement) |
|
|
Term
| What are signs associated with lower motor neuron dysfunction? |
|
Definition
-paresis/paralusis
-decreased to absent muscle tone and reflexes
-severe muscular atrophy, quick onset |
|
|
Term
| What clinical signs are associated with lesions in C1-C5? |
|
Definition
-ataxia, tetraparesis/plegia
-reflexes normal to increased in all limbs |
|
|
Term
| What clinical signs are associated with lesions in C6-T2? |
|
Definition
-ataxia. tetraparesis/plegia
-Thoracic limbs: decreased/absent reflexes
-Pelvic limbs: normal to increased reflexes |
|
|
Term
| What clinical signs are associated with lesions in T3-L3? |
|
Definition
-ataxia, tetraparesis/plegia
-reflexes normal to increased in pelvic limbs |
|
|
Term
| What clinical signs are associated with lesions in L4-S3? |
|
Definition
-mild ataxia. tetraparesis/plegia
-Pelvic limbs: decreased/absent reflexes |
|
|
Term
| What clinical signs are associated with lesions in C6-C8? |
|
Definition
-pelvic limb ataxia
-spastic thoracic limb gait
-Thoracic limb: increased extensor tone, flexor tone normal or decreased
-Pelvic limb: normal to increased tone
-common with wobbler's syndrome |
|
|
Term
| What happens in spinal shock? What do you do? |
|
Definition
-paraplegia with decreased to absent reflexes and tone for the first few hours following trauma
-wait a little while and then test again to determine whether these deficiencies were real or as a result of shock |
|
|
Term
| What is the most common spinal cord lesion? What are the signs? |
|
Definition
-lesion at T3-L3
-causes UMN signs in the pelvic limbs |
|
|
Term
| Where is the lesion if the animal presents with LMN signs in all four limbs? |
|
Definition
-suggests lesion outside of the spinal cord
-NO loss of proprioception |
|
|
Term
| What is the function of the reticular system? |
|
Definition
-ARAS: Ascending Reticular Activating System
-maintains a state of wakefulness |
|
|
Term
| What are the clinical signs associated with a lesion in the reticular formation? |
|
Definition
| -somnolence, stupor, coma |
|
|
Term
| How does one examine an animal to determine whether the lesion is in the reticular formation? |
|
Definition
|
|
Term
| CN III and CN IV are found in which part of the brain? |
|
Definition
|
|
Term
| CN V (motor, sensory) is located in which part of the brain? |
|
Definition
|
|
Term
| CN V (sensory), CN VI, CN VII, and CN VIII are found in which part of the brain? |
|
Definition
|
|
Term
| CNs IX, X, XI, and XII are located in which part of the brain? |
|
Definition
|
|
Term
| Which cranial nerves are in the mesencephalon? What are clinical signs associated with a lesion in this area of the brain? |
|
Definition
-CN III, CN IV
-strabismus, ocular paralysis, mydriasis |
|
|
Term
| Which cranial nerves are in the pons? What are clinical signs associated with a lesion in this area of the brain? |
|
Definition
-CN V motor
-atrophy of muscles of mastication |
|
|
Term
| Which cranial nerves are in the rostral medulla? What are clinical signs associated with a lesion in this area of the brain? |
|
Definition
-CN V sensory, CNs VI, VII, VIII
-head tilt, facial paralysis, absence of palpebral reflex |
|
|
Term
| Which cranial nerves are in the caudal medulla? What are clinical signs associated with a lesion in this area of the brain? |
|
Definition
-CN IX, X, XI, XII
-dysphonia, dysphagia, sterteous breathing, tongue paralysis |
|
|
Term
| A lesion in which region of the brain will lead to contralateral deficits? |
|
Definition
-thalamocortex
-sometimes mesencephalon |
|
|
Term
| The four vestibular nuclei in the rostral medulla are associated with which areas of the brain? |
|
Definition
-cerebellum (flocculonodular lobe)
-reticular formation (motion sickness)
-medial longitudinal fasciculus (MLF)
-vestibulospinal tracts |
|
|
Term
| What are signs associated with central vestibular lesions? |
|
Definition
-head tilt, strabismus, nystagmus
-proprioceptive deficits, somnolence |
|
|
Term
| What are signs associated with peripheral vestibular lesions? |
|
Definition
-head tilt, strabismus, nystagmus
-NO change in proprioception or somnolence |
|
|
Term
| What signs are associated with lesions in the cerebellum? |
|
Definition
-NO PROPRIOCEPTION DEFICITS, NO WEAKNESS
-tremors
-ataxis of head and limbs
-absence of menace ipsilaterally
-+/- vestibular signs |
|
|
Term
| What signs are associated with lesions in the thalamocortex? |
|
Definition
-abnormal behavior
-circling towards side of lesion
-seizures
-normal gait
-central blindness
-contralateral deficits in menace, postural reactions, nasal sensation |
|
|
Term
| How do you test for lesions in the thalamocortex? |
|
Definition
-mental status = behavior
-menace
-nasal sensation (symmetry)
-proprioception and hopping |
|
|
Term
| When does one use a myelography? |
|
Definition
-used to evaluate the spinal cord for evidene of compression
-use iodinated contrast medium instilled into subarachniod space to outline the spinal cord |
|
|
Term
| What are the pros and cons to using CT? |
|
Definition
Pros: shorter exam time, superior bone detail, less motion artifacts
Cons: uses ionizing radiation, limited soft tissue detail, limited multiplanar capability with large slice thickness |
|
|
Term
| What are the pros and cons to using MRI? |
|
Definition
Pros: superior soft tissue imaging, unlimited multiplanar ability, doesn't use ioning radiation
Cons: long exam time, metal can cause artifacts, motion causes problems, inferior bone imaging |
|
|
Term
| What are the two types of IVDD? |
|
Definition
-Hansen Type I: extrusion, acute
-Hansen Type II: protrusion, chronic |
|
|
Term
| What is the most common location for acute IVDD? |
|
Definition
|
|
Term
| What are the signs associated with acute IVDD? |
|
Definition
-back pain
-proprioceptive ataxia
-paraplegia +/- nociception |
|
|
Term
| What are the diagnostic indications for acute IVDD? |
|
Definition
-greater than 2yrs of age
-sudden onset
-use imaging to find lesion |
|
|
Term
|
Definition
conservative: STRICT confinement (4 weeks), anti-inflamm drugs
surgical: decompression and disk removal |
|
|
Term
| Why is bladder care so important when dealing with IVDD? |
|
Definition
| -increased extensor tone = increased tone in the external urethral sphincter, therefore may need to catheterize |
|
|
Term
| What is involved in the pathogenesis of acute spinal cord injury (ASCI)? |
|
Definition
-primary lesion can be concussive (external cause) or cimpressive (internal cause, example is ivdd)
-secondary lesion can be due to electrolyte shifts, ischemia, biochemical changes, apoptosis |
|
|
Term
| How do you diagnose ASCI? |
|
Definition
-CT can help show bone lesions, MRI can detect cord changes
-see a reduction in the vertebral canal and nociception |
|
|
Term
| What are the common fractures/luxations for ASCI in dogs? |
|
Definition
| lumbar > sacrocaudal > TL > cervical |
|
|
Term
| What are the common fractures/luxations for ASCI in cats? |
|
Definition
| sacrocaudal > lumber > TL > cervical |
|
|
Term
| ASCI in which area has the best prognosis? |
|
Definition
| -caudal to L5 cuz there's no spinal cord there |
|
|
Term
|
Definition
-immobilize vertebral column
conservative: confinement
surgical: in paralyzed patients |
|
|
Term
|
Definition
-fibrocartilaginous embolic myelopathy
-spinal cord infarct (ischemic) caused by a fragment of nucleus pulposus |
|
|
Term
| What are the clinical signs of FCEM? |
|
Definition
-acute, non-progressive
-NO PAIN
-asymmetric cutaneous trunci reflex
-Seen in large breeds and schnauzers, any age
-use MRI to confirm diagnosis |
|
|
Term
|
Definition
-early physical therapy
-condition should remain static or improve |
|
|
Term
| What are the top four differential diagnoses for chronic paraparesis? |
|
Definition
-IVDD (Type II)
-degenerative myelopathy
-spinal tumors
-lumbosacral stenosis |
|
|
Term
| What is the pathogenesis of Type II IVDD? |
|
Definition
-degeneration of nucleus pulposus, replaced by fibrocartilage
-disk bulge compresses spinal cord
-seen in large breed, middle age |
|
|
Term
| What is degenerative myelopathy? |
|
Definition
-degenerative disease of the white matterand dorsal roots
-genetic: mutation in SOD1 gene |
|
|
Term
| What are the signs associated with degenerative myelopathy? |
|
Definition
-seen in large breeds, > 5yrs
-symmetrical proprioceptive ataxia
-typically T3-L3
-NON-PAINFUL |
|
|
Term
| How do you treat degenerative myelopathy? |
|
Definition
-poor prognosis
-no good trx, steroids useless
-exercise and physical therapy |
|
|
Term
| What is degenerative lumbosacral stenosis (DLS)? |
|
Definition
-narrowing of spinal column
-seen in large breeds, > 3yrs, have difficulty rising, painful, low tail carriage |
|
|
Term
| What are the signs associated with DLS? |
|
Definition
-cauda equina syndrome (overflow incontinence, decreases tail/anal tone)
-sciatic weakness (decreased reflex, plantigrade stance, increased patellar reflex) |
|
|
Term
|
Definition
-start with decreased activity, steroids, gabapentin for pain
-can do lumbosacral stabilization |
|
|
Term
| What are the three types of spinal neoplasias? |
|
Definition
-extradural
-intradural/extramedullary
-intramedullary |
|
|
Term
| Give examples of extradural neoplasms. |
|
Definition
| lymphomas, myelomas, nerve sheath tumors |
|
|
Term
| Give examples of intradural/extramedullary neoplasms. |
|
Definition
|
|
Term
| Give examples of intramedullary neoplasms. |
|
Definition
|
|
Term
| What is diskospondylitis? |
|
Definition
-infection of intervertebral disks/endplates
-can be bacterial or fungal
-can be a hematogenous spread or from penetration
-seen in large breed, young to middle age |
|
|
Term
| What are signs associated with diskospondylitis? |
|
Definition
-fever, anorexia, lethargy
-spinal pain
-neurologic deficits (+/-) |
|
|
Term
| What is spondylosis deformans? |
|
Definition
-middle age to older
-doesn't cause neuro deficits
-could cause nerve root pain |
|
|
Term
| What is diffuse idiopathic skeletal hyperostosis (DISH)? |
|
Definition
-calcification of tendons
-usually doesn't cause spinal pain
-often an incidental finding |
|
|
Term
| What is the crossed extensor reflex reaction? |
|
Definition
-when you pinch the right toe to get a flexion, but at the same time you get the left leg extension
-indicative of chronic UMN disease |
|
|
Term
| What is Schiff-Sharrington? |
|
Definition
-lesion is at T2-L5/7
-When standing, front limbs are fine and pelvic limbs are paraplegic
-when laying down, front limbs get spastic/high tone, back have decreased tone, and head tilts back |
|
|
Term
| Severe spinal pain can be caused by three main structures. Name them. |
|
Definition
-meninges
-nerve roots
-vertebrae |
|
|
Term
|
Definition
-small breed: C2-3, large breed: C5-6
-neck pain
-proprioceptive ataxia |
|
|
Term
|
Definition
-confinement and steroids
-surgery (ventral decompression) |
|
|
Term
| What may cause atlantoaxial subluxation (AAS)? |
|
Definition
-failure of structural support ligaments between C1 and C2
-most important ligament is the transverse ligament of the axis
-Dens of C2 is very important since 3 of the 4 ligaments attach to it |
|
|
Term
|
Definition
congenital: absence or hypoplasia of dens, or of ligaments
acquired: dens fracture, ligament tear
-seen in toy breeds, <2yrs
-tetraparesis (more in thoracic)
-do NOT manipulate neck |
|
|
Term
|
Definition
-neck brace, steroids
-surgery |
|
|
Term
| What is steroid responsive meningitis-arteritis (SRMA)? |
|
Definition
-immune-mediated response against meninges and arteries in the CNS
-IgA in CSF
-breeds: BBBPG, disease of young dogs
-acute onset, fever, SEVERE pain without nro deficits |
|
|
Term
| How do you diagnose and treat SRMA? |
|
Definition
do spinal tap first, then give dex!
-CSF is cloudy, neurophilic pleocytosis
-treat with immunosuppression |
|
|
Term
| What is cervical spondylomyelopathy (CSM)? |
|
Definition
-Wobbler's Syndrome/ two engine gait
-common in large (>3yrs) or giant breeds (<3yrs)
-2 major forms: IVDD, congenital or acquired osseus malformation |
|
|
Term
| How does CSM develop? What are the signs? |
|
Definition
-disk protrusion, vertebral canal stenosis, cervival enlargement
-signs: change in gait!, cervical hyperesthesia |
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Term
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Definition
-restrict high risk activities
-pred
-surgery
**prognosis the same if you wait or if you do surgery |
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Term
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Definition
-clinical sign
-abnormal cerebral function |
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Term
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Definition
-disease
-recurrent seizures of neural/intracranial origin |
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Term
| What is status epilepticus? |
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Definition
| -prolonged seizure of more than 15 min |
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Term
| What are the phases of a seizure? |
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Definition
-prodrome: no brain changes, but feel weird; can preceed by days or hours
-aura: animal is agitated, see brain changes
-ictus: the actual seizure
-posictal: can still have deficits
-interictal: completely back to normal |
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Term
| When is the best time to have a neural exam? |
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Definition
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Term
| What are the two types of generalized seizures? |
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Definition
-motor: convulsion
-non-motor: absence seizures (rare) |
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Term
| What are the components of the generalized seizure? |
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Definition
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Term
| What are the components of focal seizures? |
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Definition
-aura present
-consciousness normal or altered
-facial involvement |
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Term
| Will extracranial causes of seizures be generalized or focal? |
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Definition
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Term
| What is idiopathic epilepsy? |
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Definition
-hereditary/primary (presents 1-5yrs)
-functional cerebral dysfunction
-usually have a normal neuro exam during icteral period (any deficits should be symmetrical) |
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Term
| What is structural epilepsy? |
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Definition
-symptomatic/secondary
-intracranial disease
-can see abnormal nro exam
-can be due to tumors, etc |
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Term
| How do you treat epilepsy? |
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Definition
-phenobarbital
-potassium bromide |
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Term
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Definition
-mechanism: increased responsiveness of GABA
-ideal level 23-30 ug/ml
-can cause sedation, PU/PD; watch for hepatotoxicity, tolerance |
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Term
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Definition
-mechanism: hyperpolarize neuronal membranes
-daily dose with a long half life
-need to make sure the diet doesn't change; not commercially available :(
-serum ALT and ALP will be elevated |
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Term
| What are some newer anti-epileptics? |
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Definition
-levetiracetam
-zonisaminde
-gabapentin |
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Term
| What are some problems associated with failure of anti-epileptics? |
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Definition
-low oral dose/low serum levels
-inadequate client education (KBr)
-poor owner compliance
-tolerance
-progressive disease
-large breed |
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