Neurologic Examination Neurologic Examination Head Neck forelimbs Trunk
Neurologic Examination
Neurologic Examination Head Neck & forelimbs Trunk & hindlinbs Tail & anus Gait & posture Ancillary aids
Cranial nerves Slap test TL reflex
Neck & forelimbs
Neck & forelimbs
Trunk & hindlinbs
Trunk & hindlinbs
Tail & anus
Gait & posture
Gait & posture Ataxia
Gait & posture Weakness
Gait & posture
Case History • 12 yo Cleveland Bay mare • Sudden onset grade 4 ataxia and paraparesis
Neurologic Examination © 2003 Joe Mayhew Click the button to play the movie
Lesion location
CSF
Possible cause?
Equine Ataxia
VIDEO CASE 1 * 7 year old riding gelding * abrupt onset ataxia * weakness * urinary incontinence
VIDEO CASE 1 © 2003 Joe Mayhew Click the button to play the movie
CSF
EHV-1 Myeloencephalopathy
VIDEO CASE 2 * 8 year old pregnant mare * sudden onset of signs * swelling at level of axis
VIDEO CASE 2 © 2003 Joe Mayhew Click the button to play the movie
Cervical radiographs
VIDEO CASE 3 * yearling TB gelding * 1 month progressive ataxia
VIDEO CASE 3 © 2003 Joe Mayhew Click the button to play the movie
Cervical radiographs
Type I CVM “dynamic compression” • mostly young patients • formative vertebral changes - DOD • vertebral canal stenosis
VIDEO CASE 4 * 4 year old Arabian gelding * 12 weeks progressive ataxia
VIDEO CASE 4 © 2003 Joe Mayhew Click the button to play the movie
Cervical radiographs
Type II CVM “static compression” • • older patients proliferative osteoarthritis caudal neck malformed pedicles and arch
Type II CVM • trauma? • osteochondrosis? • both?
VIDEO CASE 5 * adult riding gelding * abrupt onset of unsteadiness/ataxia * muscle tremors
VIDEO CASE 5 © 2003 Joe Mayhew Click the button to play the movie
Ryegrass Staggers • Diffuse Spino-vestibulo-cerebellar Syndrome • hypometric ataxia • little weakness • muscle tremor • muscle fasciculation • ataxic eyeball movements • ‘convulsive’ episodes
VIDEO CASE 6 * 6 month old Eriskay pony * 3 months progressive ataxia
VIDEO CASE 6 © 2003 Joe Mayhew Click the button to play the movie
VIDEO CASE 6
VIDEO CASE 6 Cerebellar Degeneration [Abiotrophy]
Equine Protozoal Myeloencephalitis
EPM • Sarcocystis neurona • definitive host - North American opossum • int. hosts – racoon, armadillo …. . • serum immunoblot test for antibodies • CSF pcr for antigenic sequences
EPM • Treatment • sulfadiazine and pyrimethamine • diclazuril, toltrazuril • nitazoxanide • Vaccine
West-Nile Virus Encephalomyelitis Reservoir Dead end hosts
West-Nile Virus Encephalomyelitis Clinical Signs Increased Body Temperature Anorexia Weakness Ataxia Abnormal Mentation Fasciculations Cranial Nerve Deficits Teeth Grinding Ptyalism % 65 57 94 72 67 61 44 20 7
West-Nile Virus Encephalomyelitis Diagnosis • CSF – 70% abnormal • Serology – Ig. M ELISA; 93% sensitivity
West-Nile Virus Encephalomyelitis • 35% mortality • Vaccination – at least twice yearly • Remove stagnant water
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