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Neurology: examination – adult
Introduction
- The neurologic examination is the most important diagnostic tool in the evaluation of neurologic disease.
- The objective is to localize the site of the lesion in the nervous system and decide upon possible etiologies.
- An understanding of the function and anatomy of the central nervous system (CNS) is essential.
Uses
- Suspected lesion(s) involving the CNS.
- Recumbency following trauma.
- To determine the site(s) of lesions and therefore, their possible etiologies, treatment and prognosis for recovery.
- Possible hepatic encephalopathy.
Advantages
- Diagnostically very informative.
- Within the scope of all veterinarians and no specialist equipment required, although subtle lesions can be difficult to assess if facilities and expertise are not good enough.
Disadvantages
- Neurological status can change rapidly.
- Multi-lesion diseases can be difficult to interpret.
- Must be analyzed with adjunctive diagnostics including blood work and advanced imaging.
Technical problems
- A sound knowledge of the functioning and anatomy of the CNS is essential.
- Suitable facilities are essential; this should include a trot up, different surfaces, poles and light and dark rooms.
Procedure
- 15-30 min.
Decision taking
Criteria for choosing test
- General physical examination may lead to suspicion of neurologic disease.
- History of tripping, stumbling, changes in behavior, circling or any other clinical signs associated with neurological diseases.
Risk assessment
- Horses with neurological disease can be dangerous to handle and care should be taken.
- Ensure the handler and examiner are always on the same side of the horse.
- Wear appropriate personal protective equipment.
- If in the stable with the horse, then ensure there is a safe exit route.
Requirements
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Preparation
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Technique
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Aftercare
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Mitchell C W et al (2012) The use of magnetic resonance imaging in evaluating horses with spinal ataxia. Vet Radiol & Ultrasound 53 (6), 613-620 PubMed.
- Licka T F (2011) Differentiation of ataxic and orthopedic gait abnormalities in the horse. Vet Clin North Am Equine Pract 27 (3), 411-416 PubMed.
- Knottenbelt D C (1996) Equine neurologic disease and dysfunction - a diagnostic challenge for the practitioner. Part 2 - The clinical neurologic examination. Equine Vet Educ 8 (5), 260-270 WileyOnline.
- Lunn D P & Mayhew I G (1989) The neurologic examination of horses. Equine Vet Educ 1 (2), 94-101 WileyOnline.
- Reed et al Ataxia and paresis in horses - differential diagnosis. The Compendium 3 (3).
Other sources of information
- Mayhew I G (1989) Large Animal Neurology - A Handbook for Veterinary Clinicians. Lea & Febiger, USA.