Body Systems IINeurologic Examination - Reflex testing and lesion

localisation

Lesion SiteA - H

Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

3 video case examples

Abnormal cranial nerve function

Reflex testing

0 = absent

1+ = hyporeflexia

2+ = normal

3+ = hyperreflexia

4+ = hyperreflexia & clonus

Abnormal limb function

weakness

ataxia

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

A Brainstem

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

A Brainstem

Abnormal

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

A Brainstem

Abnormal Depressedor

Absent

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

A Brainstem

Abnormal Depressedor

Absent

Abnormal

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

A Brainstem

Abnormal Depressedor

Absent

Abnormal Normalto

Clonic

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

A Brainstem

Abnormal Depressedor

Absent

Abnormal Normalto

Clonic

Abnormal

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

A Brainstem

Abnormal Depressedor

Absent

Abnormal Normalto

Clonic

Abnormal Normal to

Clonic

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

BPeripheral

Cranial Nerves

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

BPeripheral

Cranial Nerves

Abnormal

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

BPeripheral

Cranial Nerves

Abnormal Depressedor

Absent

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

BPeripheral

Cranial Nerves

Abnormal Depressedor

Absent

Normal

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

BPeripheral

Cranial Nerves

Abnormal Depressedor

Absent

Normal Normal

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

BPeripheral

Cranial Nerves

Abnormal Depressedor

Absent

Normal Normal Normal

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

BPeripheral

Cranial Nerves

Abnormal Depressedor

Absent

Normal Normal Normal Normal

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

CC1-C6

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

CC1-C6

Normal

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

CC1-C6

Normal Normal

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

CC1-C6

Normal Normal Abormal

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

CC1-C6

Normal Normal Abormal Normal to

Clonic

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

CC1-C6

Normal Normal Abormal Normal to

Clonic

Abormal

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

CC1-C6

Normal Normal Abormal Normal to

Clonic

Abormal Normalto

Clonic

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

DC7-T2

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

DC7-T2

Normal

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

DC7-T2

Normal Normal

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

DC7-T2

Normal Normal Abormal

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

DC7-T2

Normal Normal Abormal Depressedor

Absent

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

DC7-T2

Normal Normal Abormal Depressedor

Absent

Abormal

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

DC7-T2

Normal Normal Abormal Depressedor

Absent

Abormal Normalto

Clonic

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

ET3-L2

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

ET3-L2

Normal Normal Normal Normal

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

ET3-L2

Normal Normal Normal Normal Abormal Normalto

Clonic

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

FL3-S3

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

FL3-S3

Normal Normal Normal Normal

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

FL3-S3

Normal Normal Normal Normal Abormal

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

FL3-S3

Normal Normal Normal Normal Abormal Depressedor

Absent

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

HDiffuseLMN

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

HDiffuseLMN

Abormal

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

HDiffuseLMN

Abormal Depressedor

Absent

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

HDiffuseLMN

Abormal Depressedor

Absent

Abormal

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

HDiffuseLMN

Abormal Depressedor

Absent

Abormal Depressedor

Absent

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

HDiffuseLMN

Abormal Depressedor

Absent

Abormal Depressedor

Absent

Abormal

Lesion Site Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

HDiffuseLMN

Abormal Depressedor

Absent

Abormal Depressedor

Absent

Abormal Depressedor

Absent

Case 1 – 3 week old lamb

Case 1 Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

3 week old lamb

Case 1 Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

3 week old lamb

Normal Normal

Case 1 Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

3 week old lamb

Normal Normal Normal Normal

Case 1 Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

3 week old lamb

Normal Normal Normal Normal Abormal

Case 1 Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

3 week old lamb

Normal Normal Normal Normal Abormal Hyper with

clonus

Case 1 Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

3 week old lamb

Normal Normal Normal Normal Abormal Hyper with

clonus

Case 1 – 3 week old lamb• bright & alert

• normal forelimbs

• paraplegic

• hyperactive HL reflexes

• dribbling urine

Lesion at T3 – L3

T12 vertebral abscess

Case 2 – 8 YEAR OLD MARE

Case 2 Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

8 year old mare

Case 2 Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

8 year old mare

Abnormal Depressed or

Absent

Case 2 Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

8 year old mare

Abnormal Depressed or

Absent

Normal Normal Normal Normal

Case 2 Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

8 year old mare

Abnormal Depressed or

Absent

Normal Normal Normal Normal

Case 2 – 8 YEAR OLD MARE• bright & alert

• paralysed left face

• no left facial reflexes

• [additional vestibular signs – CNVIII]

Trauma to left Facial nerve in guttural pouch

Mare doing well

Case 3 – 8 yo GS Bitch

Case 3 Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

8 year old GS bitch

Case 3 Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

8 year old GS bitch

Abnormal Depressed

Case 3 Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

8 year old GS bitch

Abnormal Depressed Abnormal Depressed Abnormal Depressed

Case 3 Cranial Nerve

Function

Cranial Nerve

Reflexes

Forelimb Function

Forelimb Reflexes

Hindlimb Function

Hindlimb Reflexes

8 year old GS bitch

Abnormal Depressed Abnormal Depressed Abnormal Depressed

Case 3 – 8 yo GS Bitch• tetraparetic [weak in all 4 limbs]

• poor reflexes in all limbs

• weak tongue

• good response to edrophonium

[anticholinesterase drug]

acquired myasthenia gravis

managed on oral prednisolone

Body Systems IINeurologic Examination - Reflex testing and lesion

localisation