The safety and efficacy of neuromodulation using percutaneous electrical nerve stimulation for the management of trigeminal-mediated headshaking in 168 horses.

Summary

# Editorial Summary: Percutaneous Electrical Nerve Stimulation for Trigeminal Headshaking Trigeminal-mediated headshaking represents a challenging idiopathic condition in equine practice, with limited effective treatment options beyond medical management. Roberts and colleagues evaluated the safety profile and clinical efficacy of percutaneous electrical nerve stimulation (EquiPENS™)—a neuromodulatory technique targeting the trigeminal nerve—across 168 horses, substantially expanding the evidence base beyond preliminary case series. The procedure demonstrated both tolerability and therapeutic benefit in a large cohort with adequate long-term follow-up data, establishing meaningful clinical outcomes that had been lacking in previous smaller studies. For practitioners managing horses with persistent headshaking unresponsive to conventional treatments, these findings suggest neuromodulation warrants consideration as a viable alternative intervention, offering a mechanism of action distinct from pharmacological approaches. Knowledge of this technique's safety and efficacy profile enables more comprehensive client counselling and treatment planning in cases where traditional management has proven inadequate.

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Key Findings

• •Percutaneous electrical nerve stimulation (EquiPENS™) was evaluated in 168 horses with trigeminal-mediated headshaking
• •Study addressed limitations of earlier promising results by providing larger case numbers and extended follow-up data
• •Neuromodulation technique has been established as a clinical procedure for managing trigeminal-mediated headshaking in horses

Conditions Studied

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