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Topic:Ataxia

Ataxia in horses refers to a neurological condition characterized by a lack of coordination and balance, often manifesting as unsteady or abnormal gait. The condition can result from various underlying causes, including spinal cord compression, brain lesions, or peripheral nerve damage. Ataxia is typically classified into three types: cerebellar, vestibular, and proprioceptive, each associated with different parts of the nervous system. Diagnosis involves a combination of clinical examination, neurological assessment, and diagnostic imaging. This page compiles peer-reviewed research studies and scholarly articles that explore the causes, diagnostic approaches, and management strategies for ataxia in equine patients.
Antagonism of detomidine sedation in the horse using intravenous tolazoline or atipamezole.
Equine veterinary journal    May 19, 2006   Volume 38, Issue 3 238-241 doi: 10.2746/042516406776866408
Hubbell JA, Muir WW.The ability to shorten the duration of sedation would potentially improve safety and utility of detomidine. Objective: To determine the effects of tolazoline and atipamezole after detomidine sedation. Objective: Administration of tolazoline or atipamezole would not affect detomidine sedation. Methods: In a randomised, placebo-controlled, double-blind, descriptive study, detomidine (0.02 mg/kg bwt i.v.) was administered to 6 mature horses on 4 separate occasions. Twenty-five mins later, each horse received one of 4 treatments: Group 1 saline (0.9% i.v.) as a placebo control; Group 2 atipamezole...
Unilateral ataxia and head tilt in a 7-year-old Thoroughbred stallion. Temporohyoid osteoarthropathy.
Australian veterinary journal    April 25, 2006   Volume 84, Issue 4 136-142 doi: 10.1111/j.1751-0813.2006.tb13397.x
Hughes KJ, Hodgson DR.The research article discusses the case of a 7-year-old Thoroughbred stallion presenting symptoms such as ataxia, a leftward head tilt and a cloudy left eye, revealing a diagnosis of temporohyoid […]
Pleuropneumonia as a sequela of myelography and general anaesthesia in a Thoroughbred colt.
Australian veterinary journal    April 25, 2006   Volume 84, Issue 4 138-140 doi: 10.1111/j.1751-0813.2006.tb13399.x
Rainger JE, Hughes KJ, Kessell A, Dart CM.A 3-year-old Thoroughbred colt was presented to the University Veterinary Centre Camden for evaluation of ataxia. The horse was anaesthetised to facilitate cervical radiography and myelographic examination of the spinal cord. Recovery from anaesthesia was uneventful. Five days after general anaesthesia the horse re-presented with pleuropneumonia. It was euthanased 24 hours after presentation on humane grounds. Necropsy revealed severe tracheal erosion over the middle third of the ventral surface of the trachea, pleuropneumonia and narrowing of the cervical cord between C4 and C6. It is postula...
Isolation and genetic analysis of Japanese encephalitis virus from a diseased horse in Japan.
The Journal of veterinary medical science    April 7, 2006   Volume 68, Issue 3 293-295 doi: 10.1292/jvms.68.293
Yamanaka T, Tsujimura K, Kondo T, Yasuda W, Okada A, Noda K, Okumura T, Matsumura T.Japanese encephalitis (JE) developed in an unvaccinated half-bred horse kept in Tottori Prefecture, Japan. The animal showed ataxia with pyrexia and low appetite, and ultimately died. A viral strain was isolated from the cerebrum of the horse and was identified as JE virus (JEV) by RT-PCR using JEV specific primers. The isolated JEV was classified into genotype I by nucleotide sequence analysis of the viral envelope gene. We believe that this is the first report of the genotype I strain being isolated from a horse.
Effect of a constant rate infusion of lidocaine on the quality of recovery from sevoflurane or isoflurane general anaesthesia in horses.
Equine veterinary journal    November 22, 2005   Volume 37, Issue 6 559-564 doi: 10.2746/042516405775314772
Valverde A, Gunkelt C, Doherty TJ, Giguère S, Pollak AS.Lidocaine constant rate infusions (CRIs) are common as an intraoperative adjunct to general anaesthesia, but their influence on quality of recovery has not been thoroughly determined. Objective: To determine the effects of an intraoperative i.v. CRI of lidocaine on the quality of recovery from isoflurane or sevoflurane anaesthesia in horses undergoing various surgical procedures, using a modified recovery score system. Objective: The administration of intraoperative lidocaine CRI decreases the quality of recovery in horses. Methods: Lidocaine (2 mg/kg bwt bolus followed by 50 microg/kg bwt/min...
Acremonium strictum pulmonary infection in a horse.
Veterinary clinical pathology    November 5, 2005   Volume 34, Issue 4 413-416 doi: 10.1111/j.1939-165x.2005.tb00072.x
Pusterla N, Holmberg TA, Lorenzo-Figueras M, Wong A, Wilson WD.A 10-year-old Thoroughbred gelding was admitted to the Veterinary Medical Teaching Hospital of the University of California-Davis with a 2-week history of intermittent fever and acute onset of lethargy, anorexia, and ataxia. Although the clinical signs were nonspecific, the results of initial hematologic and biochemical analysis were consistent with a chronic inflammatory process. Thoracic radiographs revealed an increased fine reticulonodular interstitial opacity throughout the dorsal caudal lung fields. Cytologic examination of bronchoalveolar lavage (BAL) fluid showed mixed inflammation wit...
Common variable immunodeficiency in three horses with presumptive bacterial meningitis.
Journal of the American Veterinary Medical Association    July 15, 2005   Volume 227, Issue 1 114-87 doi: 10.2460/javma.2005.227.114
Pellegrini-Masini A, Bentz AI, Johns IC, Parsons CS, Beech J, Whitlock RH, Flaminio MJ.Three adult horses were evaluated for signs of musculoskeletal pain, dullness, ataxia, and seizures. A diagnosis of bacterial meningitis was made on the basis of results of CSF analysis. Because primary bacterial meningitis is so rare in adult horses without any history of generalized sepsis or trauma, immune function testing was pursued. Flow cytometric phenotyping of peripheral blood lymphocytes was performed, and proliferation of peripheral blood lymphocytes in response to concanavalin A, phytohemagglutinin, pokeweed mitogen, and lipopolysaccharide was determined. Serum IgA, IgM, and IgG co...
Neuronal intranuclear inclusion disease in a horse.
Acta neuropathologica    June 22, 2005   Volume 110, Issue 2 191-195 doi: 10.1007/s00401-005-1033-5
Pumarola M, Vidal E, Trens JM, Serafín A, Marquez M, Ferrer I.Neuronal intranuclear inclusion disease (NIID) is reported in a 16-year-old Pure Spanish breed female horse suffering from progressive ataxia and motor deficiencies. The neuropathological study revealed NIIs throughout the central nervous system, although mainly in the brain stem and spinal cord. This distribution did not correlate with neuron loss, which was marked in the hippocampus and moderate in the neocortex, particularly in the occipital cortex. As in humans, NIIs in the horse were hyaline autofluorescent inclusions composed of non-membrane-bound aggregates of filaments and fine granule...
Acute hemoperitoneum in horses: a review of 19 cases (1992-2003).
Journal of veterinary internal medicine    June 16, 2005   Volume 19, Issue 3 344-347 doi: 10.1892/0891-6640(2005)19[344:ahihar]2.0.co;2
Pusterla N, Fecteau ME, Madigan JE, Wilson WD, Magdesian KG.The medical records of 19 horses with acute hemoperitoneum were reviewed. The causes for the hemoperitoneum were idiopathic (8 horses), splenic hematoma with capsular tear (7), bleeding from the reproductive tract (3), multicentric hemangiosarcoma (1), and systemic amyloidosis (1). The affected horses were between 4 and 32 years of age (median 11.5 years). The most consistent findings on initial examination were depression, tachycardia, tachypnea, pale mucous membranes, prolonged capillary refill time, colic, and abdominal discomfort. Less common clinical signs included abdominal distention, p...
Splenic haemangiosarcoma with metastasis to the cervical musculature in an aged pony.
New Zealand veterinary journal    March 16, 2005   Volume 52, Issue 1 37-39 doi: 10.1080/00480169.2004.36388
Parkinson TJ, Mogg TD, Dykgraaf S, Collett MG.An aged pony gelding presented with sudden onset of neck pain, depression and ataxia and weakness of the hindlegs, together with longer-term weight loss. Diagnostic procedures failed to isolate the cause of these signs and, despite symptomatic treatment, the animal's condition deteriorated until it required euthanasia. Unassigned: Post mortem examination revealed the presence of multiple splenic and hepatic haemangiosarcomata, with metastases to the lung and dorsal cervical muscles overlying C1 and C2 vertebrae. No lesions were present in the spinal cord, spinal column or brain. Conclusions: T...
Detection of spinal ataxia in horses using fuzzy clustering of body position uncertainty.
Equine veterinary journal    January 20, 2005   Volume 36, Issue 8 712-717 doi: 10.2746/0425164044848163
Keegan KG, Arafat S, Skubic M, Wilson DA, Kramer J, Messer NM, Johnson PJ, O'Brien DP, Johnson G.Subjective neurological evaluation in horses is prone to bias. An objective method of spinal ataxia detection is not subject to these limitations and could be of use in equine practice and research. Objective: Kinematic data in the walking horse can differentiate normal and spinal ataxic horses. Methods: Twelve normal and 12 spinal ataxic horses were evaluated by kinematic analysis walking on a treadmill. Each body position signal was reduced to a scalar measure of uncertainty then fuzzy clustered into normal or ataxic groups. Correct classification percentage (CCP) was then calculated using m...
Equine herpes virus 2 infection in horse populations in Poland.
Acta virologica    December 15, 2004   Volume 48, Issue 3 189-192 
Ruszczyk A, Cywinska A, Banbura MW.The prevalence of Equine herpesvirus 2 (EHV-2) infections in the horse populations in Poland was investigated. Peripheral blood leukocytes (PBLs) of 139 horses were tested. The animals were divided into four groups: clinically healthy horses, horses suffering from respiratory disorders, mares with a recent abortion and horses with diagnosed ataxia. Thirty-four virus isolates were obtained from leukocytes of the tested animals by cocultivation with equine dermal cells and were identified as EHV-2 by PCR using primers for the gB gene of EHV-2 and/or primers for the sequence located upstream of t...
Utility of high-performance liquid chromatography in the characterization of iatrogenic sodium diatrizoate-induced seizures in a horse. Fitzgerald SD, Braselton WE.Diagnostic evaluation of a mildly ataxic young gelding Quarterhorse included a contrast myelogram. Unfortunately, sodium diatrizoate was inappropriately administered by intrathecal injection resulting in severe unrelenting seizure activity and necessitated the destruction of the animal. The contrast agent was identified by analyzing cerebrospinal fluid by high-performance liquid chromatography and confirmed with probe mass spectrometric analysis. This contrast agent is highly ionic, has high osmolarity, and also blocks neurotransmission at specific receptors; for these reasons it is contraindi...
Ultrasound-guided atlanto-occipital puncture for myelography in the horse. Audigié F, Tapprest J, Didierlaurent D, Denoix JM.Complications of cervical myelography arising from the puncture of the subarachnoid space to collect the cerebrospinal fluid and to inject the contrast medium have been described in humans and animals. In this study, 2 ultrasound-guided procedures were developed for puncture of the atlanto-occipital subarachnoid space, collection of cerebrospinal fluid, and injection of contrast medium. Myelography was performed on 6 ataxic horses using these procedures. The first attempt to puncture the subarachnoid space was successful in 5 horses and in one horse, a second attempt was necessary. Collection ...
Outcome of equids with clinical signs of West Nile virus infection and factors associated with death.
Journal of the American Veterinary Medical Association    August 25, 2004   Volume 225, Issue 2 267-274 doi: 10.2460/javma.2004.225.267
Salazar P, Traub-Dargatz JL, Morley PS, Wilmot DD, Steffen DJ, Cunningham WE, Salman MD.To determine outcome of equids in the western United States with clinical signs of West Nile virus (WNV) infection and identify factors associated with risk of death in infected equids. Methods: Cross-sectional study. Methods: 484 equids in Nebraska and Colorado. Methods: Owners of 484 equids with laboratory-confirmed West Nile virus infection in Nebraska and Colorado were contacted by telephone, and a questionnaire was used to obtain information on signalment, management, clinical signs, date of disease onset, duration of disease, WNV vaccination status, and health status at the time of the i...
Investigation of an outbreak of encephalomyelitis caused by West Nile virus in 136 horses.
Journal of the American Veterinary Medical Association    July 9, 2004   Volume 225, Issue 1 84-89 doi: 10.2460/javma.2004.225.84
Ward MP, Levy M, Thacker HL, Ash M, Norman SK, Moore GE, Webb PW.To describe an outbreak of encephalomyelitis caused by West Nile virus (WNV) in horses in northern Indiana. Methods: Case series. Methods: 170 horses. Methods: Horses with clinical signs suggestive of encephalomyelitis caused by WNV were examined. Date, age, sex, breed, and survival status were recorded. Serum samples were tested for anti-WNV antibodies, and virus isolation was attempted from samples of brain tissue. Climate data from local weather recording stations were collected. An epidemic curve was constructed, and case fatality rate was calculated. Results: The most common clinical sign...
Acute recumbency associated with Anaplasma phagocytophilum infection in a horse.
Journal of the American Veterinary Medical Association    July 3, 2004   Volume 224, Issue 12 1964-1931 
Nolen-Walston RD, D'Oench SM, Hanelt LM, Sharkey LC, Paradis MR.An 11-year-old Hanoverian-cross gelding was evaluated because of acute onset of ataxia, recumbency, and fever. At the stable, this and other horses had recently been infested with ticks. Results of analysis of a sample of CSF were within reference limits, but hematologic abnormalities included lymphopenia, thrombocytopenia, mild anemia, and intracytoplasmic inclusion bodies in neutrophils that were consistent with Anaplasma phagocytophilum (previously Ehrlichia equi). Results of serum biochemical analyses were characteristic of infection and included high, unconjugated bilirubin concentration....
Clinical West Nile virus infection in 2 horses in western Canada.
The Canadian veterinary journal = La revue veterinaire canadienne    May 18, 2004   Volume 45, Issue 4 315-317 
Abutarbush SM, O'Connor BP, Clark C, Sampieri F, Naylor JM.Two horses had a history of ataxia and weakness or recumbency. One recovered and was diagnosed with West Nile virus (WNV) infection by serologic testing. The other was euthanized; it had meningoencephalomyelitis, WNV was detected by polymerase chain reaction. West Nile virus infection is an emerging disease. Year 2002 is the first year in which cases have been seen in Saskatchewan. Deux chevaux présentaient une histoire d’ataxie et de faiblesse ou de décubitus. Un cheval s’est rétabli et un diagnostic d’infection au virus du Nil occidental (VNO) a été posé par épreuve sérologiqu...
Comparison of ropivacaine with a combination of ropivacaine and fentanyl for the caudal epidural anaesthesia of mares.
The Veterinary record    April 8, 2004   Volume 154, Issue 11 329-332 doi: 10.1136/vr.154.11.329
Ganidagli S, Cetin H, Biricik HS, Cimtay I.Two groups of six mares aged from eight to 18 years were anaesthetised by caudal epidural injections of ropivacaine (0.5 per cent, 0.1 mg/kg) or a combination of ripovacaine (0.08 mg/kg) and fentanyl (100 microg) in a randomised study. The onset of anaesthesia was significantly more rapid (P<0.001) and it lasted significantly longer (P<0.001) in the group anaesthetised with the combination of drugs. The surgical comfort scores of the group anaesthetised with the combination were higher than those of the group anaesthetised with ropivacaine alone (P<0.001), and the quality of intraoper...
Neurologic abnormalities and cerebrospinal fluid changes in horses administered fumonisin B1 intravenously.
Journal of veterinary internal medicine    April 3, 2004   Volume 18, Issue 2 223-230 doi: 10.1892/0891-6640(2004)18<223:naacfc>2.0.co;2
Foreman JH, Constable PD, Waggoner AL, Levy M, Eppley RM, Smith GW, Tumbleson ME, Haschek WM.The objective of this experiment was to characterize a dose-dependent toxic effect of fumonisin B1 (FB1) and to document initial neurologic signs, clinical progression, and terminal cerebrospinal fluid (CSF) changes in horses administered FB1 IV. Seventeen healthy horses were administered 0.00 (n = 4), 0.01 (n = 3), 0.05 (n = 3), 0.10 (n = 3), or 0.20 mg (n = 4) of purified FB1 IV q24h. When neurologic abnormalities observed by a masked observer became severe, atlanto-occipital CSF taps were performed and CSF pressure, cell count, cytology, protein, albumin and glucose concentrations, and crea...
Osteochondrosis of the occipital condyles and atlanto-occipital dysplasia in a Belgian horse.
The Canadian veterinary journal = La revue veterinaire canadienne    January 2, 2004   Volume 44, Issue 12 984-986 
Muirhead T, McClure JT, Bourque A, Pack L.A lesion in the cervical region of a 14-month-old Belgian gelding with severe ataxia was suspected. Necropsy revealed symmetric focal cartilage defects compatible with osteochondrosis of the occipital condyles and atlanto-occipital dysplasia. To our knowledge this is the first equine report of symmetrical osteochondrosis of the occipital condyles causing neurologic signs.
Use of magnetic motor-evoked potentials in horses with bilateral hind limb ataxia.
American journal of veterinary research    November 19, 2003   Volume 64, Issue 11 1382-1386 doi: 10.2460/ajvr.2003.64.1382
Nollet H, Van Ham L, Verschooten F, Vanderstraeten G, Deprez P.To determine the usefulness of magnetic motor-evoked potentials (MMEPs) for assessing the integrity of the cervical, thoracic, and thoracolumbar spinal cord in horses with bilateral hind limb ataxia. Methods: 9 horses and 1 donkey with bilateral hind limb ataxia of various degrees. Methods: The motor cortex was stimulated magnetically, and MMEPs were recorded bilaterally from the extensor carpi radialis and cranial tibial muscles. Results: In 5 horses and 1 donkey, MMEPs with normal onset latencies and peak-to-peak amplitude were recorded from the extensor carpi radialis muscles, whereas abnor...
Outbreak of equine herpesvirus type 1 myeloencephalitis: new insights from virus identification by PCR and the application of an EHV-1-specific antibody detection ELISA.
The Veterinary record    October 30, 2003   Volume 153, Issue 14 417-423 doi: 10.1136/vr.153.14.417
Studdert MJ, Hartley CA, Dynon K, Sandy JR, Slocombe RF, Charles JA, Milne ME, Clarke AF, El-Hage C.Five of 10 pregnant, lactating mares, each with a foal at foot, developed neurological disease. Three of them became recumbent, developed complications and were euthanased; of the two that survived, one aborted an equine herpesvirus type 1 (EHV-1)-positive fetus 68 days after the first signs were observed in the index case and the other gave birth to a healthy foal on day 283 but remained ataxic and incontinent. The diagnosis of EHV-1 myeloencephalitis was supported by postmortem findings, PCR identification of the virus and by serological tests with an EHV-1-specific ELISA. At the time of the...
Clinical and pathologic findings in two draft horses with progressive muscle atrophy, neuromuscular weakness, and abnormal gait characteristic of shivers syndrome.
Journal of the American Veterinary Medical Association    October 22, 2003   Volume 215, Issue 11 1661-1621 
Valentine BA, de Lahunta A, Divers TJ, Ducharme NG, Orcutt RS.Two Belgian geldings, 4 and 14 years old, respectively, with muscle atrophy, weakness, and abnormal gait characteristic of severe advanced shivers were examined clinically and on necropsy. Neurologic examination revealed no evidence of ataxia, and the clinical diagnosis was neuromuscular weakness and shivers. Necropsies of both horses, including examination of pituitary, brain, spinal cord, spinal roots and ganglia, and peripheral nerves, revealed no gross or histologic abnormalities. Examination of multiple skeletal muscle specimens revealed chronic myopathic changes and periodic acid-Schiff ...
A comparison of the analgesic effects of caudal epidural methadone and lidocaine in the horse.
Veterinary anaesthesia and analgesia    September 23, 2003   Volume 30, Issue 3 156-164 doi: 10.1046/j.1467-2995.2003.00145.x
Olbrich VH, Mosing M.To evaluate and compare the effects of caudal epidural administration of methadone (METH) and lidocaine (LIDO) on tolerance to thermal stimulation over the dermatomes of the perineal, sacral, lumbar and thoracic regions in the horse. Methods: A blinded, randomized, prospective, experimental cross-over study. Methods: Seven healthy horses, 15.7 +/- 4.9 years (mean +/- SD) of age, weighing 536 +/- 37 kg. Methods: The horses were randomly assigned to receive two treatments (group M: METH, 0.1 mg kg-1 or group L: LIDO, 0.35 mg kg-1) at intervals of at least 28 days. An 18-gauge 80-mm Tuohy epidura...
First case report of Sarcocystis neurona-induced equine protozoal myeloencephalitis in Japan.
The Journal of veterinary medical science    July 18, 2003   Volume 65, Issue 6 757-759 doi: 10.1292/jvms.65.757
Katayama Y, Wada R, Kanemaru T, Sasagawa T, Uchiyama T, Matsumura T, Anzai T.Equine protozoal myeloencephalitis developed in a three-year-old male Thoroughbred racehorse imported from the United States. The animal showed astasia five days after the onset of ataxia. Histopathologically, focal nonpurulent myelitis accompanied by hemorrhage and perivascular infiltration was observed in the fourth and fifth cervical spinal cord. Immunohistochemically, shizonts were occasionally observed and were positive for anti-Sarcocystis neurona (S. neurona) antiserum. S. neurona-specific antibodies were detected in the serum and cerebrospinal fluid by Western blot. This is the first e...
Neuropharmacological sequelae of persistent CNS viral infections: lessons from Borna disease virus.
Pharmacology, biochemistry, and behavior    April 2, 2003   Volume 74, Issue 4 777-787 doi: 10.1016/s0091-3057(03)00019-4
Solbrig MV, Koob GF.Borna Disease Virus (BDV) is a neurotropic RNA virus that is worldwide in distribution, causing movement and behavior disorders in a wide range of animal species. BDV has also been reported to be associated with neuropsychiatric diseases of humans by serologic study and by recovery of nucleic acid or virus from blood or brain. Natural infections of horses and sheep produce encephalitis with erratic excited behaviors, hyperkinetic movement or gait abnormalities; naturally infected cats have ataxic "staggering disease." Experimentally infected primates develop hyperactivity, aggression, disinhib...
Effects of alpha-2 adrenoceptor agonists during recovery from isoflurane anaesthesia in horses.
Equine veterinary journal    March 18, 2003   Volume 35, Issue 2 170-175 doi: 10.2746/042516403776114117
Santos M, Fuente M, Garcia-Iturralde R, Herran R, Lopez-Sanroman J, Tendillo FJ.Recovery from inhalant anaesthesia in the horse is a critical and difficult period to manage; however, several factors could help to obtain a calm recovery period including choice of anaesthetic and analgesic procedure used and the conditions under which anaesthetic maintenance and recovery occur. Objective: The objective of this study was to evaluate and compare the quality of recovery in horses administered saline, xylazine, detomidine or romifidine during recovery from isoflurane anaesthesia. Methods: Six mature and healthy horses were premedicated with i.v. xylazine and butorphanol, and an...
A review of moxidectin overdose cases in equines from 1998 through 2000.
Veterinary and human toxicology    July 26, 2002   Volume 44, Issue 4 232-235 
Khan SA, Kuster DA, Hansen SR.Moxidectin is a macrolide endectocide available as a 2% equine oral gel in the US. This report presents clinical signs of moxidectin toxicosis and its treatment in equines as reported to the ASPCA Animal Poison Control Center (APCC) from January 1998 to December 2000. Nine cases of moxidectin overdose in equines occurred: 5 had signs of toxicosis such as coma, dyspnea, depression, ataxia, tremors, seizures, or weakness. The approximate dose of moxidectin at which these signs were observed ranged from 1.0 to 5.1 mg/kg. The 4 equines that ingested moxidectin between 0.9 mg/kg to 1.7 mg/kg did no...
Reduced levels of nitric oxide metabolites in cerebrospinal fluid are associated with equine protozoal myeloencephalitis.
Clinical and diagnostic laboratory immunology    May 3, 2002   Volume 9, Issue 3 605-610 doi: 10.1128/cdli.9.3.605-610.2002
Njoku CJ, Saville WJ, Reed SM, Oglesbee MJ, Rajala-Schultz PJ, Stich RW.Equine protozoal myeloencephalitis (EPM) is a disease of horses that is primarily associated with infection with the apicomplexan Sarcocystis neurona. Infection with this parasite alone is not sufficient to induce the disease, and the mechanism of neuropathogenesis associated with EPM has not been reported. Nitric oxide (NO) functions as a neurotransmitter, a vasodilator, and an immune effector and is produced in response to several parasitic protozoa. The purpose of this work was to determine if the concentration of NO metabolites (NO(x)(-)) in the cerebrospinal fluid (CSF) is correlated with...
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