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.
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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