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farriery
veterinary
biomechanics
anatomy
nutrition
physiotherapy
2016
Expert Opinion

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.

Authors: Roberts V L H, Patel N K, Tremaine W H

Journal: Equine veterinary journal

Summary

# Editorial Summary: Neuromodulation for Trigeminal-Mediated Headshaking Trigeminal-mediated headshaking represents a frustratingly difficult condition to manage, stemming from sensitisation of the trigeminal nerve that manifests as neuropathic pain; Roberts and colleagues investigated whether percutaneous electrical nerve stimulation (PENS)—a minimally invasive neuromodulatory technique well-established in human pain management—might offer a viable alternative where conventional treatments often fall short. Seven horses underwent PENS therapy targeting the trigeminal nerve, with the procedure itself proving safe and well-tolerated across all cases. Five of the seven horses (71%) achieved medium-term remission of clinical signs, representing a notably encouraging response rate for a condition where consistent therapeutic success has historically been elusive. The safety profile and efficacy demonstrated here suggest PENS warrants serious consideration as a treatment option for equine practitioners managing trigeminal-mediated headshaking, particularly in cases refractory to other interventions, though larger cohort studies would help establish optimal electrode placement, stimulation parameters, and long-term outcome sustainability.

Read the full abstract on PubMed

Practical Takeaways

  • PENS offers a minimally invasive neuromodulatory option for managing trigeminal-mediated headshaking when conventional treatments have failed
  • Success rate of approximately 71% suggests this could become a valuable treatment protocol for this difficult-to-treat condition
  • Safety profile supports consideration of PENS as a medium-term management strategy for neuropathic pain in horses

Key Findings

  • PENS therapy was a safe procedure with no reported adverse effects in the seven horses treated
  • Medium-term remission of headshaking symptoms was achieved in five of seven horses (71%)
  • The procedure targets sensitized trigeminal nerve function through percutaneous electrical nerve stimulation

Conditions Studied

trigeminal-mediated headshakingneuropathic pain