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Neurology for the Small Animal Practitioner Cheryl Chrisman DVM, MS, Ed.S., DipACVIM (Neurology) Christopher Mariani DVM, DipACVIM (Neurology) Simon Platt BVM&S, MRCVS, DipACVIM (Neurology), DipECVN, RCVS (Neurology) Roger Clemmons DVM, Ph.D. Made Easy Series Teton NewMedia Table of Contents Section 1 Introduction Introduction ....... . : 3 Some Helpful Hints... .............22.0.0004. 3 Neuroanatomy. ..... 0.000255 e ee eee eee eee 4 Overview of the Patient Evaluation ........... 9 The Neurologic Examination Overview and Form ..... 6... eee eee eee ee eee 13 Neurologic Examination Techniques and Lesion Localization ..............--. 15 Evaluation of the Head ..........-...-000-0005 15 Evaluation of the Gait .............0. 0000-0005 22 Evaluation of the Neck, Thoracic Limbs, Back, Pelvic Limbs, Tail, and Anus ........--.- 24 Postural Reactions . . . Spinal Cord Reflexes . Miscellaneous Pain Perception . . sees : Lesion Localization ... 0.6.0... 00 000 e eee eee 37 Section 2 Dementia, Stupor, and Coma Definitions ... 0... 6.06 e eee eee eee 42 Lesion Localization ............0.000000008 43 Differentiation of Lesions Causing Stupor or Coma... . 2. ee eee 44 Differential Diagnosis .............-.020055 44 Common and Occasional Disorders .........-..-- 44 Rare Causes of Stupor and Coma......... - 45 Diagnostic Evaluation...............-- - 46 Important Historical Questions ...........- - 46 Physical Examination 46 Neurologic Examination .............-0+000004 47 Applicable Diagnostic Tests ...........-...2---8 48 Common and Occasional Disorders. .........- 50 Hypoglycemia _............ . 58 Hepatic Encephalopathy .... . 61 Meningoencephalitis ....... - 63 Hydrocephalus ..........-- Neoplasia ........ +... ++ - Hypoxialand Anoxia .......+. Cognitive Dysfunction Syndrome _. . Rare Causes of Stupor and Coma .. Diabetes Mellitus ............ Hypothyroidism ..........- Hyponatremia _...........- Hypernatremia ...........- Uremic Encephalopathy Thiamine Deficiency ....... Lysosomal Storage Disorders _.........- Epidermoid, Dermoid, and Arachnoid Cysts ...... . 84 Lissencephaly .... 0... ++ +s ee eee eee tee eet 84 Differential Diagnosis by Age Group Younger Than 1 Year of Age ...... lto 5 Years of Age........- Older Than 5 Years of Age Diagnostic Evaluation...... Important Historical Questions . Physical and Neurologic Examinations Applicable Diagnostic Tests ...................- 95 Sei Disord 99 Probable Symptomatic Epilepsy ................ 101 Idiopathic Epilepsy .............. _-101 Status Epilepticus Therapy ............ - 102 Maintenance Anticonvulsant Therapy ....... 106 Phenobarbita 106 Potassium Bromid 108