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Home / Equine Research Bank / Can Vet J / Internal neurolysis of the maxillary branch of the trigemina...
The Canadian veterinary journal = La revue veterinaire canadienne2018; 59(7); 763-769;

Internal neurolysis of the maxillary branch of the trigeminal nerve for the treatment of equine trigeminal mediated headshaking syndrome.

Abstract: A 5-year-old Hannovarian warmblood gelding was presented for recurrent headshaking exacerbated with exercise. The horse displayed clinical signs of repetitive vertical head movements, face rubbing on the forelimbs and on the ground, repetitive sneezing, and striking the muzzle with his forelimbs. The clinical signs resulted in a horse that could not be ridden and was dangerous. Clinical signs were most persistent in direct sunlight, but occurred with excitement, exercise, or bridling indoors. A diagnosis of equine trigeminal mediated headshaking syndrome was made. Surgical treatment was performed with a supraorbital approach to the maxillary branch of the trigeminal nerve as it exits the round foramen, where an internal neurolysis (nerve combing) was conducted on both the left and right nerves. Severe headshaking behavior resolved after surgery. The horse displayed face rubbing of the muzzle which began 96 hours after surgery and resolved over 12 days with corticosteroid and vitamin E therapy. The horse became pasture sound and the clinical signs had resolved in the presence of sunlight, but repetitive vertical head movements persisted under saddle which left the horse unpleasant to ride. Neurolyse interne de la branche maxillaire du nerf trijumeau pour le traitement du syndrome équin de hochement de tête à médiation du trijumeau. Un hongre hanovrien warmblood âgé de 5 ans a été présenté pour un hochement de tête récurrent exacerbé par l’exercice. Le cheval a manifesté des signes cliniques de mouvements verticaux répétitifs de la tête, du frottement de la face sur les jambes avant et sur le sol, des éternuements répétitifs et le frappement du museau avec les jambes avant. Les signes cliniques se sont traduits par un cheval qui ne pouvait pas être monté et était dangereux. Les signes cliniques étaient les plus persistants à la lumière du soleil directe, mais se produisaient lors d’un état d’excitation, de l’exercice ou avec la bride à l’intérieur. Un diagnostic de syndrome de hochement de tête à médiation du trijumeau a été posé. Le traitement chirurgical a été réalisé avec une approche supraorbitale à la branche maxillaire du nerf trijumeau au sortir du foramen rond, où une neurolyse interne (peignage des nerfs) a été effectuée sur les nerfs gauche et droit. Le comportement de hochements sévères de la tête s’est résorbé après la chirurgie. Le cheval a manifesté un frottement de la face du museau qui a commencé 96 heures après la chirurgie et s’est résorbé pendant une période de 12 jours à l’aide d’une thérapie aux corticostéroïdes et à la vitamine E. Le cheval est devenu apte au pâturage et les signes cliniques se sont résorbés en présence de la lumière du soleil, mais les mouvements verticaux répétitifs de la tête ont persisté avec une selle, ce qui a rendu le cheval peu agréable pour la monture.(Traduit par Isabelle Vallières).
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Publication Date: 2018-07-22 PubMed ID: 30026624PubMed Central: PMC6005076
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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.

This research article discusses the case of a 5-year-old horse that suffered from Trigeminal Mediated Headshaking Syndrome. The horse was treated with a surgery to the maxillary branch of the trigeminal nerve which alleviated its severe headshaking behavior.

Introduction and Presentation

  • The case involves a 5-year-old Hannovarian warmblood gelding horse that suffered from recurrent headshaking, a behavior noticeably aggravated by exercise.
  • Other symptoms included repetitive vertical head movements, rubbing its face against its forelimbs and the ground, frequently sneezing and striking its muzzle with its forelimbs.
  • Such behavior made the horse not only unrideable but also potentially dangerous.
  • These signs were especially prominent in direct sunlight and were also triggered by excitement, exercise, or bridling indoors.

Diagnosis

  • A diagnosis of equine trigeminal mediated headshaking syndrome was made, which is a condition in horses where the trigeminal nerve (shich innervates the face) is affected, leading to discomfort and headshaking.

Treatment

  • A surgical intervention was performed with a supraorbital approach to the maxillary branch of the trigeminal nerve as it exits the round foramen (a hole in the skull through which the nerve passes).
  • This surgery involved an internal neurolysis, also known as nerve combing, which is a technique involving the separation of nerve fibers to reduce nerve tension and hypersensitivity.
  • The nerve combing was performed on both the left and right nerves.

Post-Surgery Outcomes

  • The severe headshaking behavior of the horse was resolved after the surgery.
  • However, the horse started rubbing its muzzle 96 hours after surgery which took 12 days to resolve with the help of corticosteroid and vitamin E therapy.
  • The horse was then pasture sound and its symptoms had been resolved in presence of sunlight.
  • Yet, repetitive vertical head movements continued when the horse was under a saddle, which made it unpleasant to ride.

Cite This Article

APA
Bell C, Hnenny L, Torske K. (2018). Internal neurolysis of the maxillary branch of the trigeminal nerve for the treatment of equine trigeminal mediated headshaking syndrome. Can Vet J, 59(7), 763-769.

Publication

The Canadian veterinary journal = La revue veterinaire canadienne
ISSN: 0008-5286
NlmUniqueID: 0004653
Country: Canada
Language: English
Volume: 59
Issue: 7
Pages: 763-769

Researcher Affiliations

Bell, Chris
  • Elders Equine Veterinary Service, Box 66047, 3665 Portage Avenue, Winnipeg, Manitoba (Bell, Torske); Royal University Hospital, University of Saskatchewan, Saskatoon, Saskatchewan (Hnenny).
Hnenny, Luke
  • Elders Equine Veterinary Service, Box 66047, 3665 Portage Avenue, Winnipeg, Manitoba (Bell, Torske); Royal University Hospital, University of Saskatchewan, Saskatoon, Saskatchewan (Hnenny).
Torske, Kris
  • Elders Equine Veterinary Service, Box 66047, 3665 Portage Avenue, Winnipeg, Manitoba (Bell, Torske); Royal University Hospital, University of Saskatchewan, Saskatoon, Saskatchewan (Hnenny).

MeSH Terms

  • Animals
  • Dexamethasone / therapeutic use
  • Ethanol / administration & dosage
  • Glucocorticoids / therapeutic use
  • Head Movements
  • Horse Diseases / surgery
  • Horses
  • Male
  • Nerve Block / veterinary
  • Trigeminal Nerve / surgery
  • Vitamin E / therapeutic use

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Citations

This article has been cited 3 times.
  1. 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.
    doi: 10.3389/fvets.2025.1562404pubmed: 40586033google scholar: lookup
  2. 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).
    doi: 10.3390/ani14060875pubmed: 38539973google scholar: lookup
  3. 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.
    doi: 10.1111/jvim.15499pubmed: 30990929google scholar: lookup
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