Dr. Csébi Péter, Dr. Ipolyi Tamás
Sebészeti Tanszék
Neurological examination is the most important part
of the clinical evaluation of the neurological
patient
Auxilary examinations:
Radiology, MRI, CT, Scintigraphy, ect.
The neurological examination should be
always performed slowly and playfully
without causing unnecessary stress to the
animal!
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Define if the animals problem is neurological
or not
Define which part of the nervous system is
affected
Make the list of possible diseases able to cause
the condition
Make the diagnostic work-up plan in order to
confirm the diagnosis
D egenerative
V
I
T
A
ascular
Discopathia
Degenerative myelopathy
Thrombosis
diopathic
raumatic, toxic
Luxatio, fractura
nomaly
vertebtal malformatio
M etabolic
I nflammatory/infectiosus
N eoplasma, nutritional
FIP, Toxoplasma,
Discospondylitis
Lymphoma
Osteosarcoma
Menigioma
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(Pelvic) fractures
Patellar luxation
Cranial Cruciate rupture
Coxofemoral osteoarthrosis
Other diseases: myopathy,
aorta embolisation
Bilateral
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Observation
Palpation/manipulation
Cranial nerves
Postural reactions
Spinal reflexes
Urinary function
Sensory evaluation
1.
2.
3.
4.
5.
6.
7.
Mental status
Behaviour
Posture, gait
Postural reactions
Head nerves
Spinal reflexes and
Pain perception
Posture must be evaluated while the patient is at
rest. The position of the head, neck, back, and
legs are evaluated.
Head:
Tilt/Twist
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Trunk:
Abnormal muscle tone
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Limbs: proprioceptive deficit, LMN or UMN
lesion
– Increased tone in extensor muscles - UMN
– Decreased tone - LMN lesion
Uneven distribution of weight - weakness or
pain
Lameness
Must be differentiated from
monoparesis/monoplegia
 Circling
 Involuntary movement
Tremor – an involuntary, rhythmic, oscillating
movement
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Patient must be able to move freely on a non-slip
surface
Ataxia :
failure of muscle coordination
 Dysmetria :
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improper range and/or force of movement
 Paresis :
deficit of voluntary movement, but patient is able to walk
 Plegia :
complete loss of voluntary ability to move, patient cannot
stand, support itself, or walk
 Paralysis :
complete loss of motor function, term used when cranial
nerve function is completely lost
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Postural Reactions:
 Proprioceptive Positioning
 Wheelbarrowing, Neutral and with
Head Extended
 Extensor Postural Thrust Reaction
 Hopping
 Hemistanding/Hemiwalking
 Placing Reaction
The awareness of where the limbs are in space
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Visual placing
reaction
Tactile placing
reaction
triceps
Sciatic,
tibial cr.
Biceps,
ext. carpi rad.
C1-C5
Motor
function
Sensory
function
Patellar
C6-T2
Tetrapatesis, tetraplegia
UMN- all limbs
UMN- pelvic limb,
LMN- thoracic limb
Ataxia- all limbs
Hypalgesiaall limbs
Hypalgesiathoracic limb
T3-L3
L4-S1
Paraparesis, paraplegia
UMN- pelvic
limb
LMN- pelvic
limb
Ataxia- pelvic limb
Hypalgesia/analgesia Pelvic limb
Clinical signs correlate with the diameter of fibers,
but not with the localization!
Forelimbs: norm/increased 
Hindlimbs: norm/increased 
UMN sign
LMN of forelimbs
UMN of hindlimbs
Cerebral signs:
Seizures, cranial nerve
abnormalities
Encephaloptahy
Forelimbs: decreased 
Hindlimbs: decreased 
Forelimbs: decreased
Hindlimbs: norm/increased 
LMN of all four legs
No cerebral
signs
Spinal chord
lesion C1-C5
Vertebral fracture/luxation
Disc herniation,
Fibrocartilaginous embolism
Meningomyelitis
X-ray, CT, MRI
Spinal chord
lesion C6-T2
Multifocal
spinal chord
disease
Meningomyelitis
CSF (liquor)
tap, MRI, CT
Neuromus
cular
disorder
Polyradiculoneuritis
Metabolic disorders
Myasthenia
polymyositis
Blod tests
Flaccid paresis/plegia
Reduced to absent reflexes in the
hindlimbs
Possible urinary retention
Possible urinary or faecai incontinence
Spastic paresis/plegia
Increased hindlimb reflexes
Possible urinary retention
LMN signs
UMN signs
T3-L3
L4-S2
Absence femoral pulse, cold limbs, pale
or buish pads, reduction or absence of
pain sensation : Cat
Vertebral fracture, luxation,
herniated disc,
fibrocartilaginous embolism
Xray, myelography, CT, MRI
Ischemic neuropathy following an
aortic thromboembolism
Ultrasonography: HCMP
Hit by a car 1 hour ago
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Lamness in the right thoracic limb
No bears weight on the limb
The paw is held in a knuckled-over position
All other limbs ok, cranial nerves ok
Ipsilateral Horner’s syndrome on the right eye
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Superfitial pain- absent
(Deep pain- absent)
Bicipital reflex- 0
Tricipital reflex- 0
Exstensor carpi radialis reflex- 0
Proprioceptive positioning- 0
Negative sensation on medial, lateral, cranial,
and palmar aspects of the foot
Ipsilateral Horner’s syndrome
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LMN injury
Radial nerve paralysis
And what about Horner’s?
 The firs 3 thoracic segments contain neurons that
from the symphatic nerves that innervate the eye.
Yesterday jumped down off the owner’s kitchen
counter
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Paraparesis, pelvic limb
Superficial pain- present
(Deep pain- present)
Patellar reflex- increased (bilateral)
Sciatic reflex- increased (bilateral)
Withdrawal reflex- increased (bilateral)
Cranial tibial reflex- increased (bilateral)
Proprioceptive reflex decreased (bilateral)
Pain upon palpation of the spine overlying Th12-Th13
Paraparesis
UMN injury to the pelvic limbs
D egenerative
V
I
T
A
ascular
Discopathia
Degenerative myelopathy
Thrombosis
diopathic
raumatic, toxic
Luxatio, fractura
nomaly
vertebtal malformatio
M etabolic
I nflammatory/infectiosus
N eoplasma, nutritional
FIP, Toxoplasma,
Discospondylitis
Lymphoma
Osteosarcoma
Menigioma
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

Native x-ray
Myelography
CT, MRI
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Diagnosis:
Vertebral
malformation
Intervertebral disc
disease
Other vet diagnosed bilateral hip dysplasia 3
moths ago.
 No diagnostic testing, got carprofen 2x/day
 Improved slightly but now is worse
Signs:
 Difficult to get up,
 Bilateral hindlimb ataxia (worse on left side)
 Knucking over both pelvic limbs
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Cranial nerves ok
Thoracic limb ok
Pelvic limb bilateral ataxia, with shores on the
dorsal surfaces of both feet
Patellar reflex- increased (bilateral)
Sciatic reflex- decreased (bilateral)
Cranial tibial reflex- decreased (bilateral)
Proprioceptive reflex- decreased (bilateral)
Hip dysplasia- explain the signs?
 CEC
(What is pseudohyperreflexia?)
 Discopathia intervertebralis
 Neoplasma
 Degenerative myelopathy
 Fibrocartilage embolism
 Discospondylitis
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L4
L5
N. femoralis L4,5,6.
N. obturatorius (L4), 5,6.
N. gluteus cranisalis L6,7, S1.
L6
N. gluteus caudalis L7. S1
L7
CEC
N. ischiadicus L6, 7, S1, (2)
S1
N. peroneus communis
S2
N. tibialis
N. pudendus
S3
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Radiology
Myelography
CT, MRI