Summary
An 8‐year‐old Warmblood gelding was referred for evaluation of headshaking to the Clinic for Horses, University of Veterinary Medicine Hannover. Based on clinical signs and computed tomography – as well as magnetic resonance imaging – findings, otitis media was diagnosed. Medical treatment including trimethoprim potentiated sulfadimethoxine and meloxicam for 3 weeks did not result in cessation of clinical signs. Therefore, the tympanic cavity was opened transendoscopically using an Nd:YAG‐laser via the guttural pouch according to surgical procedures in human and small animal medicine, leading to a considerable improvement of clinical signs.
ZusammenfassungObwohl die Ätiologie des idiopathischen Headshaking beim Pferd noch nicht vollständig geklärt ist, wird die Trigeminusneuralgie aufgrund der im Vergleich zum Menschen ähnlichen Symptomatik und der partiell positiven Behandlungserfolge mit Cyproheptadin und Carbamazepin als ursächlich angesehen. In der Humanmedizin wird zur Therapie der Trigeminusneuralgie unter anderen die retroganglionäre Glycerolinjektion eingesetzt. Schlüsselwörter: Headshaking / Ganglion trigeminale / Glycerol / Injektion / Therapie
Treatment of idiopathic headshaking with an injection of glycerol into the trigeminal ganglion in a 5 year old Warmblood mareAccording to the similarities with human trigeminal neuralgia and the responsiveness to treatment with Cyproheptadine and Carbamazepine, equine idiopathic headshaking is suspected to be caused by trigeminal neuralgia, although the definitive reason is still unclear. In human medicine one treatment option of trigeminal neuralgia is retroganglional injection of glycerol. A five year old Warmblood mare was presented with a history of excessive headshaking induced by hot climate or sunshine. Clinical symptoms were recognized on pasture and during riding. After riding, headshaking was sustained for some hours in the stable. Based on history, clinical signs, laboratory, endoscopic and diagnostic imaging findings (x-rays of the head and computed tomography) diagnosis of idiopathic seasonal headshaking was made. The mare was treated with a computed tomography guided injection of glycerol (Glycerinum anhydriacum) in both trigeminal ganglions under general anaesthesia. Intervention was without severe complications. Follow up is lasting until today (2 years) and reveals a 95 % improvement of headshaking. In this case a long lasting significant improvement of idiopathic headshaking was achieved by the injection of glycerol in both trigeminal ganglions.
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