Contents

Section 1 Introduction
Introduction
Some Helpful Hints
Neuroanatomy
Overview of the Patient Evaluation
The Neurologic Examination Overview and Form
Neurologic Examination Techniques and Lesion Localization
Evaluation of the Head
Evaluation of the Gait
Evaluation of the Neck, Thoracic Limbs,
Back, Pelvic Limbs, Tail, and Anus
Postural Reactions
Spinal Cord Reflexes
Miscellaneous
Pain Perception
Lesion Localization

Section 2 Dementia, Stupor, and Coma
Definitions
Lesion Localization
Differentiation of Lesions Causing Stupor or Coma
Differential Diagnosis
Common and Occasional Disorders
Rare Causes of Stupor and Coma
Diagnostic Evaluation
Important Historical Questions
Physical Examination
Neurologic Examination
Applicable Diagnostic Tests
Common and Occasional Disorders
Head Trauma
Intoxication
Hypoglycemia
Hepatic Encephalopathy
Meningoencephalitis
Hydrocephalus
Neoplasia
Cerebrovascular Disorders
Hypoxia and 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
Lissencephaly

Section 3 Seizures
Definitions
Lesion Localization
Differential Diagnosis by Age Group
Younger Than 1 Year of Age
1 to 5 Years of Age
Older Than 5 Years of Age
Diagnostic Evaluation
Important Historical Questions
Physical and Neurologic Examinations
Applicable Diagnostic Tests
Seizure Disorders
Probable Symptomatic Epilepsy
Idiopathic Epilepsy
Status Epilepticus Therapy
Maintenance Anticonvulsant Therapy
Phenobarbital
Potassium Bromide
Monitoring Therapy
Diazepam
Adding a Second Drug
Other Rarely Used Anticonvulsant Drugs
At-home Therapy to Control Cluster Seizures

Section 4 Tremors
Definitions
Lesion Localization
Differential Diagnosis
Diagnostic Evaluation
Important Historical Questions
Physical and Neurologic Examinations
Applicable Diagnostic Tests
Tremor Disorders
Hypocalcemia
Hypoglycemia
Intoxications
Nonsuppurative Meningoencephalomyelitis and
Idiopathic Tremors of Adult Dogs
Idiopathic Tremors of Geriatric Dogs
Episodic Idiopathic Head Tremors or Bobbing
Hypomyelination or Dysmyelination

Section 5 Head Tilt, Dysequilibrium and Nystagmus
Definitions
Lesion Localization
The Vestibular System
Differentiation of Vestibular Lesions
Vestibular Labyrinth and Nerves (CN 8)
Vestibular Nuclei and the Medulla Oblongata
Flocculonodular Lobe of the Cerebellum
Differential Diagnosis
Vestibular Labyrinth and Nerve (PNS) Disorders
Medulla Oblongata and Cerebellar (CNS) Disorders
Diagnostic Evaluation
Important Historical Questions
Physical Examination
Neurologic Examination
Applicable Diagnostic Tests
Vestibular Labyrinth and Nerve Disorders
Idiopathic Vestibular Syndrome
Otitis Interna
Head Trauma
Iatrogenic Vestibular Syndrome from Ear Cleaning
Polyps and Neoplasia
Hypothyroidism
Aminoglycoside Intoxication
Medulla Oblongata and Cerebellar Disorders
Meningoencephalitis
Trauma
Cerebrovascular Disorders
Metronidazole Intoxication
Neoplasia
Parasite Migration

Section 6 Cranial Neuropathies and Myopathies
Clinical Signs
Definitions
Lesion Localization
Differentiation of Peripheral and Central Cranial
Nerve Lesions
Differential Diagnosis
Peripheral Nerve and Muscle Disorders
Central Nervous System Disorders (Any Cranial Nerve Sign)
Diagnostic Evaluation
Important Historical Questions
Physical Examination
Neurologic Examination
Applicable Diagnostic Tests
Peripheral Nerve and Muscle Disorders
Blindness
Anisocoria
Strabismus
Jaw Paralysis
Temporalis and Masseter Muscle Atrophy
Facial Nerve Paralysis
Deafness
Dysphagia, Megaesophagus, Dysphonia, and Stridor
Tongue Paralysis or Atrophy
Cranial Polyneuropathies
Dysautonomia
Central Nervous System Disorders

Section 7 Neck or Back Pain
Definitions
Lesion Localization
Differential Diagnosis
Diagnostic Evaluation
Important Historical Questions
Physical and Neurologic Examinations
Applicable Diagnostic Tests
Disorders That Cause Neck or Back Pain
Degenerative Intervertebral Disk Disease
Diskospondylitis and Spondylitis
Meningitis
Vertebral Fractures
Lumbosacral Degeneration
Atlantoaxial Subluxation
Caudal Cervical Spondylomyelopathy
Spondylosis Deformans
Vertebral Neoplasia
Nerve Root and Spinal Cord Neoplasia
Polymyositis and Other Polymyopathies
Polyarthritis
Intracranial Disease

Section 8 Ataxia
Definitions
Lesion Localization
Differentiation of Lesions Causing Ataxia
Cerebellar Lesions
Brainstem Lesions
Spinal Cord Lesions
Sensory Nerve Lesions
Vestibular System Lesions
Differential Diagnosis
Cerebellar Disorders
Spinal Cord Disorders
Sensory Nerve Disorders
Diagnostic Evaluation
Important Historical Questions
Physical and Neurologic Examinations
Applicable Diagnostic Tests
Cerebellar Disorders
Trauma
Meningoencephalitis
Cerebrovascular Disorders
Intoxication
Neoplasia
In-Utero Cerebellar Degeneration and Hypoplasia
Cerebellar Abiotrophy, and other Degenerations
Neuroaxonal Dystrophy
Brain Cysts
Spinal Cord Disorders
Degenerative Intervertebral Disk Disease
Caudal Cervical Spondylomyelopathy
Trauma
Meningomyelitis
Diskospondylitis
Atlantoaxial Subluxation
Neoplasia
Spinal Cord Cysts
Sensory Nerve Disorders
Sensory Polyneuropathy

Section 9 Acute Quadriparesis, Quadriplegia, Hemiparesis, or Hemiplegia
Definitions
Lesion Localization
Differentiation of Spinal Cord and
Neuromuscular Lesions
C1-C5 Spinal Cord Lesions
C6-T2 Spinal Cord Lesions
Neuromuscular Lesions
Differential Diagnosis
Spinal Cord Disorders
Neuromuscular Disorders
Diagnostic Evaluation
Important Historical Questions
Physical and Neurologic Examinations
Applicable Diagnostic Tests
Spinal Cord Disorders
Degenerative Intervertebral Disk Disease
Caudal Cervical Spondylomyelopathy
Trauma
Fibrocartilaginous Embolism
Meningomyelitis
Atlantoaxial Subluxation
Neoplasia
Spontaneous Hemorrhage
Syringomyelia
Neuromuscular Disorders
Acute Polyradiculoneuritis
Tick Paralysis
Snake Envenomation
Myasthenia Gravis
Botulism
Acute Polyneuropathies
Aminoglycoside Intoxication

Section 10 Chronic Quadriparesis
Definitions
Lesion Localization
Differentiation of Spinal Cord and Neuromuscular Lesions
C1-C5 Spinal Cord Lesions
C6-T2 Spinal Cord Lesions
Neuromuscular Lesions
Differential Diagnosis
Spinal Cord Disorders
Neuromuscular Disorders
Diagnostic Evaluation
Important Historical Questions
Physical and Neurologic Examinations
Applicable Diagnostic Tests
Spinal Cord Disorders
Degenerative Intervertebral Disk Disease
Caudal Cervical Spondylomyelopathy
Meningomyelitis
Diskospondylitis
Neoplasia
Lysosomal Storage Disorders
Spinal Cord Cysts
Leukoencephalomyelopathy
Neuromuscular Disorders
Hypothyroid Neuromyopathy
Chronic Idiopathic Polyneuropathy
Protozoal Polyradiculoneuritis/Polymyositis
Polymyopathies
Myasthenia Gravis
Diabetic Polyneuropathy
Insulinoma Polyneuropathy
Paraneoplastic Polyneuropathy
Toxic Polyneuropathy
Congenital or Hereditary Polyneuropathies

Section 11 Episodic and Exercise induced Weakness
Definitions
Lesion Localization
Differential Diagnosis
Systemic Disorders
Neuromuscular Disorders
Miscellaneous Disorders
Differential Diagnosis of Ventral Neck Flexion in Cats
Diagnostic Evaluation
Important Historical Questions
Physical Examination
Neurologic Examination
Applicable Diagnostic Tests
Systemic Disorders
Neuromuscular Disorders
Iatrogenic Corticosteroid Myopathy
Polymyositis
Myasthenia Gravis
Hypokalemic Polymyopathy
Subacute Organophosphate Intoxication
Other Intoxications
Hyperadrenocorticism (Cushing's Myopathy)
Hypoadrenocorticism
Hypothyroid Neuromyopathy
Hyperthyroid Neuromyopathy
Exercise-induced Collapse of Labrador Retrievers
Congenital and Inherited Myopathies
Lipid Storage Myopathy
Mitochondrial Myopathies
Nutritional Polymyopathies
Paraneoplastic Polymyopathy
Thiamine Deficiency
Miscellaneous Disorders
Cataplexy

Section 12 Acute Paraparesis or Paraplegia
Definitions
Lesion Localization
Differentiation of Upper Motor Neuron and Lower Motor Neuron Lesions
T3-L3 Spinal Cord Segments (UMN Lesion)
L4-S2 Spinal Cord Segments or Nerve Roots (LMN
lesion) and Lumbosacral Neuromuscular Lesions 283
Differential Diagnosis
Diagnostic Evaluation
Important Historical Questions
Physical and Neurologic Examinations
Applicable Diagnostic Tests
Neuromuscular Disorders
Aortic Thromboembolism
Spinal Cord Disorders
Degenerative Intervertebral Disk Disease
Spinal Cord Trauma
Fibrocartilaginous Embolism
Meningomyelitis

Neoplasia Section 13 Chronic Paraparesis
Definitions
Lesion Localization
Differentiation of Upper Motor Neuron and Lower
Motor Neuron Lesions
T3-L3 Spinal Cord Segments (UMN Lesion)
L4-S2 Spinal Cord Segments (LMN Lesion)
and Lumbosacral Neuromuscular Lesions
Differential Diagnosis
Diagnostic Evaluation
Important Historical Questions
Physical and Neurologic Examinations
Applicable Diagnostic Tests
Spinal Cord Disorders
Degenerative Intervertebral Disk Disease
Degenerative Myelopathy
Lumbosacral Degeneration
Meningomyelitis
Diskospondylitis
Hemivertebra and Other Vertebral Malformations
Neoplasia
Spinal Cord Cysts
Lysosomal Storage Disorders
Neuromuscular Disorders
Polyradiculoneuritis/Myositis
Other Polyneuropathies and Polymopathies

Section 14 Monoparesis and Monoplegia
Definitions
Lesion Localization
Differential Diagnosis
Acute Nonprogressive Monoparesis or Monoplegia
Chronic Progressive Monoparesis or Monoplegia
Diagnostic Evaluation
Important Historical Questions
Physical Examination
Neurologic Examination
Applicable Diagnostic Tests
Disorders Causing Monoplegia or Monoparesis
Nerve Root, Plexus, or Nerve Trauma
Fibrocartilaginous Embolism
Thromboembolism
Degenerative Intervertebral Disk Disease
Neoplasia

Section 15 Flaccid Tail, Anus, and Bladder Definitions
Lesion Localization
Differential Diagnosis
Diagnostic Evaluation
Important Historical Questions
Physical Examination
Neurologic Examination
Applicable Diagnostic Tests
Lumbosacral Disorders
Nerve Root Trauma
Lumbosacral Degeneration
Fibrocartilaginous Embolism
Diskospondylitis
Sacrocaudal Agenesis
Bite Wound Abscess
Neoplasia

Section 16 Miscellaneous Neurologic Syndromes
Definitions
Lesion Localization
Diagnostic Evaluation
Miscellaneous Disorders
Tetanus
Canine Distemper Myoclonus
Muscle Cramping Syndromes
Hyperesthesia and Self-Mutilation
Dancing Doberman Disease
Narcolepsy
Rapid-Eye-Movement Behavior Disorder
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