Neurolocalization Two: The String Cheese Incident

Karen Kline, DVM, MS, DACVIM

Dr. Karen Kline is currently performing a hybrid role between VCA Northwest Veterinary Specialists and Washington State University of College of Veterinary Medicine. Previously, she was a Neurologist at Veterinary Specialty Center of Seattle from 2008 to 2019 and Medical Director at Veterinary Specialty Center of Seattle from 2013 through 2018 respectively. She received her DVM degree from the The Ohio State University College of Veterinary Medicine in 1989 and completed a rotating internship at the Animal Medical Center in New York City in 1990. She stayed at AMC and completed her neurology residency in 1993 and stayed on a year as staff neurologist until 1994. In 1994, she became board certified in veterinary neurology through the American College of Veterinary Internal Medicine that same year. From 1995 through 2008, Dr. Kline was an associate professor of neurology and neurosurgery at Iowa State College of Veterinary Medicine. While there she obtained her Master of Science degree in veterinary pathology and completed her thesis on Immunohistochemical Differentiation of Canine Inflammatory and Infectious diseases. She has published multiple journal articles, has been an author in several veterinary textbooks and has spoken at local, national and international meetings. She obtained her certification in veterinary acupuncture in 2000. Her special interests are neurosurgery, inflammatory and infectious central nervous system diseases and spinal cord injury and therapeutics. Dr. Kline has always enjoyed the Pacific Northwest and enjoys spending her free time with her husband, and dog extraordinaire, Voodie.

Overview:

This lecture will discuss the intricacies of neurolocalization below the foreman magnum – more specifically the four different spinal cord segments, C1-C5, C6-T2, T3-L3 and L4-S2 as well as the neuromuscular system to include the nerve roots, peripheral nerve, neuromuscular junctions and muscle. Each portion of the above will be discussed and correlated with findings on the neurologic examination. The practitioner will be refamiliarized with which neurologic findings correlate with which part of the spinal cord and the neuromuscular systems and why this is important as far as determining what differentials are constructed and what diagnostics are recommended. Tips and tricks will be discussed to help the practitioner become more confident in neurolocalization below the foramen magnum and to how to make the process easier to understand.

List of items to be discussed:

1) The importance of history taking
2) Components of neurolocalization above the foramen magnum
3) Determining differentials based upon the history and signalment of the patient

Learning Objectives:

The attendee will gain an understanding of the power of neurolocalization
The attendee will gain an understanding of how this correlates to the next diagnostics steps, treatment and prognostication

This course is RACE-approved for 1.0 continuing education credits hours in jurisdictions that accept RACE-approval.