Neuropathy in horses refers to a range of disorders affecting the peripheral nervous system, including the nerves outside the brain and spinal cord. These conditions can result from various causes such as trauma, infection, metabolic disorders, or toxins, leading to symptoms like muscle weakness, atrophy, and sensory deficits. Neuropathy can impact a horse's movement, coordination, and overall performance. Diagnosis often involves clinical evaluation, nerve conduction studies, and sometimes biopsy. This page provides access to peer-reviewed research studies and scholarly articles that explore the etiology, pathophysiology, diagnostic methods, and management strategies for neuropathy in equine patients.
Baldwin CM, Ireland JL, Barakzai SZ.There is no objective information reporting the effect of unilateral laser ventriculocordectomy (VeC) on arytenoid abduction or stability. Objective: To evaluate arytenoid stability and abduction in horses with severe recurrent laryngeal neuropathy (RLN) before and after unilateral laser VeC. Methods: Prospective cohort. Methods: Eight horses with grade C or D exercising laryngeal function that underwent unilateral laser VeC were included. Exercising endoscopy was performed before and ≥6 weeks after left-sided laser VeC. Arytenoid stability at maximal exercise was calculated by measuring t...
McGorum BC, Davey T, Dosi MCM, Keen JA, Morrison LR, Pirie RS, Shaw DJ, Harris JB.Equine grass sickness (EGS) is a frequently fatal multisystem neuropathy of equids. The aetiology is unknown; proposed causes include toxicoinfection with Clostridium botulinum and a mycotoxicosis. The effect of EGS on the organisation and structural integrity of the skeletal neuromuscular junction (NMJ), the target of botulinum neurotoxins (BoNTs), is unknown. Objective: To compare the organisation and structural integrity of skeletal NMJs from EGS horses, control horses and one horse with a presumptive diagnosis of botulism. Methods: Blinded, retrospective case control. Methods: NMJs in samp...
Massie SL, Léguillette R.Barrel racing involves sprinting through a cloverleaf pattern in under 20 s. The prevalence of upper airway obstructions (UAO) in barrel racers is unknown, thus a retrospective analysis of 164 client-owned horses referred for overground endoscopy (OGE) between 2014 and 2022 was performed. Referring complaints included respiratory noise, cough, epistaxis, behaviour (owner reported stress/anxiety, refusal to enter arena, excessive head shaking), and/or poor performance. Horses performed a standardized exercise test with low and high-speed components. Videoendoscopic recordings were systematical...
Murer S, Polidori G, Beaumont F, Bogard F, Hakim H, Legrand F.Pudendal Neuralgia (PN) is a rare, debilitating disease caused by damage to the pudendal nerve, which innervates the anus, rectum, perineum, lower urinary tract, and genitalia. Although its etiology remains scientifically unknown, a number of sports practices, including horse-riding, are reported as triggering and/or aggravating factors. The present work summarizes the experimental measurements of the contact pressure at the interface between the rider and saddle, for a population of 12 experienced female riders. These tests reveal that dynamic horseback-riding leads to high levels of peak pre...
Cahalan SD, Perkins JD, Boehm I, Jones RA, Gillingwater TH, Piercy RJ.Morphological study of the neuromuscular junction (NMJ), a specialised peripheral synapse formed between a lower motor neuron and skeletal muscle fibre, has significantly contributed to the understanding of synaptic biology and neuromuscular disease pathogenesis. Rodent NMJs are readily accessible, and research into conditions such as amyotrophic lateral sclerosis (ALS), Charcot-Marie-Tooth disease (CMT), and spinal muscular atrophy (SMA) has relied heavily on experimental work in these small mammals. However, given that nerve length dependency is an important feature of many peripheral neurop...
Moreno KL, Scallan EM, Friedeck WO, Simon BT.Pelvic limb neuropathy is a rare post-anaesthetic complication. In the authors' experiences, the incidence of post-anaesthesia neuropathy is increased following MRI of the proximal metatarsus and tarsal regions when compared with previously reported incidences of post-anaesthetic neuropathy. Objective: This study reports the incidence, diagnosis, treatment and outcome of seven horses with post-anaesthesia neuropathy following proximal metatarsal and tarsal MRI. Methods: Retrospective case series. Methods: Case record review of horses receiving general anaesthesia for MRI between 1 January 2012...
Pujol R, Girard CA, Richard H, Hassanpour I, Binette MP, Beauchamp G, McDougall JJ, Laverty S.To measure the nerve fiber density in synovial membranes from healthy and OA equine joints and to investigate the relationship between synovial innervation and OA severity, synovial vascularity and synovitis. Twenty-five equine metacarpophalangeal joints were collected post-mortem. The joints were dissected and the macroscopic lesions of the articular cartilage were scored. Synovial membrane specimens (n = 50) were harvested, fixed, sectioned and scored histologically. Immunohistochemical staining and immunofluorescence with S-100 protein, that identifies nerve fibers, and ⍺-actin, that st...
Draper ACE, Piercy RJ.Recurrent Laryngeal Neuropathy (RLN) is a highly prevalent and predominantly left-sided, degenerative disorder of the recurrent laryngeal nerves (RLn) of tall horses, that causes inspiratory stridor at exercise because of intrinsic laryngeal muscle paresis. The associated laryngeal dysfunction and exercise intolerance in athletic horses commonly leads to surgical intervention, retirement or euthanasia with associated financial and welfare implications. Despite speculation, there is a lack of consensus and conflicting evidence supporting the primary classification of RLN, as either a distal ("d...
Hanche-Olsen S, Matiasek K, Molín J, Rosati M, Hahn C, Hultin Jäderlund K, Gröndahl G.Acquired equine polyneuropathy (AEP), formerly also known as Scandinavian knuckling syndrome, is one of the most prevalent polyneuropathies in equids in Norway and Sweden, with more than 400 cases registered since first observations in 1995. Despite geographical clustering and an association to forage feeding, its aetiology remains unknown. Clinically AEP is characterized by knuckling due to dysfunction of metatarsophalangeal extensor muscles. This neuropathological study aimed to gain further insights in the pathobiology of AEP and its underlying aetiopathogenesis. We thereby confirmed that a...
Fleischli JG, Laughlin TJ, Fleischli JW.Treatment of diabetic foot wounds remains a major health-care issue, with diabetic foot ulcers representing the most common causal pathway to lower-extremity amputation. Although several investigations have examined topical collagen-based dressings, none have specifically looked at equine pericardium. We, therefore, evaluated the effect of the equine pericardium dressing on neuropathic foot wounds. Methods: Twenty-three consecutive patients with 34 neuropathic foot wounds were evaluated as part of a pilot study. An equine pericardium dressing was applied in a standard manner, and the patients ...
Hahn CN, Matiasek K, Dixon PM, Molony V, Rodenacker K, Mayhew IG.Recurrent laryngeal neuropathy (RLN) is a common and debilitating peripheral nerve disease of horses, but it remains unclear if this disease is a mono- or polyneuropathy. An understanding of the distribution of the neuropathological lesions in RLN affected horses is fundamental to studying the aetiology of this very significant disease of tall horses. Objective: To determine whether RLN should be classified as a mono- or polyneuropathy. Methods: Multiple long peripheral nerves and their innervated muscles were examined systematically in 3 clinically affected RLN horses Results: Severe lesions ...
Wijnberg ID, Franssen H, Jansen GH, van den Ingh TS, van der Harst MR, van der Kolk JH.Clinical evidence of motor neuron involvement in equine grass sickness (EGS) has not been reported. Objective: Quantitative electromyography (EMG) analysis can elucidate subtle changes of the lower motor neuron system present in horses with EGS, performed ante mortem. Methods: Fourteen horses diagnosed clinically with acute, subacute or chronic EGS were examined and quantitative EMG performed. Previously published data on healthy horses and horses with proven lower motor neuron disease (LMND) were used as controls. In 8 horses post mortem examination was performed, and in 7 muscle biopsies of ...
Trim CM.Hemorrhagic myelopathy or myelomalacia is an uncommon cause of failure to stand after general anesthesia. Affected horses are usually young and have been anesthetized for relatively short times in dorsal recumbency. Clinical signs involve the hind limbs and include loss of deep pain perception. Etiology of this condition is not known. Differentiation from other forms of neuropathy and myopathy is important to the prognosis.
Duncan ID, Reifenrath P, Jackson KF, Clayton M.The terminal branches of the recurrent laryngeal nerve (RLN) of three normal ponies and six horses with sub-clinical laryngeal disease were examined qualitatively and quantitatively in an attempt to explain the preferential denervation of the laryngeal adductor muscles in the neuropathy of idiopathic laryngeal hemiplegia (ILH). The myelinated fibre spectra of all the motor nerve fibres in the left and right abductor and adductor branches of the RLN in three normal ponies were measured. The density of myelinated fibres was also calculated. There was no significant difference between the larger ...
Cummings JF, de Lahunta A, George C, Fuhrer L, Valentine BA, Cooper BJ, Summers BA, Huxtable CR, Mohammed HO.A spontaneous motor neuron disease or neuronopathy was identified in 10 horses from the northeastern United States. Signs of generalized weakness, muscle fasciculations, muscle atrophy and weight loss progressed over 1 to several months in young and old horses of various breeds. Pathologic studies revealed that degeneration and loss of motor neurons in the spinal cord and brain stem resulted in axonal degeneration in the ventral roots and peripheral and cranial nerves and denervation atrophy of skeletal muscle. Many spinal neurons were swollen, chromatolytic and contained neurofilamentous accu...
Duncan ID, Hammang JP.The left recurrent laryngeal nerves from five horses with sub-clinical neuropathy were examined by light and electron microscopy in a study designed to examine accumulation of axonal organelles at paranodal and internodal locations. Transverse sections of the nerve showed scattered fibres with split myelin sheaths and axonal accumulation of organelles. On longitudinal sections these collections were seen to result from an axonal outpouching in which dense lamellar bodies and mitochondria had accumulated. These paranodal collections, which could be found on both sides of the node, were often as...
McEntee M, Summers BA, de Lahunta A, Cummings J.A 3-year-old horse presented with intermittent generalized seizures of 2-month duration. During interictal periods, the horse appeared normal and a cause for the seizures could not be identified. Necropsy revealed opacity of the leptomeninges, covering most of one cerebral hemisphere along with thinning and collapse of the cortex in the ipsilateral pyriform lobe. Histopathology demonstrated leptomeningeal vascular proliferation and meningothelial hyperplasia. Prominent tortuous vessels of the gyri and sulci extended into some regions of the subjacent cortex, where there was neuronal loss, ecto...
Duncan ID, Schneider RK, Hammang JP.The suprascapular nerve from 14 horses, which had no clinical evidence of spinatus muscle atrophy, were obtained to determine whether the nerve was sub-clinically compressed at the scapular edge. The nerves were divided into three portions, proximal and distal to the scapular edge and as it reflected around it. In nine horses there was evidence of a chronic neuropathy which varied in severity and which was most severe at the site of reflection, where the nerve appeared constricted by a tendinous band. At this site the predominant change was that of chronic demyelination and remyelination, with...
Palmer AC, Leadon DP, Rossdale PD, Jeffcott LB.A neuropathological examination was carried out on the brains of 58 foals. Forty-two were pony foals induced at various periods of gestation from 200 days onwards. Two were pre-viable pony foals delivered by caesarean section and 14 were Thoroughbred foals (one set of twins, two stillborn, five premature, two dysmature, two convulsive and one induced). The only significant pathological change involved intracranial haemorrhage. Subarachnoid haemorrhage occurred in all of 10 pony foals induced before 301 days of gestation and in two pony foals born by caesarean section at 270 and 280 days gestat...
Duncan ID, Griffiths IR, Madrid RE.A study has been made of the pathological changes in the recurrent laryngeal nerves from horses with clinical and sub-clinical idiopathic laryngeal hemiplegia. Qualitative and quantitative studies showed in clinical cases there was a progressive distal loss of large myelinated fibres in the left recurrent nerve. Regenerating clusters and onion bulbs were frequently seen in affected nerves both at proximal and distal levels. Degenerating axons were characterized by collections of organelles, and denervated bands of Bungner were common. Similar but less severe changes were seen in the left recur...
Saunders LZ, Bistner SI, Rubin LF.An asymptomatic, ophthalmoscopically visible proliferation affected the optic disc and nerve of two aged horses. The lesion consisted of an accumulation of foamy cells, histologically akin to fat cells, which contained an unidentified lipid-like material. The affected area and its environs were permeated by tortuous, thickened blood vessels with heavy deposits of collagen in their walls. The neuropathy is considered to be a storage disease, and although the product stored is unidentified, the lesion is similar to that of human xanthelasma. The neuropathy seems distinct from the exudative optic...
Duncan ID, Griffiths IR, Madrid RE.A study has been made of the pathological changes in the recurrent laryngeal nerves from horses with clinical and sub-clinical idiopathic laryngeal hemiplegia. Qualitative and quantitative studies showed in clinical cases there was a progressive distal loss of large myelinated fibres in the left recurrent nerve. Regenerating clusters and onion bulbs were frequently seen in affected nerves both at proximal and distal levels. Degenerating axons were characterized by collections of organelles, and denervated bands of Bungner were common. Similar but less severe changes were seen in the left recur...
Draper ACE, Piercy RJ.Recurrent Laryngeal Neuropathy (RLN) is a highly prevalent and predominantly left-sided, degenerative disorder of the recurrent laryngeal nerves (RLn) of tall horses, that causes inspiratory stridor at exercise because of intrinsic laryngeal muscle paresis. The associated laryngeal dysfunction and exercise intolerance in athletic horses commonly leads to surgical intervention, retirement or euthanasia with associated financial and welfare implications. Despite speculation, there is a lack of consensus and conflicting evidence supporting the primary classification of RLN, as either a distal ("d...
Hahn CN, Matiasek K, Dixon PM, Molony V, Rodenacker K, Mayhew IG.Recurrent laryngeal neuropathy (RLN) is a common and debilitating peripheral nerve disease of horses, but it remains unclear if this disease is a mono- or polyneuropathy. An understanding of the distribution of the neuropathological lesions in RLN affected horses is fundamental to studying the aetiology of this very significant disease of tall horses. Objective: To determine whether RLN should be classified as a mono- or polyneuropathy. Methods: Multiple long peripheral nerves and their innervated muscles were examined systematically in 3 clinically affected RLN horses Results: Severe lesions ...
Duncan ID, Hammang JP.The left recurrent laryngeal nerves from five horses with sub-clinical neuropathy were examined by light and electron microscopy in a study designed to examine accumulation of axonal organelles at paranodal and internodal locations. Transverse sections of the nerve showed scattered fibres with split myelin sheaths and axonal accumulation of organelles. On longitudinal sections these collections were seen to result from an axonal outpouching in which dense lamellar bodies and mitochondria had accumulated. These paranodal collections, which could be found on both sides of the node, were often as...
Duncan ID, Reifenrath P, Jackson KF, Clayton M.The terminal branches of the recurrent laryngeal nerve (RLN) of three normal ponies and six horses with sub-clinical laryngeal disease were examined qualitatively and quantitatively in an attempt to explain the preferential denervation of the laryngeal adductor muscles in the neuropathy of idiopathic laryngeal hemiplegia (ILH). The myelinated fibre spectra of all the motor nerve fibres in the left and right abductor and adductor branches of the RLN in three normal ponies were measured. The density of myelinated fibres was also calculated. There was no significant difference between the larger ...
Wijnberg ID, Franssen H, Jansen GH, van den Ingh TS, van der Harst MR, van der Kolk JH.Clinical evidence of motor neuron involvement in equine grass sickness (EGS) has not been reported. Objective: Quantitative electromyography (EMG) analysis can elucidate subtle changes of the lower motor neuron system present in horses with EGS, performed ante mortem. Methods: Fourteen horses diagnosed clinically with acute, subacute or chronic EGS were examined and quantitative EMG performed. Previously published data on healthy horses and horses with proven lower motor neuron disease (LMND) were used as controls. In 8 horses post mortem examination was performed, and in 7 muscle biopsies of ...
Cahalan SD, Perkins JD, Boehm I, Jones RA, Gillingwater TH, Piercy RJ.Morphological study of the neuromuscular junction (NMJ), a specialised peripheral synapse formed between a lower motor neuron and skeletal muscle fibre, has significantly contributed to the understanding of synaptic biology and neuromuscular disease pathogenesis. Rodent NMJs are readily accessible, and research into conditions such as amyotrophic lateral sclerosis (ALS), Charcot-Marie-Tooth disease (CMT), and spinal muscular atrophy (SMA) has relied heavily on experimental work in these small mammals. However, given that nerve length dependency is an important feature of many peripheral neurop...
Saunders LZ, Bistner SI, Rubin LF.An asymptomatic, ophthalmoscopically visible proliferation affected the optic disc and nerve of two aged horses. The lesion consisted of an accumulation of foamy cells, histologically akin to fat cells, which contained an unidentified lipid-like material. The affected area and its environs were permeated by tortuous, thickened blood vessels with heavy deposits of collagen in their walls. The neuropathy is considered to be a storage disease, and although the product stored is unidentified, the lesion is similar to that of human xanthelasma. The neuropathy seems distinct from the exudative optic...
Hanche-Olsen S, Matiasek K, Molín J, Rosati M, Hahn C, Hultin Jäderlund K, Gröndahl G.Acquired equine polyneuropathy (AEP), formerly also known as Scandinavian knuckling syndrome, is one of the most prevalent polyneuropathies in equids in Norway and Sweden, with more than 400 cases registered since first observations in 1995. Despite geographical clustering and an association to forage feeding, its aetiology remains unknown. Clinically AEP is characterized by knuckling due to dysfunction of metatarsophalangeal extensor muscles. This neuropathological study aimed to gain further insights in the pathobiology of AEP and its underlying aetiopathogenesis. We thereby confirmed that a...
Duncan ID, Schneider RK, Hammang JP.The suprascapular nerve from 14 horses, which had no clinical evidence of spinatus muscle atrophy, were obtained to determine whether the nerve was sub-clinically compressed at the scapular edge. The nerves were divided into three portions, proximal and distal to the scapular edge and as it reflected around it. In nine horses there was evidence of a chronic neuropathy which varied in severity and which was most severe at the site of reflection, where the nerve appeared constricted by a tendinous band. At this site the predominant change was that of chronic demyelination and remyelination, with...
Trim CM.Hemorrhagic myelopathy or myelomalacia is an uncommon cause of failure to stand after general anesthesia. Affected horses are usually young and have been anesthetized for relatively short times in dorsal recumbency. Clinical signs involve the hind limbs and include loss of deep pain perception. Etiology of this condition is not known. Differentiation from other forms of neuropathy and myopathy is important to the prognosis.
Cummings JF, de Lahunta A, George C, Fuhrer L, Valentine BA, Cooper BJ, Summers BA, Huxtable CR, Mohammed HO.A spontaneous motor neuron disease or neuronopathy was identified in 10 horses from the northeastern United States. Signs of generalized weakness, muscle fasciculations, muscle atrophy and weight loss progressed over 1 to several months in young and old horses of various breeds. Pathologic studies revealed that degeneration and loss of motor neurons in the spinal cord and brain stem resulted in axonal degeneration in the ventral roots and peripheral and cranial nerves and denervation atrophy of skeletal muscle. Many spinal neurons were swollen, chromatolytic and contained neurofilamentous accu...
Palmer AC, Leadon DP, Rossdale PD, Jeffcott LB.A neuropathological examination was carried out on the brains of 58 foals. Forty-two were pony foals induced at various periods of gestation from 200 days onwards. Two were pre-viable pony foals delivered by caesarean section and 14 were Thoroughbred foals (one set of twins, two stillborn, five premature, two dysmature, two convulsive and one induced). The only significant pathological change involved intracranial haemorrhage. Subarachnoid haemorrhage occurred in all of 10 pony foals induced before 301 days of gestation and in two pony foals born by caesarean section at 270 and 280 days gestat...
McEntee M, Summers BA, de Lahunta A, Cummings J.A 3-year-old horse presented with intermittent generalized seizures of 2-month duration. During interictal periods, the horse appeared normal and a cause for the seizures could not be identified. Necropsy revealed opacity of the leptomeninges, covering most of one cerebral hemisphere along with thinning and collapse of the cortex in the ipsilateral pyriform lobe. Histopathology demonstrated leptomeningeal vascular proliferation and meningothelial hyperplasia. Prominent tortuous vessels of the gyri and sulci extended into some regions of the subjacent cortex, where there was neuronal loss, ecto...
Fleischli JG, Laughlin TJ, Fleischli JW.Treatment of diabetic foot wounds remains a major health-care issue, with diabetic foot ulcers representing the most common causal pathway to lower-extremity amputation. Although several investigations have examined topical collagen-based dressings, none have specifically looked at equine pericardium. We, therefore, evaluated the effect of the equine pericardium dressing on neuropathic foot wounds. Methods: Twenty-three consecutive patients with 34 neuropathic foot wounds were evaluated as part of a pilot study. An equine pericardium dressing was applied in a standard manner, and the patients ...
Pujol R, Girard CA, Richard H, Hassanpour I, Binette MP, Beauchamp G, McDougall JJ, Laverty S.To measure the nerve fiber density in synovial membranes from healthy and OA equine joints and to investigate the relationship between synovial innervation and OA severity, synovial vascularity and synovitis. Twenty-five equine metacarpophalangeal joints were collected post-mortem. The joints were dissected and the macroscopic lesions of the articular cartilage were scored. Synovial membrane specimens (n = 50) were harvested, fixed, sectioned and scored histologically. Immunohistochemical staining and immunofluorescence with S-100 protein, that identifies nerve fibers, and ⍺-actin, that st...
Murer S, Polidori G, Beaumont F, Bogard F, Hakim H, Legrand F.Pudendal Neuralgia (PN) is a rare, debilitating disease caused by damage to the pudendal nerve, which innervates the anus, rectum, perineum, lower urinary tract, and genitalia. Although its etiology remains scientifically unknown, a number of sports practices, including horse-riding, are reported as triggering and/or aggravating factors. The present work summarizes the experimental measurements of the contact pressure at the interface between the rider and saddle, for a population of 12 experienced female riders. These tests reveal that dynamic horseback-riding leads to high levels of peak pre...
Moreno KL, Scallan EM, Friedeck WO, Simon BT.Pelvic limb neuropathy is a rare post-anaesthetic complication. In the authors' experiences, the incidence of post-anaesthesia neuropathy is increased following MRI of the proximal metatarsus and tarsal regions when compared with previously reported incidences of post-anaesthetic neuropathy. Objective: This study reports the incidence, diagnosis, treatment and outcome of seven horses with post-anaesthesia neuropathy following proximal metatarsal and tarsal MRI. Methods: Retrospective case series. Methods: Case record review of horses receiving general anaesthesia for MRI between 1 January 2012...
Massie SL, Léguillette R.Barrel racing involves sprinting through a cloverleaf pattern in under 20 s. The prevalence of upper airway obstructions (UAO) in barrel racers is unknown, thus a retrospective analysis of 164 client-owned horses referred for overground endoscopy (OGE) between 2014 and 2022 was performed. Referring complaints included respiratory noise, cough, epistaxis, behaviour (owner reported stress/anxiety, refusal to enter arena, excessive head shaking), and/or poor performance. Horses performed a standardized exercise test with low and high-speed components. Videoendoscopic recordings were systematical...
McGorum BC, Davey T, Dosi MCM, Keen JA, Morrison LR, Pirie RS, Shaw DJ, Harris JB.Equine grass sickness (EGS) is a frequently fatal multisystem neuropathy of equids. The aetiology is unknown; proposed causes include toxicoinfection with Clostridium botulinum and a mycotoxicosis. The effect of EGS on the organisation and structural integrity of the skeletal neuromuscular junction (NMJ), the target of botulinum neurotoxins (BoNTs), is unknown. Objective: To compare the organisation and structural integrity of skeletal NMJs from EGS horses, control horses and one horse with a presumptive diagnosis of botulism. Methods: Blinded, retrospective case control. Methods: NMJs in samp...
Baldwin CM, Ireland JL, Barakzai SZ.There is no objective information reporting the effect of unilateral laser ventriculocordectomy (VeC) on arytenoid abduction or stability. Objective: To evaluate arytenoid stability and abduction in horses with severe recurrent laryngeal neuropathy (RLN) before and after unilateral laser VeC. Methods: Prospective cohort. Methods: Eight horses with grade C or D exercising laryngeal function that underwent unilateral laser VeC were included. Exercising endoscopy was performed before and ≥6 weeks after left-sided laser VeC. Arytenoid stability at maximal exercise was calculated by measuring t...
