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Impact of Different Diagnostic Procedures on Diagnosis, Therapy, and Outcome in Horses with Headshaking: Recommendations for Fast-Track Advanced Diagnostic and Therapeutic Protocols.
Abstract: Most horses affected by headshaking (HS) are diagnosed with idiopathic trigeminal-mediated headshaking (i-TMHS) when no underlying disease is found. Diagnosis is made by the exclusion of differentials considering history, clinical signs, and diagnostic investigations. Therefore, in horses presented with headshaking, many diagnostic procedures and therapies are conducted. Retrospectively, the digital patient records of 240 horses with HS were analysed regarding the impact of diagnostic procedures on diagnosis, therapy, and outcome. Horses were extensively examined using a standardised protocol including clinical (ophthalmologic, orthopaedic, neurologic, dental) examination, blood analysis, and imaging techniques (endoscopy, radiographs, computed tomography (CT), and magnetic resonance imaging). Many findings were revealed but were of clinical relevance in only 6% of the horses. These horses were, therefore, diagnosed with secondary headshaking (s-HS). In addition, all of these horses demonstrated a positive outcome. The CT of the head revealed 9/10 of the clinically relevant findings. Other diagnostic procedures had no major additional impact. Conclusively, the diagnostic investigation of horses with HS should aim at differentiating i-TMHS from s-HS. The clinical relevance of findings should be verified through diagnostic anaesthesia or targeted therapy depending on risks, invasiveness, and expected benefits. To reduce the multitude of examinations, diagnostic investigations should focus on the CT of the head in those horses with suspicion of i-TMHS based on typical history, clinical signs, and physical examination.
Publication Date: 2022-11-13 PubMed ID: 36428354PubMed Central: PMC9686903DOI: 10.3390/ani12223125Google 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
- Clinical Examination
- Clinical Findings
- Clinical Pathology
- Clinical Signs
- Clinical Study
- Computed Tomography
- Diagnosis
- Diagnostic Technique
- Disease Diagnosis
- Disease Treatment
- Equine Health
- Equine-Assisted Therapies
- Headshaking
- Horses
- Imaging Techniques
- Magnetic Resonance Imaging
- Outcome Assessment
- Radiology
- Retrospective Study
- Veterinary Medicine
- Veterinary Practice
Summary
This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.
The research focuses on how using different diagnostic procedures affects the detection, treatment, and outcomes in horses suffering from a condition known as headshaking. It recommends adopting more efficient diagnostic and therapeutic practices, particularly the CT scan of the head, to identify if the animal is suffering from primary (idiopathic) or secondary headshaking.
Understanding Headshaking in Horses
- This study revolves around a condition in horses known as headshaking (HS), where the dominant diagnosis is idiopathic trigeminal-mediated headshaking (i-TMHS) if no underlying disease is found.
- The diagnosis of HS often has to rule out different factors by analyzing the horse’s history, presenting clinical signs, and conducting several medical investigations.
- Therefore, horses showing symptoms of HS often undergo many diagnostic procedures and treatments.
Methodology: Retrospective Analysis of Patient Records
- The research takes into account the digital records of 240 horses previously diagnosed with HS, studying the influence of various diagnostic procedures on diagnosis, therapy, and outcome.
- The methodology included a standardized protocol of conducting a thorough examination of the horse, including ophthalmologic, orthopaedic, neurologic, and dental evaluations, blood work, and several imaging techniques such as endoscopy, radiographs, CT scans, and MRI.
Findings
- In the course of the analysis, investigators discerned multiple findings, but only 6% of these were clinically relevant, leading these horses to be diagnosed with secondary headshaking (s-HS).
- Horses diagnosed with s-HS showed positive outcomes after treatment.
- Almost all clinically relevant findings (9 out of 10 cases) were observed via CT scans of the head, with other diagnostic measures having a far less significant impact.
Recommendations
- The research suggests that diagnosing horses with HS should focus on distinguishing between i-TMHS and s-HS.
- The clinical relevance of symptoms in the horses should be confirmed through diagnostic anaesthesia, or via targeted therapy depending upon the risk factors, invasiveness of the procedure, and expected benefits.
- To reduce the burden of multiple examinations, investigations should primarily focus on performing CT scans of the head, especially for horses suspected of having i-TMHS based on their history, observed clinical signs, and physical examination.
Cite This Article
APA
Kloock T, Hellige M, Kloock A, Feige K, Niebuhr T.
(2022).
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), 12(22).
https://doi.org/10.3390/ani12223125 Publication
Researcher Affiliations
- Clinic for Horses, University of Veterinary Medicine Hannover Foundation, Bünteweg 9, 30559 Hanover, Germany.
- Clinic for Horses, University of Veterinary Medicine Hannover Foundation, Bünteweg 9, 30559 Hanover, Germany.
- Department of Cell Biology, NYU Langone Medical Center, 550 First Avenue, New York, NY 10016, USA.
- Clinic for Horses, University of Veterinary Medicine Hannover Foundation, Bünteweg 9, 30559 Hanover, Germany.
- Clinic for Horses, University of Veterinary Medicine Hannover Foundation, Bünteweg 9, 30559 Hanover, Germany.
Conflict of Interest Statement
The authors declare no conflict of interest.
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Citations
This article has been cited 5 times.- Heun F, Delarocque J, Feige K, Hellige M. Trigeminal Nerve Asymmetry in Horses With Idiopathic Trigeminal-Mediated Headshaking: A Retrospective Case-Control Magnetic Resonance Imaging Study. J Vet Intern Med 2025 Sep-Oct;39(5):e70196.
- 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.
- Lloyd-Edwards RA, Mulders E, Sloet van Oldruitenborgh-Oosterbaan MM, Veraa S. Computed Tomography of the Hyoid Apparatus in Equine Headshaking Syndrome. Vet Sci 2025 May 23;12(6).
- Kloock T, Hellige M, Kloock A, Feige K, Niebuhr T. Application of the HRE-S to 140 horses with trigeminal-mediated headshaking and the association of clinical signs with diagnosis, therapy, and outcome. Front Vet Sci 2024;11:1329054.
- Bell T, Kyriazopoulou P, Mowbray C, Murphy BA. Equine Headshaking Syndrome: Triggers, Seasonality, and Treatment Efficacy in Australia. Animals (Basel) 2024 Mar 13;14(6).
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