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Introduction ChatGPT (OpenAI Incorporated, Mission District, San Francisco, United States) is an artificial intelligence (AI) chatbot with advanced communication skills and a massive knowledge database. However, its application in medicine, specifically in neurolocalization, necessitates clinical reasoning in addition to deep neuroanatomical knowledge. This article examines ChatGPT's capabilities in neurolocalization. Methods Forty-six text-based neurolocalization case scenarios were presented to ChatGPT-3.5 from November 6th, 2023, to November 16th, 2023. Seven neurosurgeons evaluated ChatGPT's responses to these cases, utilizing a 5-point scoring system recommended by ChatGPT, to score the accuracy of these responses. Results ChatGPT-3.5 achieved an accuracy score of 84.8% in generating "completely correct" and "mostly correct" responses. ANOVA analysis suggested a consistent scoring approach between different evaluators. The mean length of the case text was 69.8 tokens (SD 20.8). Conclusion While this accuracy score is promising, it is not yet reliable for routine patient care. We recommend keeping interactions with ChatGPT concise, precise, and simple to improve response accuracy. As AI continues to evolve, it will hold significant and innovative breakthroughs in medicine.

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BACKGROUND: No available literature supports the claim that the patellar and withdrawal (flexor) reflexes are the only reliable segmental reflexes in dogs. OBJECTIVE: Measure intra- and interobserver agreement of 8 segmental reflexes in dogs without clinical evidence of orthopedic or neurologic disease. ANIMALS: One-hundred and one client- or staff-owned dogs between 1 and 10 years of age with no clinical evidence of orthopedic disease, myelopathy, or neuromuscular disease. METHODS: Descriptive study. The intraobserver proportion of agreement (%) of responses to selected segmental reflexes in right versus left limbs by 3 observers was calculated and reported. The interobserver agreement of 2 observers of responses to selected reflexes was estimated by calculating proportions of agreement, kappa values, and 95% confidence intervals. A segmental reflex with an acceptable agreement was defined as that with a proportion of agreement ≥90% and a Kappa value ≥0.61 in both limbs. RESULTS: The intraobserver proportion of agreement for all 3 observers was high (≥95%) for the extensor carpi radialis, withdrawal, patellar, and cranial tibial reflexes. Between observers 1 and 3 and observers 2 and 3, the interobserver proportion of agreement was high (≥ 92%) for the extensor carpi radialis (κ 0.66, not determined [ND]), withdrawal (both limbs, κ ND), patellar (κ ND), and cranial tibial reflexes (κ ND). CONCLUSIONS AND CLINICAL IMPORTANCE: The extensor carpi radialis, withdrawal, patellar, and cranial tibial reflexes had a higher proportion of agreement and kappa values between 2 observers.

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BACKGROUND: Trazodone is an anxiolytic used PO to decrease anxiety in dogs. Whether or not trazodone affects the neurologic examination in dogs has not been previously reported. OBJECTIVE: Investigate whether trazodone administration is associated with changes in the neurologic examination in healthy dogs. ANIMALS: Thirty-two healthy dogs between 1 and 6 years old with no previously diagnosed medical conditions and perceived by their owners as neurologically normal. METHODS: Baseline sedation and anxiety assessments and neurologic examination were performed on each dog, followed by trazodone administration (6.25-8.60 mg/kg PO). The sedation and anxiety assessments and neurologic examination were repeated 2.5 hours after trazodone administration. The examinations were performed by a single board-certified veterinary neurologist and were video-recorded. The videos were randomized and reviewed by a different neurologist, blinded to the previous evaluations, who scored the examinations. RESULTS: Seven of 32 (22%) dogs had worse scores on their neurologic examination after receiving trazodone, manifesting as new or progressive PR deficits. Although not clinically relevant, 18.7% of the dogs had consciousness levels that changed from bright, alert, responsive to quiet, alert, responsive after trazodone administration. No other changes were observed on neurologic examination. Sedation and anxiety scores were significantly different after trazodone administration compared to before (P < .001 and P < .001, respectively). CONCLUSIONS AND CLINICAL IMPORTANCE: Most dogs did not have changes on neurologic examination after trazodone administration. However, approximately 20% of dogs had new or worsening PR deficits after receiving trazodone. Ideally, trazodone should not be given before neurologic examination in dogs.

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BACKGROUND: Cerebrospinal fluid (CSF) analysis aids in categorizing underlying disease processes in patients with neurologic disease. Convention suggests that CSF should be collected caudal to the lesion. However, little evidence exists to justify this assertion. HYPOTHESIS/OBJECTIVES: Evaluate the clinicopathologic differences between CSF collected from the cerebellomedullary (CM) and lumbar cisterns in dogs presented for evaluation of neurologic disease. ANIMALS: Fifty-one client-owned dogs undergoing magnetic resonance imaging (MRI) and CSF collection for investigation of neurologic disease. METHODS: Cerebrospinal fluid was prospectively collected from the CM and lumbar cisterns in all patients. The total protein (TP) concentration, red blood cell (RBC) count, and total nucleated cell count (TNCC) were analyzed within 30 minutes of collection. Results and cytology findings were interpreted by a single pathologist. RESULTS: Fifty-one paired samples were collected. The TNCC (P < .001), RBC (P < .001), and TP (P < .001) were different between collection sites. When grouped by neurolocalization, TP (intracranial, P < .001; cervical, P < .001; thoracolumbar, P < .001) and RBC (intracranial, P < .001; cervical, P ≤ .002; thoracolumbar, P = .006) counts were significantly different. The TNCC was significantly different in the cervical (P = .04) and thoracolumbar localizations (P = .004) but not for intracranial (P = .30) localizations. The pathologist's interpretation differed between sites in 66.7% of the cases (34/51). CONCLUSIONS: In dogs with lesions that neurolocalized to the brain or cervical spinal cord, there may be clinical benefit in collecting fluid from both the CM and lumbar cisterns. In dogs with thoracolumbar myelopathy, CSF collected from the CM cistern may not be representative of the underlying disease process.

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O objetivo deste estudo retrospectivo foi identi [1]icar cães com neoplasmas envolvendo o sistema nervoso central (SNC), atendidos entre janeiro de 2003 a junho de 2011, no HVU-UFSM, e obter informações a respeito da raça, do sexo, da idade, dos sinais neurológicos, da localização, da evolução clínica, do tipo e da origem do tumor e dos achados de exames complementares. Os 26 neoplasmas envolvendo o SNC incluídos nesse estudo ocorreram principalmente em Boxers (35%), com predomínio de idade de cinco anos ou mais (92,3%). A evolução dos sinais clínicos nos neoplasmas encefálicos variou entre sete e 115 dias e nos medulares entre sete a 420 dias. Os sinais neurológicos principais em cães com neoplasmas encefálicos e medulares foram alteração do nível de consciência (58%), caracterizada principalmente por sonolência, e hiperestesia espinhal (57%), respectivamente. As regiões tálamo-cortical e T3-L3 foram as mais acometidas (58% e 43%, respectivamente). Dos 12 neoplasmas que afetaram o encéfalo, 10 eram primários (83,3%). Dos 14 neoplasmas que afetaram a medula espinhal, apenas quatro eram primários (28,6%). Dos neoplasmas encefálicos e medulares primários, o mais comum foi o meningioma, perfazendo 40% e 75% dos casos, respectivamente.

This retrospective study was aimed to identify dogs with neoplasms affecting the central nervous system (CNS) and compile information on the affected breeds, sex, age group, anatomical site of the tumor, type of clinical signs and clinical course, and laboratory results. The study included the cases submitted to the Veterinary Teaching Hospital (HVU) of the Federal University of Santa Maria (UFSM), Brazil, from January 2003 to June 2011. The 26 neoplasms affecting the CNS included in this study occurred mainly in Boxers (35%) and the predominantly affected age-group was 5-year-old or older (92.3%). The course of clinical signs in dogs with brain neoplasms was 7-115 days and that of spinal cord tumors was 7-420 days. The most frequently observed neurological signs in dogs with brain and spinal cord neoplasms were respectively changes in the conscience levels (58%), which were characterized by somnolence, and spinal hyperesthesia (57%). The cortico-thalamic region and the T3-L3 spinal cord segment were the most frequently anatomical sites involved (58% and 43%, respectively). Ten out 12 neoplasms affecting the brain were primary (83.3%) whereas only four of those 14 neoplasms affecting the spinal cord were primary (28.6%). Meningioma was the most frequent m primary neoplasms affecting the brain and spinal cord of dogs, consisting respectively of 40% e 75% of the cases.

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