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Neurological causes of lameness

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Abstract

Neurological conditions can mimic orthopaedic disorders and lead to lameness as the main clinical sign, commonly described using the terms paresis, plegia or ataxia. This chapter covers neurological examination, diagnostic procedures, traumatic nerve injury, vascular disease, degenerative disease, inflammatory diseases, neoplasia, neurological conditions caused by toxins and intermittent lameness.

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Figures

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12.1 Labrador Retriever showing left pelvic limb nerve root signature caused by lumbosacral foraminal stenosis. (© Sebastien Behr)
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12.2 Lesion localization for monoparesis. Spinal cord segments C6–T2 and L4–S3 are highlighted. Designed and drawn by Vicki Martin Design and printed with their permission.
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12.5 Anatomy of peripheral innervation of the thoracic limb. Designed and drawn by Vicki Martin Design and printed with their permission.
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12.6 Cutaneous autonomous zones of innervation of the thoracic limb. Designed and drawn by Vicki Martin Design and printed with their permission. (Based on )
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12.9 Miniature Schnauzer with thoracic limb monoparesis and proprioceptive deficit due to an ischaemic myelopathy. Note the knuckling of the right thoracic limb. (© Sebastien Behr)
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12.10 Neurological pathways of the cutaneous trunci reflex. Cutaneous stimulation along the thoracolumbar region often elicits a twitching of the skin. The twitching is due to confraction of the cutaneous trunci muscle. Designed and drawn by Vicki Martin Design and printed with their permission.
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12.11 Pathway of the sympathetic innervation of the eye (Horner’s syndrome). (© Jacques Penderis)
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12.12 Dog with neurological thoracic limb lameness showing ipsilateral Horner’s syndrome caused by a brachial plexus tumour. (© Sebastien Behr)
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12.13 Anatomy of peripheral innervation of the pelvic limb. Designed and drawn by Vicki Martin Design and printed with their permission.
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12.14 Cutaneous autonomous zones of innervation of the pelvic limb. Designed and drawn by Vicki Martin Design and printed with their permission. (Based on )
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12.17 Electromyogram of the cranial tibial muscle in a dog recorded under general anaesthesia showing fibrillation potentials due to denervation. (© Sebastien Behr)
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12.18 Dorsal STIR MR image of a lumbar plexus tumour (arrowed) in a dog. (© Sebastien Behr)
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12.20 Sensory loss associated with brachial plexus avulsion. Shaded zones are dermatomes that lack sensation. (a) Cranial plexus avulsion. (b) Caudal plexus avulsion. (c) Complete plexus avulsion. Designed and drawn by Vicki Martin Design and printed with their permission. (Based on )
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12.21 Transverse CT myelogram of a cat with a brachial plexus avulsion injury. Contrast medium can be seen escaping from the dura at the level of the intervertebral foramen (arrowed).
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12.22 Transverse T2-weighted MR image at the level of L3 in a dog with an ischaemic myelopathy. Note the well demarcated hyperintensity within the spinal cord (arrowed). (© Sebastien Behr)
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12.23 Doppler ultrasonogram of an aortic thrombus in a Greyhound with intermittent progressive paraparesis and exercise intolerance. Note the obstruction of the blood flow in the aorta (orange) due to the thrombus (arrowed), leading to hypoperfusion of the hindlimbs. (© Sebastien Behr)
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12.24 Transverse T2-weighted MR image of a lateralized cervical disc extrusion (Hansen type I) at C5 in a dog causing severe ventrolateral compression of the spinal cord and nerve root (arrow showing the lateralized disc extrusion). (© Sebastien Behr)
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12.25 Transverse T2-weighted MR image of a cervical juxta-facet cyst at C5–C6 in a dog causing dorsolateral compression of the spinal cord and nerve root (arrow showing the juxta-facet cyst). (© Sebastien Behr)
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12.26 Lateral survey radiographs of the cervical spine of a Great Dane. Note the articular facet hypertrophy (arrowed) at the level of C5–C6. (© Sebastien Behr)
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12.27 CT scan of a dog showing bilateral lumbosacral foraminal stenosis due to lateralized spondylosis and osteoproliferation (arrowed). (© Sebastien Behr)
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12.28 Dorsal STIR MR image of the lumbar spine in a dog. Note the thickened and hyperintense L7 nerve root (arrowed), within the vertebral canal secondary to foraminal stenosis. (© Sebastien Behr)
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12.29 Transverse T2-weighted MR image of a severe and lateralized lumbosacral foraminal stenosis due to lateralized spondylosis (arrowed) in a 2-year-old dog, causing pelvic limb lameness. (© Sebastien Behr)
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12.31 Sagittal T2-weighted MR images of the caudal cervical vertebral column (arrowed) (a) before and (b) after traction. The ventral compression of the spinal cord at the level of the C6–C7 intervertebral disc almost completely resolves on the traction image consistent with a traction-responsive disc-associated lesion at C6–C7. (© Sebastien Behr)
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12.32 Lateral survey radiograph of a dog showing discospondylitis (A) and lumbosacral ventral spondylosis (B). Note the irregular endplates at L7–S1 consistent with osteolysis. (© Sebastien Behr)
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12.33 A 9-year-old Yorkshire Terrier with right forelimb lameness and muscle atrophy due to a peripheral nerve sheath tumour. (© Sebastien Behr)
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12.34 Transverse T2-weighted MR image at the level of L7–S1 in a dog showing an L7 peripheral nerve sheath tumour (arrowed). (© Sebastien Behr)
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12.35 Dorsal STIR MR image at the level of the brachial plexus in a dog (ventral to the vertebral column). Note the enlargement of the brachial plexus on the left (arrowed) due to a brachial plexus tumour. (© Sebastien Behr)
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12.36 Transverse post-contrast CT scan showing contrast uptake by and enlargement of peripheral nerve C8 (arrowed), as well as associated foraminal enlargement, in a dog. (© Sebastien Behr)
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12.37 Intraoperative view during thoracic limb amputation as treatment for confirmed malignant peripheral nerve sheath tumour affecting the radial nerve (arrowed) in a dog. Tumour excision was complete according to histopathology. (© Sebastien Behr and Rob White)

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