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Nessler JN, Delarocque J, Kloock T, Twele L, Neudeck S, Meyerhoff N, Riese F, Cavalleri JMV, Tipold A, Feige K, Niebuhr T. Sensory nerve conduction stimulus threshold measurements of the infraorbital nerve and its applicability as a diagnostic tool in horses with trigeminal-mediated headshaking. BMC Vet Res 2024; 20:201. [PMID: 38750534 PMCID: PMC11097574 DOI: 10.1186/s12917-024-04068-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 05/07/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND To determine whether sensory nerve conduction stimulus threshold measurements of the infraorbital nerve are able to differentiate horses with idiopathic trigeminal-mediated headshaking (i-TMHS) from healthy horses and from horses with secondary trigeminal-mediated headshaking (s-TMHS). In a prospective trial, headshaking horses were examined using a standardized diagnostic protocol, including advanced diagnostics such as computed tomography and 3-Tesla-magnetic resonance imaging (MRI), to differentiate s-TMHS from i-TMHS. Clinically healthy horses served as controls. Within this process, patients underwent general anesthesia, and the minimal sensory nerve conduction stimulus threshold (SNCT) of the infraorbital nerve was measured using a bipolar concentric needle electrode. Sensory nerve action potentials (SNAP) were assessed in 2.5-5 mA intervals. Minimal SNCT as well as additional measurements were calculated. RESULTS In 60 horses, SNAP could be recorded, of which 43 horses had i-TMHS, six had suspected s-TMHS, three horses had non-facial headshaking, and eight healthy horses served as controls. Controls had a minimal SNCT ≥ 15 mA, whereas 14/43 horses with i-TMHS and 2/6 horses with s-TMHS showed a minimal SNCT ≤ 10 mA. Minimal SNCT ≤ 10 mA showed 100% specificity to distinguish TMHS from controls, but the sensitivity was only 41%. CONCLUSION A minimal SNCT of the infraorbital nerve ≤ 10 mA was able to differentiate healthy horses from horses with TMHS. Nevertheless, a higher minimal SNCT did not exclude i-TMHS or s-TMHS and minimal SNCT does not distinguish s-TMHS from i-TMHS.
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Affiliation(s)
- Jasmin Nicole Nessler
- Department of Small Animal Internal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Foundation, Hannover, Germany.
| | - Julien Delarocque
- Clinic for Horses, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Foundation, Hannover, Germany
| | - Tanja Kloock
- Clinic for Horses, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Foundation, Hannover, Germany
| | - Lara Twele
- Clinic for Horses, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Foundation, Hannover, Germany
| | - Stephan Neudeck
- Clinic for Horses, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Foundation, Hannover, Germany
| | - Nina Meyerhoff
- Department of Small Animal Internal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Foundation, Hannover, Germany
| | - Franziska Riese
- Department of Small Animal Internal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Foundation, Hannover, Germany
| | - Jessica-M V Cavalleri
- Clinical unit of equine internal medicine, Department of small animals and horses, University of veterinary medicine, Vienna, Austria
| | - Andrea Tipold
- Department of Small Animal Internal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Foundation, Hannover, Germany
| | - Karsten Feige
- Clinic for Horses, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Foundation, Hannover, Germany
| | - Tobias Niebuhr
- Clinic for Horses, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Foundation, Hannover, Germany
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Kloock T, Pickles KJ, Roberts V, Uhlendorf F, Twele L, Wilkens HL, Stehle E, Feige K, Niebuhr T. History, Rest and Exercise Score (HRE-S) for assessment of disease severity in horses with trigeminal-mediated headshaking. Equine Vet J 2024; 56:464-474. [PMID: 37608443 DOI: 10.1111/evj.13986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 07/20/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND In horses with trigeminal-mediated headshaking (TMHS), clinical signs are likely to be expression of neuropathic facial pain. Currently, subjective assessment of disease severity is used as measure of compromise of animal's welfare. OBJECTIVES To develop and validate a precise scoring system for TMHS: History, Rest and Exercise Score (HRE-S). The HRE-S consists of three subscores: history score (H-S), resting score (R-S) and exercise score (E-S). STUDY DESIGN Retrospective observational study. METHODS Seven masked observers with different experience used HRE-S to score 40 video recordings taken during rest and lungeing including five duplicates. Video recordings were taken from nine horses with TMHS and three controls. Inter- and intraobserver reliability and practicability of HRE-S were assessed. For every video recording severity of clinical signs was graded by every observer using an intuitive global-type-scale and interobserver reliability was calculated. Convergent validity was evaluated comparing HRE-S to groups created by an existing score (grade 0-3). Discriminant validity was analysed comparing HRE-S to groups created by intuitive global-type-scale. RESULTS Reliability for HRE-S was excellent, irrespective of observers experience: Spearman's Rho = 0.946, p < 0.001 (intraobserver reliability) and intraclass correlation coefficient = 0.98, p < 0.001 (interobserver reliability). Interobserver reliability for intuitive global-type-scale was fair to substantial: Fleiss' κappa = 0.48 (R-S) -0.63 (E-S). Groups created by intuitive global-type-scale had significantly different R-S and E-S (p < 0.05), demonstrating discriminant validity. Convergent validity was proven as horses with grade 3/3 had significantly higher average E-S and total scores compared with an existing score than those with grade 0/3 or 1/3 (p < 0.001). MAIN LIMITATIONS Retrospective nature, video recordings, sample size. CONCLUSIONS HRE-S is a valid and reliable score evaluating disease severity in TMHS, independent of observers' experience.
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Affiliation(s)
- Tanja Kloock
- Clinic for Horses, University of Veterinary Medicine Hannover, Hanover, Germany
| | - Kirstie J Pickles
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, UK
| | | | | | - Lara Twele
- Clinic for Horses, University of Veterinary Medicine Hannover, Hanover, Germany
| | - Henriette L Wilkens
- Clinic for Horses, University of Veterinary Medicine Hannover, Hanover, Germany
| | | | - 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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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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Lu J, Yang B, Zhang W, Cheng H, Zeng J, Wang Y, Wei W, Liu Z. Transplantation of olfactory ensheathing cells can alleviate neuroinflammatory responses in rats with trigeminal neuralgia. Brain Res 2024; 1825:148732. [PMID: 38104922 DOI: 10.1016/j.brainres.2023.148732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 09/07/2023] [Accepted: 12/14/2023] [Indexed: 12/19/2023]
Abstract
Trigeminal neuralgia (TN) is a common form of facial pain, which primarily manifests as severe pain similar to facial acupuncture and electric shock. Olfactory ensheathing cells (OECs) are glial cells with high bioactivity; these cells are essential for the periodic regeneration of the olfactory nerve and have been utilized for the repair of nerve injuries. A member of the P2X receptor family, P2X7R, is an ion channel type receptor that has been confirmed to participate in various pain response processes. In this study, we transplanted OECs into trigeminal nerve-model rats with distal infraorbital nerve ligation to observe the therapeutic effect of transplanted OECs in rats. Additionally, we utilized the P2X7R-specific inhibitor brilliant blue G (BBG) to study the therapeutic mechanisms of cell transplantation. The facial mechanical pain threshold of these rats significantly increased following cell transplantation. The immunohistochemistry, immunoblotting, and RT-qPCR results demonstrated that the levels of P2X7R, (NOD)-like receptor protein-3 (NLRP3), nuclear factor-κB (NF-κB), interleukin (IL)-1β, and IL-18 in the trigeminal ganglion of rats treated with OEC transplantation or BBG treatment were significantly lower than those in the injured group without treatment. Overall, our results demonstrate that OEC transplantation can alleviate TN in rats, and it can reduce the expression of P2X7R related inflammatory factors in TN rats, reducing neuroinflammatory response in TG.
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Affiliation(s)
- Jiafeng Lu
- Department of Anatomy, Basic Medical School, Nanchang University, Nanchang 330006, China
| | - Baolin Yang
- Department of Anatomy, Basic Medical School, Nanchang University, Nanchang 330006, China
| | - Wenjun Zhang
- Rehabilitation Medicine Department, Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - Hui Cheng
- Department of Anatomy, Basic Medical School, Nanchang University, Nanchang 330006, China
| | - Jingnan Zeng
- Department of Anatomy, Basic Medical School, Nanchang University, Nanchang 330006, China
| | - Yuanli Wang
- Department of Anatomy, Basic Medical School, Nanchang University, Nanchang 330006, China
| | - Wei Wei
- Department of Anatomy, Basic Medical School, Nanchang University, Nanchang 330006, China
| | - Zengxu Liu
- Department of Anatomy, Basic Medical School, Nanchang University, Nanchang 330006, China.
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Zamith Cunha R, Semprini A, Salamanca G, Gobbo F, Morini M, Pickles KJ, Roberts V, Chiocchetti R. Expression of Cannabinoid Receptors in the Trigeminal Ganglion of the Horse. Int J Mol Sci 2023; 24:15949. [PMID: 37958932 PMCID: PMC10648827 DOI: 10.3390/ijms242115949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 10/17/2023] [Accepted: 10/31/2023] [Indexed: 11/15/2023] Open
Abstract
Cannabinoid receptors are expressed in human and animal trigeminal sensory neurons; however, the expression in the equine trigeminal ganglion is unknown. Ten trigeminal ganglia from five horses were collected post-mortem from an abattoir. The expression of cannabinoid receptors type 1 (CB1R) and type 2 (CB2R), and the cannabinoid-related receptors like transient receptor potential vanilloid type 1 (TRPV1), peroxisome proliferator-activated receptor gamma (PPARɣ), and G protein-related receptor 55 (GPR55) in the trigeminal ganglia (TG) of the horse were studied, using immunofluorescence on cryosections and formalin-fixed paraffin-embedded (FFPE) sections. Neurons and glial cells were identified using fluorescent Nissl staining NeuroTrace® and an antibody directed against the glial marker glial fibrillary acidic protein (GFAP), respectively. Macrophages were identified by means of an antibody directed against the macrophages/microglia marker ionized calcium-binding adapter molecule 1 (IBA1). The protein expression of CB1R, CB2R, TRPV1, and PPARɣ was found in the majority of TG neurons in both cryosections and FFPE sections. The expression of GPR55 immunoreactivity was mainly detectable in FFPE sections, with expression in the majority of sensory neurons. Some receptors were also observed in glial cells (CB2R, TRPV1, PPARγ, and GPR55) and inflammatory cells (PPARγ and GPR55). These results support further investigation of such receptors in disorders of equine trigeminal neuronal excitability.
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Affiliation(s)
- Rodrigo Zamith Cunha
- Department of Veterinary Medical Sciences, University of Bologna, 37200 Bologna, Italy; (R.Z.C.); (A.S.); (G.S.); (F.G.); (M.M.)
| | - Alberto Semprini
- Department of Veterinary Medical Sciences, University of Bologna, 37200 Bologna, Italy; (R.Z.C.); (A.S.); (G.S.); (F.G.); (M.M.)
| | - Giulia Salamanca
- Department of Veterinary Medical Sciences, University of Bologna, 37200 Bologna, Italy; (R.Z.C.); (A.S.); (G.S.); (F.G.); (M.M.)
| | - Francesca Gobbo
- Department of Veterinary Medical Sciences, University of Bologna, 37200 Bologna, Italy; (R.Z.C.); (A.S.); (G.S.); (F.G.); (M.M.)
| | - Maria Morini
- Department of Veterinary Medical Sciences, University of Bologna, 37200 Bologna, Italy; (R.Z.C.); (A.S.); (G.S.); (F.G.); (M.M.)
| | - Kirstie J. Pickles
- School of Veterinary Medicine and Science, University of Nottingham, Nottingham LE12 5RD, UK;
| | - Veronica Roberts
- Bristol Vet School, University of Bristol, Bristol BS40 5DU, UK;
| | - Roberto Chiocchetti
- Department of Veterinary Medical Sciences, University of Bologna, 37200 Bologna, Italy; (R.Z.C.); (A.S.); (G.S.); (F.G.); (M.M.)
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Labbe KA, Allshouse KA, Gilmour LJ, Arnold CE, Whitfield-Cargile CM, Griffin CE. The prevalence of headshaking in horses with primary and secondary dental sinusitis and computed tomographic evidence of infraorbital canal pathology. Equine Vet J 2023; 55:1038-1044. [PMID: 36641799 DOI: 10.1111/evj.13924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 01/05/2023] [Indexed: 01/16/2023]
Abstract
BACKGROUND Sinusitis is a common disease of horses yet there are a limited number of reports in the literature that describe the prevalence of infraorbital canal (IOC) pathology and headshaking behaviour in horses diagnosed specifically with primary sinusitis and secondary dental sinusitis. Given the impact that these behaviours can have on horses' intended athletic use, investigation is warranted. OBJECTIVES To determine the occurrence of IOC pathology in horses with concurrent primary or secondary dental sinusitis based on computed tomography (CT) findings and to assess whether the frequency of headshaking behaviour is influenced by the presence of IOC pathology. STUDY DESIGN Retrospective case series. METHODS Computed tomography studies were assessed for sinusitis (unilateral or bilateral), IOC pathology (unilateral or bilateral) and description of IOC disease including displacement, deformation, periosteal proliferation, hyperostosis, osteolysis and infraorbital nerve exposure. Behaviour outcome was determined by client questionnaire five or more years following CT scan. RESULTS A total 65 out of 66 horses diagnosed with primary or secondary dental sinusitis demonstrated IOC changes on CT. Hyperostosis (86%), periosteal proliferation (85%) and osteolysis (86%) were common CT findings. Hyperostosis was frequently found to involve both the IOC and supporting bone structure. Five cases were euthanized immediately after CT acquisition or during hospitalisation following diagnostic investigations. Follow-up was obtained in 48/61 cases, with five horses showing headshaking behaviour. MAIN LIMITATIONS Infraorbital nerve histopathology was not performed. The limited number of cases with no IOC pathology prevented direct comparison between sinusitis groups both with IOC pathology and without IOC changes. The client questionnaire carries a memory bias. CONCLUSION Computed tomography changes involving the IOC may not predict headshaking behaviours in sinusitis secondary to dental disease. This finding is important in the context that these behaviours render some horses unusable and unsafe for their intended riding discipline.
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Affiliation(s)
- Karyn A Labbe
- Department of Large Animal Clinical Sciences, School of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Kimberly A Allshouse
- Department of Large Animal Clinical Sciences, School of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Lindsey J Gilmour
- Department of Large Animal Clinical Sciences, School of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Carolyn E Arnold
- Department of Large Animal Clinical Sciences, School of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Canaan M Whitfield-Cargile
- Department of Large Animal Clinical Sciences, School of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Cleet E Griffin
- Department of Large Animal Clinical Sciences, School of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, USA
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Ma X, Zhu T, Ke J. Progress in animal models of trigeminal neuralgia. Arch Oral Biol 2023; 154:105765. [PMID: 37480619 DOI: 10.1016/j.archoralbio.2023.105765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 06/30/2023] [Accepted: 07/10/2023] [Indexed: 07/24/2023]
Abstract
OBJECTIVE This review aims to systematically summarize the methods of establishing various models of trigeminal neuralgia (TN), the scope of application, and current animals used in TN research and the corresponding pain measurements, hoping to provide valuable reference for researchers to select appropriate TN animal models and make contributions to the research of pathophysiology and management of the disease. DESIGN The related literatures of TN were searched through PubMed database using different combinations of the following terms and keywords including but not limited: animal models, trigeminal neuralgia, orofacial neuropathic pain. To find the maximum number of eligible articles, no filters were used in the search. The references of eligible studies were analyzed and reviewed comprehensively. RESULTS This study summarized the current animal models of TN, categorized them into the following groups: chemical induction, photochemical induction, surgery and genetic engineering, and introduced various measurement methods to evaluate animal pain behaviors. CONCLUSIONS Although a variety of methods are used to establish disease models, there is no ideal TN model that can reflect all the characteristics of the disease. Therefore, there is still a need to develop more novel animal models in order to further study the etiology, pathological mechanism and potential treatment of TN.
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Affiliation(s)
- Xiaohan Ma
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, China; Department of Oral and Maxillofacial Trauma and Temporomandibular Joint Surgery, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, China
| | - Taomin Zhu
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, China; Department of Oral and Maxillofacial Trauma and Temporomandibular Joint Surgery, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, China
| | - Jin Ke
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, China; Department of Oral and Maxillofacial Trauma and Temporomandibular Joint Surgery, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, China.
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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. Animals (Basel) 2022; 12:ani12223125. [PMID: 36428354 PMCID: PMC9686903 DOI: 10.3390/ani12223125] [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: 09/29/2022] [Revised: 11/02/2022] [Accepted: 11/11/2022] [Indexed: 11/16/2022] Open
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.
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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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Pickles K. Trigeminal‐mediated headshaking: A diagnostic challenge. EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Kirstie Pickles
- School of Veterinary Medicine and Science University of Nottingham Leicestershire UK
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Ellis KL, Contino EK, Nout‐Lomas YS. Poor performance in the horse: Diagnosing the non‐orthopaedic causes. EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Katherine L. Ellis
- Gail Holmes Equine Orthopedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences Colorado State University Fort Collins Colorado USA
| | - Erin K. Contino
- Gail Holmes Equine Orthopedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences Colorado State University Fort Collins Colorado USA
| | - Yvette S. Nout‐Lomas
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences Colorado State University Fort Collins Colorado USA
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12
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Rørvang MV, Nicova K, Yngvesson J. Horse odor exploration behavior is influenced by pregnancy and age. Front Behav Neurosci 2022; 16:941517. [PMID: 35967896 PMCID: PMC9366077 DOI: 10.3389/fnbeh.2022.941517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 06/30/2022] [Indexed: 11/13/2022] Open
Abstract
In spite of a highly developed olfactory apparatus of horses, implying a high adaptive value, research on equine olfaction is sparse. Our limited knowledge on equine olfaction poses a risk that horse behavior does not match human expectations, as horses might react fearful when exposed to certain odors, which humans do not consider as frightening. The benefit of acquiring more knowledge of equine olfaction is therefore twofold; (1) it can aid the understanding of horse behavior and hence reduce the risk of dangerous situations, and (2) there may be unexplored potential of using odors in several practical situations where humans interact with horses. This study investigated behavior and olfactory sensitivity of 35 Icelandic horses who were presented with four odors: peppermint, orange, lavender and cedar wood in a Habituation/Dishabituation paradigm. The response variables were sniffing duration per presentation and behavioral reaction (licking, biting, snorting, and backing), and data were analyzed for potential effects of age, sex and pregnancy. Results showed that habituation occurred between successive odor presentations (1st vs. 2nd and 2nd vs. 3rd presentations: P < 0.001), and dishabituation occurred when a new odor was presented (1st vs. 3rd presentations: P < 0.001). Horses were thus able to detect and distinguish between all four odors, but expressed significantly longer sniffing duration when exposed to peppermint (peppermint vs. orange, lavender and cedar wood: P < 0.001). More horses expressed licking when presented to peppermint compared to cedar wood and lavender (P = 0.0068). Pregnant mares sniffed odors less than non-pregnant mares (P = 0.030), young horses (age 0-5 years) sniffed cedar wood for longer than old horses (P = 0.030), whereas sex had no effect (P > 0.050). The results show that horses’ odor exploration behavior and interest in odors varies with age and pregnancy and that horses naïve to the taste of a substrate, may be able to link smell with taste, which has not been described before. These results can aid our understanding of horses’ behavioral reactions to odors, and in the future, it may be possible to relate these to the physiology and health of horses.
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Affiliation(s)
- Maria Vilain Rørvang
- Department Biosystems and Technology, Swedish University of Agricultural Sciences, Lomma, Sweden
- *Correspondence: Maria Vilain Rørvang,
| | - Klára Nicova
- Department of Ethology, Institute of Animal Science, Prague, Czechia
| | - Jenny Yngvesson
- Department Biosystems and Technology, Swedish University of Agricultural Sciences, Lomma, Sweden
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Ogden N, Thomas H, Carslake H, Kane‐Smyth J. Trigeminal neuropathy in two horses following trauma to the infraorbital and mental nerves. EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Nadine Ogden
- Leahurst Equine Hospital University of Liverpool Neston UK
| | - Hannah Thomas
- Thomas Veterinary Services Gwernyffynnon Farm Rhosesmor UK
| | - Harry Carslake
- Leahurst Equine Hospital University of Liverpool Neston UK
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Adalbert R, Cahalan S, Hopkins EL, Almuhanna A, Loreto A, Pór E, Körmöczy L, Perkins J, Coleman MP, Piercy RJ. Cultured dissociated primary dorsal root ganglion neurons from adult horses enable study of axonal transport. J Anat 2022; 241:1211-1218. [PMID: 35728923 PMCID: PMC9558156 DOI: 10.1111/joa.13719] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 06/12/2022] [Accepted: 06/13/2022] [Indexed: 11/29/2022] Open
Abstract
Neurological disorders are prevalent in horses, but their study is challenging due to anatomic constraints and the large body size; very few host‐specific in vitro models have been established to study these types of diseases, particularly from adult donor tissue. Here we report the generation of primary neuronal dorsal root ganglia (DRG) cultures from adult horses: the mixed, dissociated cultures, containing neurons and glial cells, remained viable for at least 90 days. Similar to DRG neurons in vivo, cultured neurons varied in size, and they developed long neurites. The mitochondrial movement was detected in cultured cells and was significantly slower in glial cells compared to DRG‐derived neurons. In addition, mitochondria were more elongated in glial cells than those in neurons. Our culture model will be a useful tool to study the contribution of axonal transport defects to specific neurodegenerative diseases in horses as well as comparative studies aimed at evaluating species‐specific differences in axonal transport and survival.
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Affiliation(s)
- Robert Adalbert
- Comparative Neuromuscular Diseases Laboratory, Department of Clinical Science and Services, Royal Veterinary College, London, UK.,Department of Anatomy, Histology, and Embryology, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Stephen Cahalan
- Comparative Neuromuscular Diseases Laboratory, Department of Clinical Science and Services, Royal Veterinary College, London, UK
| | - Eleanor L Hopkins
- John van Geest Centre for Brain Repair, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Abdulaziz Almuhanna
- Comparative Neuromuscular Diseases Laboratory, Department of Clinical Science and Services, Royal Veterinary College, London, UK
| | - Andrea Loreto
- John van Geest Centre for Brain Repair, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.,Andrea Loreto, Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
| | - Erzsébet Pór
- Department of Anatomy, Histology, and Embryology, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Laura Körmöczy
- Department of Anatomy, Histology, and Embryology, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Justin Perkins
- Comparative Neuromuscular Diseases Laboratory, Department of Clinical Science and Services, Royal Veterinary College, London, UK
| | - Michael P Coleman
- John van Geest Centre for Brain Repair, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Richard J Piercy
- Comparative Neuromuscular Diseases Laboratory, Department of Clinical Science and Services, Royal Veterinary College, London, UK
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15
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Aleman M, Sheldon SA, Jospin G, Coil D, Stratton‐Phelps M, Eisen J. Caecal microbiota in horses with trigeminal‐mediated headshaking. Vet Med Sci 2022; 8:1049-1055. [PMID: 35060350 PMCID: PMC9122421 DOI: 10.1002/vms3.735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background Trigeminal‐mediated headshaking (TMHS) in horses is a form of neuropathic pain of undetermined cause that often results in euthanasia. The role of microbiota in TMHS has not been investigated in diseased horses. Objective To investigate if gastrointestinal microbiota in the cecum is different in horses with TMHS compared to a control population, during a summer season with clinical manifestations of disease. Animals Ten castrated horses: five with TMHS and five neurologically normal controls. Methods All horses were sourced from our institution and kept under the same husbandry and dietary conditions. All horses were fed orchard grass hay for 30 days and then were euthanized due to chronic untreatable conditions including TMHS and orthopedic disease (control group). Caecal samples for microbiota analysis were collected within 20 min after euthanasia. Sequencing was performed using an Illumina MiSeq platform and the microbiome was analyzed. Results The caecal microbiota of horses with TMHS was similar to control horses in terms of diversity but differed significantly with Methanocorpusculum spp. having higher abundance in horses with TMHS. Conclusions and clinical importance Methanocorpusculum spp. was more abundant in the cecum of horses with TMHS. However, its role in disease is unknown. Furthermore, it could also represent an incidental finding due to our small population size.
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Affiliation(s)
- Monica Aleman
- Department of Medicine and Epidemiology University of California Davis Davis California USA
| | - Shara. A. Sheldon
- Department of Medicine and Epidemiology University of California Davis Davis California USA
| | - Guillaume Jospin
- The Genome Center University of California Davis Davis California USA
| | - David Coil
- The Genome Center University of California Davis Davis California USA
| | | | - Jonathan Eisen
- The Genome Center University of California Davis Davis California USA
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16
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Almuhanna AH, Cahalan SD, Lane A, Goodwin D, Perkins J, Piercy RJ. Optimisation and validation of immunohistochemical axonal markers for morphological and functional characterisation of equine peripheral nerves. Equine Vet J 2020; 53:1188-1198. [PMID: 33338316 DOI: 10.1111/evj.13403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 11/03/2020] [Accepted: 12/11/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Horses are affected by various peripheral nerve disorders but defining their aetiology and pathophysiology is hampered by limited understanding of associated morphological and pathological changes and involvement of specific axonal types. OBJECTIVES To investigate the hypothesis that selected antibody markers, used in conjunction with various tissue processing methods, would enable identification of axons with different functional modalities within a range of equine peripheral nerves. STUDY DESIGN Optimisation and validation study. METHODS A range of antibodies were evaluated immunohistochemically via fluorescence confocal microscopy in cadaver equine nerve samples of primary motor, mixed or primary sensory functions (recurrent laryngeal, phrenic and plantar digital) within formalin-fixed paraffin-embedded (FFPE) and formalin-fixed frozen (FFF) tissues subjected to different antigen retrieval protocols. RESULTS Immunohistochemistry of FFPE-derived nerve samples with selected antibodies and specific antigen retrieval methods enabled identification of myelinated and unmyelinated axons, cholinergic, sympathetic and peptidergic axons. The recurrent laryngeal and phrenic nerves are composed of myelinated cholinergic (motor), myelinated sensory fibres, unmyelinated adrenergic (sympathetic) axons and unmyelinated peptidergic (sensory) axons. In contrast, as expected, the plantar digital nerve had no myelinated motor fibres being mainly composed of myelinated sensory fibres, unmyelinated sympathetic and unmyelinated peptidergic sensory axons. MAIN LIMITATION Attempts specifically to label parasympathetic fibres were unsuccessful in any nerve examined in both FFPE and FFF tissues. CONCLUSIONS A panel of antibody markers can be used to reveal morphological and functional properties of equine nerves. Future work should enable better characterisation of morphological changes in equine neuropathies at various stages of disease development.
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Affiliation(s)
- Abdulaziz H Almuhanna
- Comparative Neuromuscular Diseases Laboratory, Department of Veterinary Clinical Sciences, Royal Veterinary College, Royal College Street, London, UK
| | - Stephen D Cahalan
- Comparative Neuromuscular Diseases Laboratory, Department of Veterinary Clinical Sciences, Royal Veterinary College, Royal College Street, London, UK
| | - Annette Lane
- Comparative Neuromuscular Diseases Laboratory, Department of Veterinary Clinical Sciences, Royal Veterinary College, Royal College Street, London, UK
| | - David Goodwin
- Comparative Neuromuscular Diseases Laboratory, Department of Veterinary Clinical Sciences, Royal Veterinary College, Royal College Street, London, UK
| | - Justin Perkins
- Comparative Neuromuscular Diseases Laboratory, Department of Veterinary Clinical Sciences, Royal Veterinary College, Royal College Street, London, UK
| | - Richard J Piercy
- Comparative Neuromuscular Diseases Laboratory, Department of Veterinary Clinical Sciences, Royal Veterinary College, Royal College Street, London, UK
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17
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Overview of the Current Situation in a Sample of Headshakers and Owner Assessment of Effective Therapeutic Measures Used in Germany. J Equine Vet Sci 2020; 95:103270. [PMID: 33276935 DOI: 10.1016/j.jevs.2020.103270] [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: 03/20/2020] [Revised: 09/08/2020] [Accepted: 09/08/2020] [Indexed: 11/23/2022]
Abstract
Equine headshaking syndrome is a problematic behavior that has been described in literature for more than 100 years. The signs of headshaking syndrome appear frequently and violently so that riding the horse can be dangerous. The aim of this research was to gain an overview of the underlying causes of equine headshaking syndrome to identify effective treatment options, reduce the distress of horses and, in a second step, potentially improve therapeutic possibilities for horse owners and veterinarians. Most studies on prevalence originate from Anglo-American countries, so this research was to provide an overview of German horses; therefore, an online survey was designed by experts in the field (researchers and veterinarians) and answered by German horse owners. Questionnaires were pretested by a small group of horse owners (n = 5) and redesigned accordingly. The final questionnaire consisted of 27 questions, which were divided into seven open questions with an associated text field and 20 multiple-choice questions (Supplementary Material 1). For some of the multiple-choice questions, multiple answers were permitted. In total, 163 completed questionnaires were obtained from owners of headshaking horses (ntotal = 163). Gender distribution of the horses resulted in 64.4% geldings, 33.7% mares, and 1.8% stallions. Most horses were German warmbloods (55.4%). The average age was 12.7 years (with a wide range of 5 to 34 years). The vertical movement of the head was the most frequently mentioned symptom in 75.5% of the evaluated horses. In 18.4% of the cases, the horse owners identified stress as the main trigger for headshaking. Furthermore, 18.4% claimed that their horses suffered from additional stereotypical behavior. The percentages do not refer to the same horses here. 11.0% of the participants in this study tried scientifically evaluated therapies such as surgical therapy (1.2%) or medical treatment (9.8%). In addition, 54.0% of the owners utilized a nose cover to reduce the symptoms of the headshaking syndrome. A high percentage of 84.0% used alternative therapies such as physiotherapy (31.9%), change of equipment (22.7%), or change of riding style (29.4%). Overall, this study provides a useful overview of causes and effective therapies.
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18
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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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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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20
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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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21
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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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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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23
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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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Sheldon SA, Aleman M, Costa LRR, Santoyo AC, Weich KM, Howey Q, Madigan JE. Luteinizing hormone concentrations in healthy horses and horses with trigeminal-mediated headshaking over an 8-hour period. J Vet Intern Med 2019; 33:885-888. [PMID: 30773684 PMCID: PMC6430929 DOI: 10.1111/jvim.15451] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 01/30/2019] [Indexed: 12/04/2022] Open
Abstract
Background Trigeminal‐mediated headshaking results from a low threshold for firing of the trigeminal nerve. A seasonal component has been implicated in onset of clinical signs, which occur during the spring and summer months. Geldings are overrepresented in the affected population and hormonal differences as compared to a healthy control population of geldings might contribute to headshaking. Objective/Hypothesis To assess concentrations of luteinizing hormone (LH) over an 8‐hour period in gelded healthy controls and horses affected with headshaking. Our hypothesis was that geldings with seasonal headshaking would have higher concentrations of LH over an 8‐hour period compared to control horses during the summer when affected horses manifested headshaking. Animals Twelve geldings (6 controls and 6 affected). Methods Prospective controlled trial. Blood samples were drawn every 15 minutes over an 8‐hour time period during summer from all horses to measure circulating LH concentrations by using a radioimmunoassay for equine LH. All affected horses were actively affected by headshaking at the time of sample collection. Results No statistically significant differences in LH concentrations were found throughout the study period in headshakers as compared to control horses. Time had no significant effect, but a slight decrease in LH concentrations was observed for all horses. The main limitation of the study was the low number of horses. Conclusions and Clinical Importance Horses affected with headshaking did not have significant differences in circulating LH during the late summer as compared to control horses.
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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
| | - Kalie M 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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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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26
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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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27
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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; 8:E102. [PMID: 29941850 PMCID: PMC6071069 DOI: 10.3390/ani8070102] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 05/31/2018] [Accepted: 06/18/2018] [Indexed: 11/16/2022] Open
Abstract
Trigeminal-nerve-mediated headshaking represents a major welfare challenge for owners and veterinarians and is caused by a low threshold firing of the trigeminal nerve resulting in pain manifested as violent head jerking that often terminates the horse’s career and life due to poor quality of life and suffering. As metabolic changes such as acid⁻base status and electrolytes play a role in nerve firing, this study sought to assess the effects following administration of hypertonic solutions on headshaking behavior in affected horses. This prospective randomized controlled crossover design utilized six horses affected with trigeminal-mediated headshaking and three treatment groups receiving intravenous administration of 5% dextrose solution at 2 mL/kg bwt (DS), NaCl 7.5% at 4 mL/kg bwt (HS), or NaHCO₃ 8.4% at 2 mmol/kg bwt (HB). Horses were assessed for headshaking behavior changes at times T0 (baseline, before infusion) and T15, 30, 60, 120 min post infusion. Venous blood variables: pH, HCO₃−, standard base excess (SBE), Na⁺, Cl−, K⁺, Ca2+, Mg2+, total magnesium (tMg), glucose, and lactate were measured at T0 (baseline, before infusion) and T5, 15, 30, 60, 120 min post infusion. Strong ion difference (SID) and anion gap (AG) were calculated for each time point. With HB treatment, there was greater than 50% reduction in headshaking rate. There was an effect of time on increasing headshaking rate. There was an effect of breed on headshaking rate. Changes in blood parameters following DS were virtually absent. Infusion of HS caused mild changes and did not vary much from baseline except for SID and AG. Only infusion of HB caused blood pH and HCO₃− to be outside of the physiologic range (alkalemia and metabolic alkalosis, respectively), SBE to double or triple, AG to decrease, and SID to increase compared to baseline. Infusion of DS was followed by increase in blood glucose and decrease in blood Na⁺. Infusion of HS was followed by increase in Na⁺ and Cl− and decrease in Mg2+. Infusion of HB was followed by decrease in Mg2+. Blood tMg, K⁺, and Ca2+ decreased slightly, but did not vary greatly from baseline following any of the treatments, remaining within physiologic ranges. Changes in blood composition were transient. Among all treatments, only HB had an effect on headshaking rate. The limited effects following these fluids were likely due to normal mechanisms of regulation of blood levels of pH and electrolytes. Further investigations of changes in electrolytes that might affect nerve firing should be explored.
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Affiliation(s)
- Shara Sheldon
- Department of Nutrition, University of California, Davis, CA 95616, USA.
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
| | - Monica Aleman
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
| | - Lais Costa
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
| | - A Cristina Santoyo
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
| | - Quinn Howey
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
| | - John Madigan
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
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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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Dyson S, Berger J, Ellis AD, Mullard J. Development of an ethogram for a pain scoring system in ridden horses and its application to determine the presence of musculoskeletal pain. J Vet Behav 2018. [DOI: 10.1016/j.jveb.2017.10.008] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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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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Ross SE, Murray JK, Roberts VLH. Prevalence of headshaking within the equine population in the UK. Equine Vet J 2017; 50:73-78. [PMID: 28608565 DOI: 10.1111/evj.12708] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 06/06/2017] [Indexed: 12/27/2022]
Abstract
REASON FOR PERFORMING STUDY Headshaking in horses has been reported to be most commonly due to idiopathic neuropathic facial pain (trigeminal-mediated headshaking). The prevalence of headshaking in horses in the UK is unknown. OBJECTIVES To estimate owner-reported prevalence of headshaking in horses in the UK and to report their case background and disease characteristics, as reported by owners. STUDY DESIGN Cross-sectional web based owner questionnaire. METHODS The questionnaire was advertised online via social media, horse forums, veterinary websites and equestrian magazines from 17th June 2016, until >1000 responses had been obtained. All UK horse owners were eligible to complete the questionnaire, however only one questionnaire could be completed per owner. RESULTS The estimated prevalence of owner-reported headshaking in the sample population of horses (n = 1014), within the last year, was 4.6% (95% confidence interval 3.5-6.1), whereas 6.2% (95% confidence interval 4.9-7.9) of horses were reported by their owners to have shown signs of headshaking at any time-point since ownership. There was no association of sex or breed. Nineteen percent of headshaking horses were reported to show headshaking at rest. Fewer than one-third (30.2%, n = 19) of headshaking horses had been examined by a veterinarian for headshaking. Of horses seen by a veterinarian, the cause for headshaking remained unknown in the majority of cases (57.9% responses) and trigeminal-mediated headshaking was reported as a diagnosis in just one case. MAIN LIMITATIONS The accuracy in data reporting by horse owners was not verified in this study. There may be a potential for bias towards over-reporting due to the nature of survey participation. CONCLUSIONS Within this sample, owner-reported prevalence of signs of headshaking within the last year, in horses in the UK was 4.6%. Over two-thirds of owners of headshaking horses did not seek veterinary intervention for headshaking. Trigeminal-mediated headshaking was rarely reported by owners as a diagnosis.
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Affiliation(s)
- S E Ross
- School of Veterinary Sciences, University of Bristol, Somerset, UK
| | - J K Murray
- School of Veterinary Sciences, University of Bristol, Somerset, UK
| | - V L H Roberts
- School of Veterinary Sciences, University of Bristol, Somerset, UK
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Abstract
There has been great progress in the understanding of basic neurobiologic mechanisms of pain, but this body of knowledge has not yet translated into new and improved analgesics. Progress has been made regarding pain assessment in horses, but more work is needed until sensitive and accurate pain assessment tools are available for use in clinical practice. This review summarizes and updates the knowledge concerning the cornerstones of pain medicine (understand, assess, prevent, and treat). It highlights the importance of understanding pain mechanisms and expressions to enable a rational approach to pain assessment, prevention, and management in the equine patient.
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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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Diseases of the Nervous System. Vet Med (Auckl) 2017. [PMCID: PMC7322266 DOI: 10.1016/b978-0-7020-5246-0.00014-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Roberts VLH, Patel NK, Tremaine WH. Neuromodulation using percutaneous electrical nerve stimulation for the management of trigeminal-mediated headshaking: A safe procedure resulting in medium-term remission in five of seven horses. Equine Vet J 2015; 48:201-4. [DOI: 10.1111/evj.12394] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 11/18/2014] [Indexed: 12/26/2022]
Affiliation(s)
- V. L. H. Roberts
- School of Veterinary Sciences; University of Bristol; Somerset UK
| | - N. K. Patel
- Institute of Neurosciences; Southmead Hospital; Bristol UK
| | - W. H. Tremaine
- School of Veterinary Sciences; University of Bristol; Somerset UK
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Wilmink S, Warren-Smith CMR, Roberts VLH. Validation of the accuracy of needle placement as used in diagnostic local analgesia of the maxillary nerve for investigation of trigeminally mediated headshaking in horses. Vet Rec 2015; 176:148. [PMID: 25433055 DOI: 10.1136/vr.102518] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Diagnostic local anaesthesia of the maxillary nerve is a valuable aid in the diagnosis of trigeminally mediated headshaking in horses. Our objective is to validate the accuracy of needle placement in this procedure and to identify any correlation between accuracy of the technique and operator experience. Using a small volume of contrast medium, the procedure was performed bilaterally on 30 horse cadaver heads by three groups with different levels of experience with the technique. The location of deposition was then identified using computed tomography (CT). Contrast medium was deposited around the target site in 53.3% (32/60) of injections. An experienced operator succeeded in deposition around the target area significantly (p<0.05) more often (80%, 16/20) than did the less and non-experienced performers (40%, 16/40). A negative response to diagnostic local anaesthesia of the maxillary nerve does not disprove facial dysaesthesia as the cause of headshaking in that horse as a false negative response could arise due to failure to deposit local anaesthetic around the target area. Increased experience in performing the procedure decreases the probability of false negative results.
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Affiliation(s)
- S Wilmink
- Department of Clinical Veterinary Science, University of Bristol, Langford House, Langford, North Somerset, UK
| | - C M R Warren-Smith
- Department of Clinical Veterinary Science, University of Bristol, Langford House, Langford, North Somerset, UK
| | - V L H Roberts
- Department of Clinical Veterinary Science, University of Bristol, Langford House, Langford, North Somerset, UK
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Idiopathic headshaking: is it still idiopathic? Vet J 2014; 201:21-30. [PMID: 24821361 DOI: 10.1016/j.tvjl.2014.03.031] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Revised: 03/25/2014] [Accepted: 03/27/2014] [Indexed: 11/21/2022]
Abstract
The clinical syndrome of equine idiopathic headshaking (HSK) was first described in the veterinary literature over 100 years ago, and the disorder continues to be a cause of substantial distress for the horse, frustration for the owner and therapeutic challenge for the veterinarian. This review presents a summary of the current knowledge of clinical signs, signalment, aetiopathogenesis, anatomy, diagnosis and treatment of idiopathic HSK. Recent advances in understanding the pathogenesis of the disease will be discussed with reference to human trigeminal neuralgia, along with the implications this may have for potential therapies.
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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 2013; 28:250-3. [PMID: 24428325 PMCID: PMC4895556 DOI: 10.1111/jvim.12237] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2013] [Revised: 08/29/2013] [Accepted: 09/19/2013] [Indexed: 11/29/2022] Open
Affiliation(s)
- M Aleman
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA
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