Case 3

	SIGNALMENT: Mixed breed canine, m/c, 6 years old
	HISTORY: Onset of head tilt, ataxia, and circling to right of 48 hours duration. Signs are progressive. Dog can now hardly stand without falling over to the right.
	PHYSICAL EXAMINATION: T 102.5 HR 80 RR 31 CRT <2.0 secs. MM pink WT 70 lbs. Right eyelid droops, paresis of right facial muscles. Spontaneous nystagmus with jerk to right. Right eye deviates ventro-lateral when head is extended. Prolapse of right membrane nicatans.
	NEUROLOGICAL EXAMINATION:

E. POSTURAL REACTIONS:
          (0=absent, +1=decreased, +2=normal, +3=increased/exaggerated, NE=not examined)

LEFT	REACTIONS	RIGHT
	Proprioceptive Positioning PL TL
2		2
2		2
2	Wheelbarrowing	2
	Hopping PL TL
2		2
2		2
2	Extensor Postural Thrust	2
2	Hemistand-Hemiwalk	2
2	Tonic Neck	2
	Placing, tactile PL TL
2		2
2		2
	Placing, visual PL TL
2		2
2		2

F. SPINAL REFLEXES:
          (0=absent, +1=decreased, +2=normal, +3=increased/exaggerated, +4=clonic, NE=not examined)

LEFT	REFLEX, SPINAL SEGMENT	RIGHT
2	Quadriceps (L4-L6)	2
2	Flexion, PL (L5-S1)	2
2	Flexion, TL (C6-T1)	2
2	Triceps (C7-T1)	2
0	Crossed Extensor	0
2	Perineal (S1-S2)	2

G. CRANIAL NERVES:
          (0=absent, +1=decreased, +2=normal, +3=increased/exaggerated, NE=not examined)

LEFT	(Response/Test)	RIGHT
2	Menace (CN II & VII)	0
2	Palpebral (CN V & VII)	0
2	Pupil Size	miotic
	PLR’S Stimulate left eye Stimulate right eye (CN II & III)
2		2
2		2
0	Strabismus	0
present, horizonal with jerk right.	Nystagmus	present, horizonal with jerk right.
2	Facial Sensation (CN V)	2
2	Mastication (CN V)	2
2	Swallowing/Gag (CN IX & X)	2
2	Tongue (CN XII)	2

H. SENSATION:
          (0=absent, +1=decreased, +2=normal, +3=increased/exaggerated, NE=not examined)

Location
Hyperesthesia	not present
Superficial pain	+2
Deep pain	+2

	Generalized LMN		Peripheral nerve
	Spinal Cord C1-C5		Spinal Cord C6-T2
	Spinal Cord T3-L3		Spinal Cord L4-S3
	Cauda equina		Peripheral vestibular
	Central vestibular		Brainstem
	Cerebral cortex		Cerebellum
	Cranial neuropathy		Myopathy
	Musculoskeletal	Expert's Anatomic Diagnosis

LESION LOCATION:            Where is the lesion located? Right Left Bilateral Expert's Lesion Location REVIEW RADIOGRAPHS: Lumbosacral:     Thoracolumbar:     Cervical:     Skull:     Appendicular          WHICH SET ILLUSTRATES THIS CASE?