Difference between revisions of "Polyneuritis Equi"

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(Created page with "* A non-infectious central nervous inflammatory disease * Polyneuritis equi (PNE) is an uncommon disease which affects mature horses * Formerly k...")
 
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** In endemic areas, ''Sarcocystis neurona'' myelitis (equine protozoal myelitis), rabies and ''rhodococcus equi'' myeloencepahlitis should also be considered.
 
** In endemic areas, ''Sarcocystis neurona'' myelitis (equine protozoal myelitis), rabies and ''rhodococcus equi'' myeloencepahlitis should also be considered.
  
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Cauda Equina Traction - in small animals
 +
:Tail pull injury
 +
:Esp. cats after RTA
 +
:Lesion via longitudinal traction
 +
:Sacrocaudal dislocation/fracture
 +
:Limp tail
 +
:Incontinence
 +
:Hindlimb Paresis
 +
:Diagnosis on Clinical signs and history
 +
:+/- Radiographs to show dislocation/fracture
 +
:Prognosis difficult to predict
 +
:Poor prognosis if tail limp & no anal tone
 +
:Supportive treatment
 +
:Persist for >3 months if possible
 +
 +
Cauda Equina Neuritis - large animals
 +
:Equine version of Idiopathic polyradiculoneuritis
 +
:Extradural nerve roots of cauda equina thickened and discoloured
 +
:Inflammatory infiltrate (lymphocytes, plasma cells, macrophages)
 +
:Extensive axonal damage and demyelination
 +
:Cranial nerve involvement often occurs
 +
:Aetiology unknown:
 +
:Antecedent infection?
 +
:Antibodies to PNS myelin?
 +
:Paralysis & anaesthesia of tail
 +
:Urinary incontinence
 +
:Loss of anal reflex
 +
:Failure to defaecate
 +
:Pain/hypersensitivity in gluteal/tail-head area
 +
:Clinical signs
 +
:Recovery unlikely - most animals are destroyed.
  
 
[[Category:Central Nervous System - Idiopathic Pathology]]
 
[[Category:Central Nervous System - Idiopathic Pathology]]

Revision as of 14:00, 9 March 2011

  • A non-infectious central nervous inflammatory disease
  • Polyneuritis equi (PNE) is an uncommon disease which affects mature horses
  • Formerly known as 'cauda equina syndrome' or 'cauda equina neuritis'
  • May occur as:
    • A disease effecting the spinal nerve roots and ganglia of the cauda equina.
    • A disease effecting the cranial nerves.
  • Cauda equina disease is characterised by progressive loss of anal tone, tail paralysis, urinary and/or faecal incontinence, urine scalding of the hindlimbs, hyperaesthesia and muscle fasciculations over hindquarters.
  • If the pelvic nerve roots are also involved, there may be changes in hindlimb gait.
  • Cranial nerve signs may be apparent, including signs associated with facial nerve paralysis.
  • Changes in the CSF are often non-specific.
    • There is usually a moderate mononucloear pleocytosis.
    • Protein is usually elveated.
  • Histologically, the disease presents as a severe, chronic, destructive lymphocytic and histiocytic polyradiculoneuritis.
  • Pathogenesis is not completely understood, but considered to be a T-lymphocyte mediated response to myelin, followed by destruction of myelin and axons by macrophages
  • Disease appears similar to:
    • Guillain-Barré Syndrome (GBS), an autoimmune demyelinating diease in humans
    • Experimental allergic neuritis (EAN) in laboratory animals
  • Important differential diagnoses for progressive neurologic signs effecting the bladder, rectum, perineum, tail, penis and hindlimbs in horses include:
    • Equine herpesvirus-1 myeloencephalopathy
    • Sacral/coccygeal trauma
    • Equine motor neuron disease
    • Abberant parasite migration (e.g. Strongylus spp.)
    • In endemic areas, Sarcocystis neurona myelitis (equine protozoal myelitis), rabies and rhodococcus equi myeloencepahlitis should also be considered.


Cauda Equina Traction - in small animals

Tail pull injury
Esp. cats after RTA
Lesion via longitudinal traction
Sacrocaudal dislocation/fracture
Limp tail
Incontinence
Hindlimb Paresis
Diagnosis on Clinical signs and history
+/- Radiographs to show dislocation/fracture
Prognosis difficult to predict
Poor prognosis if tail limp & no anal tone
Supportive treatment
Persist for >3 months if possible

Cauda Equina Neuritis - large animals

Equine version of Idiopathic polyradiculoneuritis
Extradural nerve roots of cauda equina thickened and discoloured
Inflammatory infiltrate (lymphocytes, plasma cells, macrophages)
Extensive axonal damage and demyelination
Cranial nerve involvement often occurs
Aetiology unknown:
Antecedent infection?
Antibodies to PNS myelin?
Paralysis & anaesthesia of tail
Urinary incontinence
Loss of anal reflex
Failure to defaecate
Pain/hypersensitivity in gluteal/tail-head area
Clinical signs
Recovery unlikely - most animals are destroyed.