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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. [PMID: 38645651 PMCID: PMC11027008 DOI: 10.3389/fvets.2024.1329054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 03/15/2024] [Indexed: 04/23/2024] Open
Abstract
Background Horses with trigeminal-mediated headshaking (TMHS) exhibit different headshaking patterns (HSPs), electric shock-like jerking, signs of nasal irritation, and painful facial expressions. The History Rest and Exercise Score (HRE-S) was developed to objectively clarify the severity of the condition in affected horses. This score considers the history and severity of clinical signs at rest and exercise. This study aimed to assess the frequency of different clinical signs and their individual associations with diagnosis, treatment, and outcome in horses diagnosed with TMHS.The clinical records of horses presented with headshaking (HS) at the Clinic for Horses, University of Veterinary Medicine Hannover, between 2006 and 2021 were assessed retrospectively for clinical signs, diagnosis, and treatment. A total of 140 horses were included in the study. Video recordings were evaluated using the HRE-S and compared to the score described by Talbot. Following discharge, owners were interviewed via telephone about the outcome. Correlations between the presence and severity of clinical signs, diagnosis, and outcome were evaluated. Results The following clinical signs were significantly correlated with a higher HRE-S and grade by Talbot: HS at walk (independently of HSP) (52.9%, 74/140), increased total number of demonstrated HSP (independent of the dominant HSP) (more than one HSP per horse in 91.4%, 128/140), signs of nasal irritation (75.9%, 104/137), painful facial expression (67.8%, 80/118), and electric shock-like jerking (77.5%, 107/138). Diagnosis and outcome do not correlate with the presence of the above-mentioned clinical signs. Conclusion The HRE-S was confirmed as a valid tool to evaluate disease severity in a cohort of 140 horses with HS. Additionally, clinical signs identified as indicators for higher disease severity may have a stronger negative effect on patient welfare, but they do not correlate with diagnosis or outcome.
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Affiliation(s)
- Tanja Kloock
- Clinic for Horses, University of Veterinary Medicine Hannover, Hanover, Germany
| | - Maren Hellige
- Clinic for Horses, University of Veterinary Medicine Hannover, Hanover, Germany
| | - Anke Kloock
- Department of Cell Biology, NYU Langone Medical Center, New York City, NY, United States
| | - Karsten Feige
- Clinic for Horses, University of Veterinary Medicine Hannover, Hanover, Germany
| | - Tobias Niebuhr
- Clinic for Horses, University of Veterinary Medicine Hannover, Hanover, Germany
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2
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Hyytiäinen HK, Boström A, Asplund K, Bergh A. A Systematic Review of Complementary and Alternative Veterinary Medicine in Sport and Companion Animals: Electrotherapy. Animals (Basel) 2022; 13:ani13010064. [PMID: 36611674 PMCID: PMC9817672 DOI: 10.3390/ani13010064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022] Open
Abstract
Electrotherapy modalities are currently used in the treatment of animals, but the evidence base supporting their use has not yet been systematically reviewed. Cochrane guidelines, as adapted by the Swedish Agency for Health Technology Assessment and Assessment of Social Services, were followed for this systematic review. A literature search regarding all currently known electrotherapy modalities applied to horses, dogs, and cats was conducted for the years 1980-2020 using three databases: CABI, PubMed, and Web of Science Core Collection. Of the 5385 references found, 41 articles were included in the review: 13 papers on pulsed electromagnetic field therapy (PEMFT), 7 on neural electrical muscle stimulation (NEMS), 5 on transcutaneous electrical nerve stimulation (TENS), 4 on static magnets, 3 on interference, 2 each on percutaneous electrical neural stimulation (PENS), bioelectricity, and diathermy, and 1 each on micro-pulsed stimulation, capacitive coupled electrical stimulation, and microwave therapy. The literature per modality was limited in quantity (mean 3.7 papers). Half of the articles were assessed to have a high risk of bias (20 high, 7 moderate, and 14 low). The existing literature used a spectrum of indications and treatment parameters, which makes comparisons and drawing conclusions to support the use of these modalities in clinical practice challenging. The current scientific evidence is not sufficient to support the clinical effects of electrotherapies for any clinical indication in horses, dogs or cats. The selected suggestive results warrant further high-quality research on PEMFT, NEMS, TENS, and PENS.
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Affiliation(s)
- Heli K. Hyytiäinen
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, P.O. Box 57, 00014 Helsinki, Finland
| | - Anna Boström
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, P.O. Box 57, 00014 Helsinki, Finland
| | - Kjell Asplund
- Department of Public Health and Clinical Medicine, Umeå University, SE 901 87 Umeå, Sweden
| | - Anna Bergh
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, SE 750 07 Uppsala, Sweden
- Correspondence:
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3
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Fairburn AJ, Meehan LJ, Roberts VLH. Computed tomographic findings in 101 horses presented for the investigation of headshaking. EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Alison J. Fairburn
- Bristol Veterinary School University of Bristol Somerset UK
- Bell Equine Veterinary Clinic, Mereworth Kent UK
| | - Lucinda Jayne Meehan
- Bristol Veterinary School University of Bristol Somerset UK
- VetCT, St. John's Innovation Centre Cambridge UK
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JOHNSON JP, VINARDELL T, DAVID F. Ultrasound-guided injections of the equine head and neck: review and expert opinion. J Equine Sci 2021; 32:103-115. [PMID: 35023988 PMCID: PMC8731684 DOI: 10.1294/jes.32.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 09/15/2021] [Indexed: 12/04/2022] Open
Abstract
Ultrasound-guided injections can be used for a wide variety of conditions in the horse, including both diagnostic and therapeutic applications. Benefits of ultrasound guidance include more accurate deposition of injectate compared with blind approaches. Improved identification of vital structures, including nerves and blood vessels, allows their avoidance and thus reduces procedure-associated complications. Validation of such ultrasound-guided techniques has shown that they can be easily learnt by inexperienced veterinarians, assuming a proper knowledge of the sonographic anatomy. In many cases they can be employed in the field with a high level of accuracy, using widely available equipment, and with complete adherence to the sterility principles. Many ultrasound-guided injection techniques of the axial skeleton in the horse have been described in past years, enabling the equine veterinarian to perform more accurate treatments of specific anatomical areas. The goal of this review is to discuss diagnostic and therapeutic ultrasound-guided injection techniques of the skull and cervical spine in the horse, including those for the retrobulbar space, maxillary and inferior alveolar nerves, atlanto-occipital and atlanto-axial junctions, and cervical articular process joints, as well as the 1st cervical nerve, the C2 and C3 nerve plexus, and the 6th, 7th, and 8th cervical nerve roots.
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Affiliation(s)
- Jessica P. JOHNSON
- Equine Veterinary Medical Center, A Member of
Qatar Foundation, P.O. Box 6788, Doha, Qatar
| | - Tatiana VINARDELL
- Equine Veterinary Medical Center, A Member of
Qatar Foundation, P.O. Box 6788, Doha, Qatar
- College of Health & Life Science, Hamad Bin
Khalifa University, A Member of Qatar Foundation, P.O. Box 34110, Doha,
Qatar
| | - Florent DAVID
- Equine Veterinary Medical Center, A Member of
Qatar Foundation, P.O. Box 6788, Doha, Qatar
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5
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Zhang B, Wang W, Wang S, Li S, Liu M, Wang L, Yang C. Clinical Study on Electronic Medical Neuroelectric Stimulation Based on the Internet of Things to Treat Epilepsy Patients with Anxiety and Depression. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:6667309. [PMID: 33791085 PMCID: PMC7994104 DOI: 10.1155/2021/6667309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 02/03/2021] [Accepted: 03/03/2021] [Indexed: 11/18/2022]
Abstract
With the continuous development and improvement of the level of medical technology in our country in recent years, the treatment of epilepsy has been constantly updated and developed. Nerve electrical stimulation is considered to be a very effective method for treating epilepsy with anxiety and depression. There are many traditional methods for the treatment of epilepsy. For example, vagus nerve stimulation (VNS) has been applied earlier, and the therapeutic effect has been confirmed, but it will cause serious complications and is easier to be uncomfortable; deep brain stimulation for epilepsy is still in the immature stage, and there is no final conclusion. Therefore, this article proposes a clinical study on the treatment of patients with epilepsy with anxiety and depression based on the electronic medical nerve stimulation of the Internet of Things. First of all, this article uses the literature method to study the causes of epilepsy and previous treatment methods. Then, we designed an experimental study of epilepsy with depression based on the Internet of Things electronic medical neuroelectric stimulation therapy and selected the core quality of life questionnaire, SDS, and SAS as observation indicators. Finally, the comparison of epilepsy symptoms and depression and anxiety between the control group and the observation group before and after treatment was analyzed. The results of the experiment showed that, among the 50 subjects in the study, the observation group that used electrical nerve stimulation therapy had 5 people who stopped seizures after treatment, accounting for 10%, while in the control group of traditional drug treatment methods, after treatment, only one person stopped the seizure, accounting for 2%. In addition, the SAS and SDS scores of the observation group were also lower than those of the control group. Therefore, the use of nerve electrical stimulation to treat epilepsy with anxiety and depression symptoms has better performance and can help patients recover as soon as possible.
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Affiliation(s)
- Bo Zhang
- Neurosurgery Department, The People's Hospital of Zhaoyuan City, Yantai 264030, Shandong, China
| | - Weijie Wang
- Neurosurgery Department, The People's Hospital of Zhaoyuan City, Yantai 264030, Shandong, China
| | - Shenguo Wang
- Neurosurgery Department, The People's Hospital of Zhaoyuan City, Yantai 264030, Shandong, China
| | - Shaoping Li
- Neurosurgery Department, The People's Hospital of Zhaoyuan City, Yantai 264030, Shandong, China
| | - Mingchao Liu
- Neurosurgery Department, The People's Hospital of Zhaoyuan City, Yantai 264030, Shandong, China
| | - Lantian Wang
- Neurosurgery Department, The People's Hospital of Zhaoyuan City, Yantai 264030, Shandong, China
| | - Caijun Yang
- Neurosurgery Department, The People's Hospital of Zhaoyuan City, Yantai 264030, Shandong, China
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6
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Riedler DC, Zsoldos RR, Robel M, Jobst ID, Licka TF. Movement Caused by Electrical Stimulation of the Lumbosacral Region in Standing Horses. J Equine Vet Sci 2020; 91:103116. [PMID: 32684261 DOI: 10.1016/j.jevs.2020.103116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 04/12/2020] [Accepted: 05/04/2020] [Indexed: 11/29/2022]
Abstract
Electrical stimulation is commonly used as a modality for physical therapy in human and veterinary medicine. However, studies measuring the movement generated by electrical stimulation in horses are rare. The present study therefore evaluates the range of movement provoked by a commercially available physical therapy unit (FES310) and contrasts it with the movement generated by manually induced pelvic inclination (back rounding). Ten horses were tested on three measurement days over one week. Electrical stimulation was applied via a back treatment pad (belonging to the FES310 system) containing six electrodes (three on either side of the spine) placed over the lumbosacral region. This system produced a pulsed, biphasic electrical stimulation in a rectangular waveform which was gradually increased to a maximum of 10 volts. Before and after electrical stimulation testing, manual pelvic inclination was achieved by pressure on two points lateral to the root of the tail. Muscle tone and lameness were evaluated before and after treatments. Skinfold thickness, body condition score, and body mass were measured to detect possible confounding factors. Using kinematics, the angle ranges during movement of ten three-dimensional angles of the trunk, the pelvis, and the hind limbs were further analyzed. Movement was produced with manual stimulation in every tested individual on all measurement days and with electrical stimulation on at least one measurement day. The electrical stimulation led to significantly (P < .05) smaller angle ranges which were 15 %-57 % of the median of the manually stimulated movement. Strong positive correlations between angle ranges of the electrically generated movement were found for the hind limbs implicating their involvement in the movement created. Correlations between skinfold thickness, body condition score, and body mass with the angle ranges were weak and not significant. Before and after electrical and manual stimulation, muscle tone and lameness were similar. In the present study, both electrical and manual stimulation were proven to produce significant trunk and hind limb movement. Within this study's electrical stimulation treatment protocol, the movement generated by electrical stimulation was significantly less than the movement caused by manual pelvic inclination. However, electrical stimulation could easily be applied over a longer period and in a higher frequency than it would be possible for manual pelvic inclination. This treatment shows potential for stabilization and or mobilization of the lumbosacral region, although its efficiency as a therapeutic tool and its effect on specific orthopedic problems and is to be evaluated in further research.
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Affiliation(s)
- Daniela C Riedler
- University Clinic for Horses, Department of Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | - Rebeka R Zsoldos
- School of Agriculture and Food Sciences, The University of Queensland, Gatton, Queensland, Australia
| | - Matthias Robel
- University Clinic for Horses, Department of Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | - Isabelle D Jobst
- University Clinic for Horses, Department of Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | - Theresia F Licka
- University Clinic for Horses, Department of Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria; Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Midlothian, Scotland, United Kingdom.
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7
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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 2019; 52:238-243. [PMID: 31461784 PMCID: PMC7317358 DOI: 10.1111/evj.13174] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 07/27/2019] [Indexed: 01/01/2023]
Abstract
Background Early results from the use of neuromodulation by percutaneous electrical nerve stimulation for the management of trigeminal‐mediated headshaking in horses were promising but lacked sufficient case numbers and long‐term follow‐up. The neuromodulatory procedure has since been established as EquiPENS™. Objectives The aim of this study was to report long‐term results from a larger number of cases and to investigate for predictors of outcome. Study design Prospective case series using international, multi‐centre data. Methods Eligible cases were horses with a veterinary diagnosis of trigeminal‐mediated headshaking, which received EquiPENS™ neuromodulation at trained centres between August 2013 and November 2017. The standard protocol was an initial three‐procedure course, with additional procedures should a horse go into remission but then relapse. Data collected included signalment, history, diagnostic tests performed, details of any complications, whether horses had gone into remission and the length of remission. Results Results were obtained from 168 horses, with 530 procedures. The complication rate was 8.8% of procedures. In all but one case, complications were mild and transient, without self‐trauma. Remission of headshaking following the initial course occurred in 53% (72/136) of horses. Median length of time recorded in remission was 9.5 weeks (range 2 days to 156 weeks ongoing). Where signs recurred, most horses went back into remission following additional procedures, usually for longer than from the previous procedure. No predictors for outcome were determined. Main limitations No placebo or control group, owner‐assessed results. Conclusions EquiPENS™ neuromodulation can be an effective and safe treatment for the management of trigeminal‐mediated headshaking in some horses. An increased understanding of neuromodulation could help optimise the technique. Advances in treatment for trigeminal‐mediated headshaking will remain limited until there is a greater understanding of the aetiopathogenesis of the condition.
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Affiliation(s)
- V L H Roberts
- Bristol Veterinary School, University of Bristol, Somerset, UK
| | - M Bailey
- Bristol Veterinary School, University of Bristol, Somerset, UK
| | | | - N K Patel
- Institute of Neurosciences, Southmead Hospital Bristol, Westbury-on-Trym, Bristol, UK
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8
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Dingle A, Zeng W, Ness JP, Albano N, Minor RL, Feldman C, Austin M, Brodnick SK, Shulzhenko N, Sanchez R, Lake WB, Williams JC, Poore SO, Suminski AJ. Strategies for interfacing with the trigeminal nerves in rodents for bioelectric medicine. J Neurosci Methods 2019; 324:108321. [PMID: 31229585 DOI: 10.1016/j.jneumeth.2019.108321] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 06/05/2019] [Accepted: 06/19/2019] [Indexed: 01/19/2023]
Abstract
BACKGROUND Bioelectric medicine seeks to modulate neural activity via targeted electrical stimulation to treat disease. Recent clinical evidence supports trigeminal nerve stimulation as a bioelectric treatment for several neurological disorders; however, the mechanisms of trigeminal nerve stimulation and potential side effects remain largely unknown. The goal of this study is to optimize the methodology and reproducibility of neural interface implantation for mechanistic studies in rodents. NEW METHOD(S) This article describes a single incision surgical approach to the infraorbital nerve of rats and mice and the supraorbital nerve in rats for trigeminal nerve stimulation studies. This article also presents the use of cortical evoked potentials and electromyography as methods for demonstrating effective engagement between the implanted electrode and target nerve. COMPARISON WITH EXISTING METHOD(S) A number of surgical approaches to the infraorbital nerve in rats exist, many of which are technically difficult. A simple, standardized approach to infraorbital nerve in rats and mice, as well as the supraorbital nerve of rats is integral to reproducibility of future trigeminal nerve stimulation studies. CONCLUSION The infraorbital nerve of rats and mice can be easily accessed from a single dorsal incision on the bridge of the nose that avoids major anatomical structures such as the facial nerve. The supraorbital nerve is also accessible in rats from a single dorsal incision, but not mice due to size. Successful interfacing and engagement of the infra- and supraorbital nerves using the described methodology is demonstrated by recording of evoked cortical potentials and electromyography.
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Affiliation(s)
- Aaron Dingle
- Division of Plastic Surgery, Department of Surgery, University of Wisconsin-Madison, United States.
| | - Weifeng Zeng
- Division of Plastic Surgery, Department of Surgery, University of Wisconsin-Madison, United States
| | - Jared P Ness
- Department of Biomedical Engineering, University of Wisconsin-Madison, United States
| | - Nicholas Albano
- Division of Plastic Surgery, Department of Surgery, University of Wisconsin-Madison, United States
| | - Rashea L Minor
- School of Veterinary Medicine, University of Wisconsin-Madison, United States
| | - Coner Feldman
- Division of Plastic Surgery, Department of Surgery, University of Wisconsin-Madison, United States
| | - Mark Austin
- Department of Biomedical Engineering, University of Wisconsin-Madison, United States
| | - Sarah K Brodnick
- Department of Biomedical Engineering, University of Wisconsin-Madison, United States
| | - Nikita Shulzhenko
- Division of Plastic Surgery, Department of Surgery, University of Wisconsin-Madison, United States
| | - Ruston Sanchez
- Division of Plastic Surgery, Department of Surgery, University of Wisconsin-Madison, United States
| | - Wendell B Lake
- Department of Neurological Surgery, University of Wisconsin-Madison, United States
| | - Justin C Williams
- Department of Biomedical Engineering, University of Wisconsin-Madison, United States; Department of Neurological Surgery, University of Wisconsin-Madison, United States
| | - Samuel O Poore
- Division of Plastic Surgery, Department of Surgery, University of Wisconsin-Madison, United States; Department of Biomedical Engineering, University of Wisconsin-Madison, United States
| | - Aaron J Suminski
- Department of Biomedical Engineering, University of Wisconsin-Madison, United States; Department of Neurological Surgery, University of Wisconsin-Madison, United States.
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9
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Edwards RA, Hermans H, Veraa S. Morphological variations of the infraorbital canal during CT has limited association with headshaking in horses. Vet Radiol Ultrasound 2019; 60:485-492. [PMID: 31161704 DOI: 10.1111/vru.12773] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 03/01/2019] [Accepted: 04/03/2019] [Indexed: 12/14/2022] Open
Abstract
Headshaking is a common problem in horses. The etiology is unknown but thought to involve sensory input from branches of the trigeminal nerve, some of which are within the infraorbital canal. The objective of this retrospective cross-sectional study was to describe the CT anatomy and variations of the infraorbital canal in horses with local disease processes and normal horses, and to examine associations between those findings and headshaking. Computed tomography scans were reviewed and morphological changes of the infraorbital canal were described. Presence of changes was then tested for association with headshaking prevalence, presence of disease processes in the region of the infraorbital canal, age, and sex. Nonparametric tests were used and a P-value of .05 was considered significant. A total of 218 horses were included, 9% of which had headshaking and 45% had CT lesions in the region of the infraorbital canal. Morphological changes to the bone of the infraorbital canal were found in 121 horses (56%) and included the following: increased mineralization 39 (18%), decreased mineralization 89 (41%), deformed shape 51 (23%), displaced position 43 (20%), and disruption 11 (5%). All changes of the infraorbital canal significantly increased in frequency with the presence of adjacent disease. Increased mineralization and disruption of the infraorbital canal were significantly associated with headshaking in horses with adjacent disease; the latter only reached significance after exclusion of dentally immature horses. No other changes were significantly associated with the presence of headshaking. No association was found between headshaking and the age or sex of the horse.
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Affiliation(s)
- Ralph A Edwards
- Division of Diagnostic Imaging, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Hanneke Hermans
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Stefanie Veraa
- Division of Diagnostic Imaging, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
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Pickles K. Is Electrical Nerve Stimulation the Answer for Management of Equine Headshaking? Vet Clin North Am Equine Pract 2019; 35:263-274. [PMID: 31047766 DOI: 10.1016/j.cveq.2019.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Horses with trigeminal mediated headshaking (TMHS) have a decreased activation threshold of the trigeminal nerve and clinical signs are suspected to be a manifestation of trigeminal neuralgia. Electrical nerve stimulation (ENS) is used for management of neuralgia in humans and appears to work via gate control theory. Use of an equine specific percutaneous ENS program in over 130 TMHS horses has resulted in approximately 50% success return to previous work. Electroacupuncture may also be useful in the management TMHS. Optimization of ENS procedures for TMHS is likely to require a greater understanding of the etiopathogenesis of the aberrant neurophysiology.
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Affiliation(s)
- Kirstie Pickles
- Chine House Veterinary Hospital, 12 Cossington Road, Sileby, Leicestershire LE12 7RS, UK.
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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; 33:1464-1472. [PMID: 30990929 PMCID: PMC6524471 DOI: 10.1111/jvim.15499] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 04/03/2019] [Indexed: 12/25/2022] Open
Abstract
Background Oral administration of magnesium and boron might have a beneficial effect on headshaking behavior in horses. Objective Evaluate the effects of oral magnesium alone or in combination with boron on headshaking behavior in affected horses. Animals Twelve geldings (6 healthy controls and 6 affected). Methods Prospective randomized controlled dietary trial over 42 days in 12 horses (6 horses diagnosed with trigeminal‐mediated headshaking and 6 unaffected healthy controls). All horses received a hay diet and were randomized into 3 treatment groups: pelleted feed combination (PF), pelleted feed combination with magnesium (M), and pelleted feed combination with magnesium‐boron (MB) with a week washout of hay only between treatments. Headshaking behavior and biochemical blood variables were assessed at baseline (hay only) and then after each week of supplementation. Results All 3 diet interventions increased blood ionized and total magnesium. Groups M and MB further increased Mg2+ when compared to PF. Horses receiving treatments had a significant reduction in headshaking behavior, as measured by incidence rate ratio (IRR), when compared to unsupplemented hay diet (44% for PF, IRR, 0.558; CI, 0.44, 0.72; P < .001; 52% for M, IRR, 0.476; CI, 0.37, 0.62; P < .001; and 64% for MB, IRR, 0.358; CI, 0.27, 0.48; P < .001). Conclusions and Clinical Importance Magnesium in combination with boron had the greatest decrease in headshaking. Oral supplementation with magnesium or magnesium in combination with boron should be considered in horses affected with headshaking.
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Affiliation(s)
- Shara A Sheldon
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
| | - Monica Aleman
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
| | - Lais R R Costa
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
| | - Kalie Weich
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
| | - Quinn Howey
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
| | - John E Madigan
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
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12
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Thomson K, Chan C, Dyson S. Head tossing behaviour in six horses: Trigeminal‐mediated head‐shaking or musculoskeletal pain? EQUINE VET EDUC 2019. [DOI: 10.1111/eve.13084] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- K. Thomson
- Centre for Equine Studies Animal Health Trust Newmarket Suffolk UK
| | - C. Chan
- Centre for Equine Studies Animal Health Trust Newmarket Suffolk UK
| | - S. Dyson
- Centre for Equine Studies Animal Health Trust Newmarket Suffolk UK
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13
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Pickles KJ. Electrical nerve stimulation for the management of equine trigeminal mediated headshaking. EQUINE VET EDUC 2019. [DOI: 10.1111/eve.12800] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- K. J. Pickles
- Chine House Veterinary Hospital Sileby Leicestershire UK
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14
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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; 33:923-932. [PMID: 30666732 PMCID: PMC6430935 DOI: 10.1111/jvim.15410] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 12/12/2018] [Indexed: 12/24/2022] Open
Abstract
Background Trigeminal‐mediated headshaking results from low‐threshold firing of the trigeminal nerve resulting in apparent facial pain. Magnesium may have neuroprotective effects on nerve firing that potentially dampen signs of neuropathic pain. This hypothesis has not been investigated in horses with trigeminal‐mediated headshaking. Objective To investigate head‐shaking behavior in affected horses after IV magnesium sulfate infusion. Animals Six geldings with trigeminal‐mediated headshaking. Methods Prospective randomized crossover study. Horses were controlled for diet and infused IV with 5% dextrose solution (DS; control solution at 2 mL/kg body weight [BW]) and MgSO4 50% solution (MSS at 40 mg/kg BW). Head‐shaking behavior was recorded at times T0 (baseline, before infusion) and T15, T30, T60, and T120 minutes post‐infusion. Venous blood variables such as pH, HCO3−, standard base excess (SBE), Na+, Cl−, K+, Ca2+, Mg2+, total magnesium (tMg), glucose, and lactate were measured; strong ion difference (SID) and anion gap (AG) were calculated for each time point. Results Blood variables including pH, Na+, Cl−, K+, SID, AG, lactate, Ca2+, tMg, and Mg2+ had significant changes with MSS as compared to DS treatment. Glucose, SBE, and HCO3− did not have significant changes. A 29% reduction in head‐shaking rate occurred after MSS treatment but no change occurred after DS treatment. Conclusions and Clinical Importance Administration of MSS IV increased plasma total and ionized magnesium concentrations and significantly decreased head‐shaking behavior in horses with trigeminal‐mediated headshaking.
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Affiliation(s)
- Shara A Sheldon
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
| | - Monica Aleman
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
| | - Lais Rosa R Costa
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
| | - Ana C Santoyo
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
| | - Quinn Howey
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
| | - John E Madigan
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
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15
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Roberts V. Trigeminal-mediated headshaking in horses: prevalence, impact, and management strategies. VETERINARY MEDICINE (AUCKLAND, N.Z.) 2019; 10:1-8. [PMID: 30666296 PMCID: PMC6330979 DOI: 10.2147/vmrr.s163805] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Trigeminal-mediated headshaking is a little-understood neuropathic facial pain condition of the horse. The condition may affect around 1% of the equine population to a degree of severity sufficient to require veterinary attention. As a pain condition, this represents a significant welfare issue. Horses are usually more severely affected at exercise which can leave them unable to perform, or even dangerous to ride and handle. With little known about the condition and variable response to treatments, severely affected horses are often euthanized. This review article considers the literature on trigeminal-mediated headshaking, focusing on what is known, and indeed not known, about the prevalence of the condition and its impact. The current published management options are considered, along with their challenges and limitations.
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Affiliation(s)
- Veronica Roberts
- Bristol Vet School, Faculty of Health Sciences, University of Bristol, Langford, North Somerset BS40 5HB, UK,
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16
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Roberts V. Managing headshaking in horses: an update. IN PRACTICE 2018. [DOI: 10.1136/inp.k1493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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17
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Devereux S. Electroacupuncture as an additional treatment for headshaking in six horses. EQUINE VET EDUC 2017. [DOI: 10.1111/eve.12776] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- S. Devereux
- Equine Acupuncture and Chiropractic Referrals Meadow Rise Farley Salisbury Wiltshire UK
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18
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Hermans H, Veraa S, Wolschrijn CF, van Loon JPAM. Local anaesthetic techniques for the equine head, towards guided techniques and new applications. EQUINE VET EDUC 2017. [DOI: 10.1111/eve.12757] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- H. Hermans
- Department of Equine SciencesFaculty of Veterinary Medicine Utrecht UniversityUtrecht The Netherlands
| | - S. Veraa
- Division of Diagnostic ImagingFaculty of Veterinary Medicine Utrecht UniversityUtrecht The Netherlands
| | - C. F. Wolschrijn
- Department of Pathobiology Faculty of Veterinary Medicine Utrecht University Utrecht The Netherlands
| | - J. P. A. M. van Loon
- Department of Equine SciencesFaculty of Veterinary Medicine Utrecht UniversityUtrecht The Netherlands
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19
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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. [PMID: 28555189 PMCID: PMC5431280 DOI: 10.3389/fvets.2017.00072] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 04/25/2017] [Indexed: 11/25/2022] Open
Abstract
Trigeminal-mediated headshaking is an idiopathic neuropathic facial pain syndrome in horses. There are clinical similarities to trigeminal neuralgia, a neuropathic facial pain syndrome in man, which is usually caused by demyelination of trigeminal sensory fibers within either the nerve root or, less commonly, the brainstem. Our hypothesis was that the neuropathological substrate of headshaking in horses is similar to that of trigeminal neuralgia in man. Trigeminal nerves, nerve roots, ganglia, infraorbital, and caudal nasal nerves from horse abattoir specimens and from horses euthanized due to trigeminal-mediated headshaking were removed, fixed, and processed for histological assessment by a veterinary pathologist and a neuropathologist with particular experience of trigeminal neuralgia histology. No histological differences were detected between samples from horses with headshaking and those from normal horses. These results suggest that trigeminal-mediated headshaking may have a different pathological substrate from trigeminal neuralgia in man.
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Affiliation(s)
- Veronica L Roberts
- School of Veterinary Clinical Sciences, University of Bristol, Bristol, Somerset, UK
| | - Debra Fews
- School of Veterinary Clinical Sciences, University of Bristol, Bristol, Somerset, UK
| | - Jennifer M McNamara
- Centre for Comparative and Clinical Anatomy, University of Bristol, Bristol, UK
| | - Seth Love
- Department of Neuropathology, University of Bristol Institute of Clinical Neurosciences, Southmead Hospital, Bristol, UK
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20
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Uhlendorf F, Hellige M, Cavalleri JVM, Feige K, Ohnesorge B. Nd:YAG laser-assisted transendoscopic procedure for treatment of otitis media in a horse. EQUINE VET EDUC 2017. [DOI: 10.1111/eve.12406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- F. Uhlendorf
- Clinic for Horses; University of Veterinary Medicine Foundation; Hannover Germany
| | - M. Hellige
- Clinic for Horses; University of Veterinary Medicine Foundation; Hannover Germany
| | - J. V. M. Cavalleri
- Clinic for Horses; University of Veterinary Medicine Foundation; Hannover Germany
| | - K. Feige
- Clinic for Horses; University of Veterinary Medicine Foundation; Hannover Germany
| | - B. Ohnesorge
- Clinic for Horses; University of Veterinary Medicine Foundation; Hannover Germany
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21
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Schlachter C, Lewis C. Electrophysical Therapies for the Equine Athlete. Vet Clin North Am Equine Pract 2016; 32:127-47. [PMID: 27012509 DOI: 10.1016/j.cveq.2015.12.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
A good rehabilitation program takes into account the possible causes for the injury. Once the underlying cause of the injury is determined, a veterinarian can construct an appropriate rehabilitation plan and use the available electrophysical therapies to their greatest effect. Treating the horse correctly for the type and location of injury, and the stage of rehabilitation of the tissue, helps ensure full rehabilitation success. This article discusses when and how to use the most common electrophysical therapies in horses including transcutaneous electrical nerve stimulation, neuromuscular electrical stimulation, functional electric stimulation, pulsed electromagnetic field therapy, therapeutic ultrasound, laser therapy, shockwave therapy, and vibration therapy.
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22
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Wright S. Highlights of recent clinically relevant papers. EQUINE VET EDUC 2015. [DOI: 10.1111/eve.12434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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