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Caudal anaesthesia of the infraorbital nerve for diagnosis of idiopathic headshaking and caudal compression of the infraorbital nerve for its treatment, in 58 horses.
Abstract: Idiopathic headshaking is often a facial pain syndrome, but a diagnostic protocol has not been described. In a previous study, caudal compression of the infraorbital nerve for treatment offered a fair success rate, but low case numbers and short follow-up time were limitations. Objective: To describe a diagnostic protocol for headshaking, examining the role of bilateral local analgesia of the posterior ethmoidal nerve (PET block). To report longer-term follow-up after surgery of the original cases and further cases and to determine whether changes to the technique influence success rates and complications. Methods: Records of horses that had undergone PET block and caudal compression surgery at 3 hospitals were reviewed. Modifications to the surgical technique included placing additional coils into the infraorbital canal and/or performing concurrent laser cautery of the nerve. Follow-up information was obtained by telephone contact with owners. Results: The PET block was performed in 27 horses, with a positive result in 23 of 27 (85%). Surgery was performed in 58 horses. A successful outcome was initially achieved in 35 of 57 (63%) horses, but recurrence occurred between 9 and 30 months later in 9 (26%). Surgery was repeated in 10 of 31 (32%) horses. Final success rate, considering only response to the last performed surgery, was 28 of 57 (49%) horses with median follow-up time of 18 months (range 2-66 months). Nose-rubbing was reported post operatively in 30 of 48 (63%) horses. This resolved in all but 4 horses, which were subjected to euthanasia. Response to PET block or change in surgical technique did not appear to influence outcome or complications. Conclusions: The diagnostic protocol described is recommended for the investigation of headshakers. Caudal compression offers the best prognosis for a successful outcome compared with other treatments, for horses in which the only alternative is euthanasia. Surgical treatment of the disorder requires refinement, and the pathogenesis of the disorder requires investigation.
© 2012 EVJ Ltd.
Publication Date: 2012-03-13 PubMed ID: 22413870DOI: 10.1111/j.2042-3306.2012.00553.xGoogle Scholar: Lookup The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
Summary
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This research paper focuses on a diagnostic and treatment protocol for idiopathic headshaking in horses, a condition often related to facial pain. The study assesses the effectiveness of bilateral local analgesia of the posterior ethmoidal nerve for diagnosis and caudal compression of the infraorbital nerve for treatment, using a sample of 58 horses and a long-term follow-up period.
Objectives and Methods
- One aim of the study was to design a thorough diagnostic method for identifying headshaking in horses, focusing on the use of the posterior ethmoidal nerve’s (PET) analgesia.
- The researchers also aimed to present a more extended follow-up report on the use of caudal compression of the infraorbital nerve as a treatment for the condition.
- The research was carried out in three veterinary hospitals where the records of horses which underwent both PET block and caudal compression surgery were reviewed.
Results and Findings
- Out of 27 horses that underwent PET block, 23 horses (85%) showed a positive result, indicating the diagnostics’ effectiveness.
- Out of 58 that underwent surgery, initial success was observed in 35 (63%) horses.
- However, symptoms returned in 9 of those horses between 9 and 30 months after the surgery.
- Surgery was repeated in 10 of 31 (32%) horses, implying that the initial treatment was not permanently successful.
- Ultimately, the final success rate, considering only the outcomes of the last conducted surgery, was 28 of 57 (49%) with a median follow-up period of 18 months.
- Post-operative nose rubbing, a side-effect, was reported by 63% of horses, but this was resolved in all but four cases which unfortunately, led to euthanasia.
Conclusions
- The results suggest that the proposed diagnostic method of using PET block is effective in diagnosing headshaking in horses.
- Additionally, caudal compression was found to offer the best prognosis for a successful outcome among available treatments.
- However, it was noted that surgical treatment for this disorder requires further refinement to enhance its effectiveness and reduce the chance of symptom recurrence.
- Furthermore, a deeper understanding of the disease’s pathogenesis is necessary to improve both diagnostic and treatment methods.
Cite This Article
APA
Roberts VL, Perkins JD, Skärlina E, Gorvy DA, Tremaine WH, Williams A, McKane SA, White I, Knottenbelt DC.
(2012).
Caudal anaesthesia of the infraorbital nerve for diagnosis of idiopathic headshaking and caudal compression of the infraorbital nerve for its treatment, in 58 horses.
Equine Vet J, 45(1), 107-110.
https://doi.org/10.1111/j.2042-3306.2012.00553.x Publication
Researcher Affiliations
- Department of Clinical Veterinary Science, University of Bristol, Langford House, Langford, North Somerset, UK. veronica.roberts@bristol.ac.uk
MeSH Terms
- Animals
- Behavior, Animal
- Head / physiopathology
- Head Movements
- Horse Diseases / physiopathology
- Horse Diseases / surgery
- Horses
- Orbit / innervation
- Retrospective Studies
- Time Factors
Citations
This article has been cited 12 times.- Kloock T, Hellige M, Kloock A, Feige K, Niebuhr T. Impact of Different Diagnostic Procedures on Diagnosis, Therapy, and Outcome in Horses with Headshaking: Recommendations for Fast-Track Advanced Diagnostic and Therapeutic Protocols. Animals (Basel) 2022 Nov 13;12(22).
- Vuerich M, Nannarone S. Retrograde Approach to Maxillary Nerve Block: An Alternative in Orofacial Surgeries in Horses. Animals (Basel) 2022 May 27;12(11).
- Roberts VLH, Bailey M, Patel NK. The safety and efficacy of neuromodulation using percutaneous electrical nerve stimulation for the management of trigeminal-mediated headshaking in 168 horses. Equine Vet J 2020 Mar;52(2):238-243.
- Sheldon SA, Aleman M, Costa LRR, Weich K, Howey Q, Madigan JE. Effects of magnesium with or without boron on headshaking behavior in horses with trigeminal-mediated headshaking. J Vet Intern Med 2019 May;33(3):1464-1472.
- Sheldon SA, Aleman M, Costa LRR, Santoyo AC, Howey Q, Madigan JE. Intravenous infusion of magnesium sulfate and its effect on horses with trigeminal-mediated headshaking. J Vet Intern Med 2019 Mar;33(2):923-932.
- Roberts V. Trigeminal-mediated headshaking in horses: prevalence, impact, and management strategies. Vet Med (Auckl) 2019;10:1-8.
- Bell C, Hnenny L, Torske K. Internal neurolysis of the maxillary branch of the trigeminal nerve for the treatment of equine trigeminal mediated headshaking syndrome. Can Vet J 2018 Jul;59(7):763-769.
- Sheldon S, Aleman M, Costa L, Santoyo AC, Howey Q, Madigan J. Alterations in Metabolic Status and Headshaking Behavior Following Intravenous Administration of Hypertonic Solutions in Horses with Trigeminal-Mediated Headshaking. Animals (Basel) 2018 Jun 25;8(7).
- Roberts VL, Fews D, McNamara JM, Love S. Trigeminal Nerve Root Demyelination Not Seen in Six Horses Diagnosed with Trigeminal-Mediated Headshaking. Front Vet Sci 2017;4:72.
- Doherty O, Casey V, McGreevy P, Arkins S. Noseband Use in Equestrian Sports - An International Study. PLoS One 2017;12(1):e0169060.
- Aleman M, Rhodes D, Williams DC, Guedes A, Madigan JE. Sensory evoked potentials of the trigeminal nerve for the diagnosis of idiopathic headshaking in a horse. J Vet Intern Med 2014 Jan-Feb;28(1):250-3.
- de Preux M, Precht C, Becker R, Stieglitz L, Easley J, Koch C. Navigated minimally invasive puncture of the trigeminal cistern in horses-a cadaveric study in preparation for a controlled rhizotomy. Front Vet Sci 2025;12:1562404.
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