Headshaking in horses is a condition characterized by involuntary, repetitive movements of the head, often described as shaking, flicking, or jerking motions. This behavior can occur spontaneously and is sometimes associated with specific triggers such as light, sound, or exercise. The underlying causes of headshaking are not fully understood but may involve neuropathic pain, particularly related to the trigeminal nerve. The condition can affect a horse's quality of life and performance. Various diagnostic approaches are employed to identify potential causes, and management strategies may include environmental modifications, medical treatments, and protective gear. This page compiles peer-reviewed research studies and scholarly articles that explore the etiology, diagnosis, and management of headshaking in horses.
McCarthy PH.A detailed description is given of the structures forming the borders of Viborg's triangle and those structures contained within and adjacent to the triangle. Changes in the size, shape and prominence of these structures with changes of head and neck posture of the horse are also described.
McGorum BC, Dixon PM.VASOMOTOR rhinitis (VR) is a chronic, non-seasonal disease of the nasal mucosa of man with symptoms including profuse bilateral watery nasal discharge, sneezing, nasal airflow obstruction, nasal pruritus and loss of smell. The disease is believed to result from nasal hyper-reactivity to exogenous and endogenous stimuli including temperature and humidity changes, odours and physical or emotional stress (Groves, Gray, Downton and Blau 1985). Although the aetiology of this non-infectious and non-allergic rhinitis is not completely understood, it is believed to be largely due to an imbalance in th...
Lane JG, Mair TS.The clinical records of 100 cases of headshaking in horses were reviewed. Possible causes of the abnormal behaviour were identified in 11 animals; these included ear mite infestation, otitis interna, cranial nerve dysfunction, cervical injury, ocular disease, guttural pouch mycosis, dental periapical osteitis and suspected vasomotor rhinitis. However, in only two of these could it be shown that correction of the abnormality led to elimination of the headshaking. The additional clinical signs exhibited by the other idiopathic cases of headshaking included evidence of nasal irritation, sneezing ...
Parry BW, Gay CC, McCarthy MA.Eighteen horses were used to investigate the influence of head position on arterial blood pressure, measured indirectly at the coccygeal artery. Head height significantly altered systolic pressure, diastolic pressure, pulse pressure, and mean arterial pressure, such that head-lowering decreased and head-raising increased all variables.
Gerring EL, Thomsett LR.It is reported that in Australia, the finding of Psoroptes cuniculi (Delafond) (including its synonym P. hippotis Raill. & Henry) in the ears of head-shaking horses is relatively common among thoroughbred racing horses in southern Queensland. A survey of the ears of horses undergoing theatre surgery showed that about 20% of the horses were infested.
Reich L.Horses' kicks can produce two types of head and neck injuries: injuries of the mid-face and injuries of the larynx. Typical cases as seen by the author are presented. The treatment of mid-face injuries is performed according to principles of plastic surgical repair. After frontal-nasal injuries, a revision of the nasal septum must be done. Involvement of the larynx requires external layer repair of mucosa and cartilage.
Spiesshofer P, Hawkins AE, Berner D, Previdelli RL, Fiske-Jackson AR.To describe, in detail, the relevant anatomy and surgical approach to access the paracondylar process (PCP) and report its application in a clinical case of headshaking. Methods: A seven-year-old, mixed breed mare. Methods: Experimental study/case report. Methods: A seven-year-old mixed breed mare was presented for investigation of acute onset progressing violent headshaking, resulting in the horse falling on multiple occasions. The horse was highly reactive to palpation over the right PCP. Standing computed tomographic (CT) investigation and ultrasonographic examination of the head detected a...
Pickles KJ, Marlin DJ, Williams JM, Roberts VLH.Equine trigeminal-mediated (TGM) headshaking (HS) is a neuropathic facial pain syndrome characterised by varying intensity and frequencies of head movements and signs of nasal irritation. An accurate method for quantification and/or characterisation of HS severity is lacking. Objective: To develop and validate an objective measure of TGMHS. Methods: Prospective case control study. Methods: Horses presenting for investigation of HS were recruited alongside those presenting for forelimb lameness (LAME) and pre-purchase examination as well as healthy controls (CONTROL). Head movement data were co...
Beldeanu S, Tay MCA, Daniel C, Dosi MCM, Hahn CN, James O, Townsend NB, Liuti T, Schwarz T, Parkinson NJ.Fractures of the paracondylar process of the occipital bone may cause headshaking, neck pain and neurologic deficits. The condition is being recognised more frequently with increasing availability of computed tomography. However, to date only limited information is available as to presentation, treatment, surgical approach and outcome. Objective: To describe the clinical signs, imaging findings, treatment, surgical approach and outcome in three horses diagnosed with paracondylar process fracture. Methods: Retrospective case series. Methods: Clinical records and diagnostic images of affected ca...
Franzen V, Gruber NA, Klußmann S, Schoster A, May A.Trigeminal-mediated headshaking is a neuropathic facial pain condition in horses. No treatment has been entirely successful. Repetitive transcranial magnetic stimulation (rTMS) is used in human medicine as a treatment for various neuropathic pain conditions, and good results have been achieved in cases of trigeminal neuralgia. Objective: Apply rTMS to horses with trigeminal-mediated headshaking (TMHS) and to evaluate tolerability, application of the setting, and success rate. Methods: Seventeen horses with nonseasonal signs of TMHS. Methods: Other underlying causes of headshaking were ruled ou...
Witt P, Stas EKL, Hardeman LC, van Proosdij ER, Weerts EAWS, Lloyd-Edwards RA, Veraa S, Kranenburg LC, van den Boom R.A sixteen-year-old Friesian mare was admitted to the university clinic with the following clinical signs: anorexia, weight loss, fever, bilateral nasal discharge, unilateral facial paralysis and a non-healing corneal lesion. Endoscopic examination of the upper airways showed thickening of the proximal portion of the right stylohyoid bone. Computed tomography imaging showed pneumocephalus due to grade 3 unilateral temporohyoid osteoarthropathy (THO) with fracture of the petrous temporal bone. The horse did not improve following medical treatment. Surgical intervention was declined by the owner ...
Forni G, Ellero N, Mannini A, Scacco L, Freccero F.A 3-year-old Quarter Horse stallion was referred for headshaking (HS) syndrome of one month duration. The horse underwent complete HS workup. Physical examination revealed up-and-down head movements associated with nose snorting during lunging and riding, in the absence of other abnormalities at rest or in motion. Lameness, neurologic and behavioural evaluations were unremarkable. Endoscopic examination of the upper respiratory tract showed bilateral guttural pouches (GPs) inflammation. The mucosal surface was altered by the presence of areas of microbullous appearance coalescing into some bul...
Heun F, Delarocque J, Feige K, Hellige M.Nerve atrophy results in trigeminal nerve (TN) asymmetry detectable by magnetic resonance imaging (MRI) in humans, but similar studies have not been performed in horses with idiopathic trigeminal-mediated headshaking (ITMHS). Objective: Horses with ITMHS show greater MRI-detected trigeminal-nerve asymmetry than controls. Methods: A total of 20 adult horses with ITMHS and six unaffected control horses. Methods: Retrospective case-control study of the TN cross-sectional area (TNCSA) based on 3-Tesla MRI scans of the equine brain. TNCSA and its side-to-side differences at four defined measurement...
Aleman M, Morales CJ.Idiopathic trigeminal-mediated headshaking is a painful neuropathic disorder characterized by sudden, violent, predominantly vertical head movements of unknown etiology. Clinical signs may be seasonal or persistent and triggered by light, sound, exercise, or tactile nasal stimulation. The pathophysiology is multifactorial, involving abnormal trigeminal nerve excitability influenced by hormonal, environmental, and dietary factors. Treatment is challenging and typically multimodal, aiming to reduce trigeminal hypersensitivity and improve quality of life.
Hartl B, Strohmayer C, Vali Y, Lyrakis M, Kneissl SM.Horses with hyoid bone disease may present with clinical symptoms such as exercise intolerance, resistance to ridden work, anorexia, or headshaking. This study aims to describe the computed tomographic (CT) signs and prevalence of hyoid disease and to evaluate their association with other CT changes of the head. Unassigned: In this study, four investigators conducted a retrospective analysis of their findings after reviewing the medical records of 200 horses that had undergone CT scans between 2009 and 2019. A total of 32 parameters were analyzed, and associations were evaluated between those ...
Maier J, Rosenstand MG, Thim P, Aalund M.Introduction Imaging experience made us suspect an overrepresentation of ponytails in riders admitted as polytrauma after falling from their horse. Methods In a single-centre case-control study conducted over three months, we reviewed the records of all admitted polytraumatised patients for trauma mechanism and presence of ponytail on CT. Cerebral CTs were reviewed in the three standard imaging planes using a bone or lung window. Ponytail was diagnosed if most or all of the hair on the head was gathered and secured at the back of the head with a hair tie. Data were analysed with Fisher's exact...
