Comprehensive Neurological Examination / IVG Hospitals

Comprehensive Neurological Examination

This service is available at:
Massachusetts Veterinary Referral Hospital

During your appointment, the neurologist will:

• obtain a detailed medical history,
• perform a physical examination, and
• perform a comprehensive neurological examination.

The purpose of the neurological exam is to determine whether your pet has neurological disease and the most likely location (neurolocalization) of the disease within the nervous system.

It is important to note that the neurological exam only suggests the location of the disease, and does not tell us which disease is present.

Neurology is like real estate…it’s all about location, location, location.  For example, if you lined up 3 dogs in a row, one that had a brain tumor, one that had a stroke and one that had a focal area of inflammation in the same area of the brain, their clinical signs would be similar to identical.

Thus, the neurological exam tells us the location of disease and allows us to focus our diagnostic testing to a specific area of the nervous system.

The neurological examination includes 5 major components:

Mental Status
Your pet will be observed in the exam room while the neurologist obtains the medical history to get an idea of the level of consciousness displayed by your pet.

Your pet should be fully alert and interact normally with you, the doctor, and his/her environment.

Altered level of consciousness (dull, disoriented, stupor, coma) can indicate disease in the front part of the brain (forebrain) or in the brainstem.

Your pet may also have altered mental status from being systemically ill, so this does not necessarily mean he or she has a neurological disease.

Gait & Posture
As part of the neurological exam, the neurologist will observe your pet’s gait and body posture.

Often the doctor will have you walk your pet in the hallway or outdoors where there is good traction.

While watching your pet walk, the neurologist is trying to determine whether there are any abnormalities which suggest neurological disease, such as weakness or ataxia (incoordination).

The neurologist is also looking for lameness which can be attributed to either orthopedic disease (e.g., arthritis, cruciate ligament injury) or neurological disease.

By analyzing the gait, we often can narrow the location of disease to the spinal cord, brain, or peripheral nerves.

Cranial Nerve Examination
There are 12 pairs of cranial nerves which leave the brain and supply various structures of the head.

The neurologist will perform a series of tests that will examine each of these nerves individually.  These nerves originate and exit from specific areas of the brain.

By testing these nerves individually, we often can narrow the location of the disease to a specific area of the brain.

Postural Reactions
Postural reaction testing is a series of tests which analyze your pet’s conscious and unconscious recognition of the location of limbs in space.

The legs that show abnormalities helps narrow the location of the disease.  For example, abnormalities in the postural reaction testing in the right legs could indicate disease on the right side of the cervical (neck) spinal cord or brainstem or the left side of the forebrain.

Spinal Reflexes
The neurologist will test your pet’s reflexes.  You might be familiar with some of these as they are similar to tests for people.

For example, the patellar reflex (knee jerk) is the same as in people where the doctor strikes the patellar tendon on the knee and looks for a knee jerk. This reflex tests the femoral nerve.

By testing this and other reflexes, the neurologist will be able to determine if there is spinal cord disease or disease of the nerve as it travels through the leg.