Wunderink Gerlinde J, Bergwerff Ursula E A, Vos Victoria R, Delany Mark W, Willems Dorien S, Hut Peter R
Department of Public Health Sciences, Division of Farm Animal Health, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.
Division of Pathology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.
BMC Vet Res. 2020 Oct 21;16(1):398. doi: 10.1186/s12917-020-02580-4.
This case report describes the clinical signs of a calf with focal diplomyelia at the level of the fourth lumbar vertebra. Magnetic resonance imaging (MRI) images and histological findings of the affected spinal cord are included in this case report. This case differs from previously reported cases in terms of localization and minimal extent of the congenital anomaly, clinical symptoms and findings during further examinations.
The calf was presented to the Farm Animal Health clinic, Faculty of Veterinary Medicine, Utrecht University, with an abnormal, stiff, 'bunny-hop' gait of the pelvic limbs. Prominent clinical findings included general proprioceptive ataxia with paraparesis, pathological spinal reflexes of the pelvic limbs and pollakiuria. MRI revealed a focal dilated central canal, and mid-sagittal T2 hyperintense band in the dorsal part of the spinal cord at the level of the third to fourth lumbar vertebra. By means of histology, the calf was diagnosed with focal diplomyelia at the level of the fourth lumbar vertebra, a rare congenital malformation of the spinal cord. The calf tested positive for Schmallenberg virus antibodies, however this is not considered to be part of the pathogenesis of the diplomyelia.
This case report adds value to future clinical practice, as it provides a clear description of focal diplomyelia as a previously unreported lesion and details its diagnosis using advanced imaging and histology. This type of lesion should be included in the differential diagnoses when a calf is presented with a general proprioceptive ataxia of the hind limbs. In particular, a 'bunny-hop' gait of the pelvic limbs is thought to be a specific clinical symptom of diplomyelia. This case report is of clinical and scientific importance as it demonstrates the possibility of a focal microscopic diplomyelia, which would not be evident by gross examination alone, as a cause of hind-limb ataxia. The aetiology of diplomyelia in calves remains unclear.
本病例报告描述了一头患有第四腰椎水平局灶性脊髓纵裂的小牛的临床症状。本病例报告还包括了受影响脊髓的磁共振成像(MRI)图像和组织学检查结果。该病例在先天性异常的定位和范围、临床症状以及进一步检查结果方面与先前报道的病例有所不同。
这头小牛被送至乌得勒支大学兽医学院的农场动物健康诊所,其骨盆肢体呈现异常、僵硬的“兔跳”步态。突出的临床症状包括全身性本体感觉共济失调伴轻瘫、骨盆肢体的病理性脊髓反射以及尿频。MRI显示在第三至第四腰椎水平脊髓背侧有局灶性扩张的中央管以及矢状面T2高信号带。通过组织学检查,该小牛被诊断为第四腰椎水平的局灶性脊髓纵裂,这是一种罕见的脊髓先天性畸形。该小牛的施马伦贝格病毒抗体检测呈阳性,但这并不被认为是脊髓纵裂发病机制的一部分。
本病例报告为未来的临床实践增添了价值,因为它清晰地描述了局灶性脊髓纵裂这一先前未报道的病变,并详细介绍了使用先进成像和组织学手段进行诊断的过程。当小牛出现后肢全身性本体感觉共济失调时,这种类型的病变应纳入鉴别诊断。特别是,骨盆肢体的“兔跳”步态被认为是脊髓纵裂的一种特定临床症状。本病例报告具有临床和科学重要性,因为它证明了局灶性微观脊髓纵裂作为后肢共济失调病因的可能性,而这种情况仅通过大体检查是无法发现的。小牛脊髓纵裂的病因仍不清楚。