Summary: At the moment, therapy of equine idiopathic headshaking is difficult, as there is no adequate treatment for all trigeminal nerve branches available. In humans, trigeminal neuralgia, a similar disease, can be treated by the injection of glycerol into the trigeminal nerve root. The purpose of this study was to develop a minimally invasive injection technique into the trigeminal ganglion and to describe the effects of a glycerol injection. This study was performed on eight neurologically healthy horses. Under general anaesthesia and computer-tomographic guidance, a biopsy needle was moved through the guttural pouch into the trigeminal ganglion. Glycerol (1.6-1.9 ml) was injected into the trigeminal ganglion of one side of the head. Subsequently, the horses were clinically and neurologically examined at planned intervals. After the glycerol injection, the examination was performed every day during the first two weeks, then every other day for the next two weeks and then two times a week. After six weeks, the horses were euthanized and the trigeminal nerve and its surroundings were investigated macroscopically and histologically. A Wilcoxon signed rank test was used for non-normally distributed data. Statistical significance was set at p < 0.05. The glycerol injection could be accomplished in all of the eight cases. In one horse, severe neurologic signs occurred (increased sensitivity and pruritus at the head and neck on both sides and hypermetric, ataxic movements) which were ascribed to a meningitis in the post mortem examination. Another horse showed neurologic signs (torticollis to the left side, hemi-facial spasm and hyperaesthesia at head and neck on the left side as well as generalized ataxia) for unknown reasons which disappeared after adequate therapy. On both sides, signs of a degenerative neuropathy which were significantly more severe (p < 0.05) on the glycerol-treated side were observed. It was concluded that the glycerol injection is practicable in horses. Anatomical differences between horses and humans necessitate a diverging procedure and with respect to this the needle guidance by computed tomography was considered feasible. The degeneration detected in the histopathological examination indicated reduced conductivity of the trigeminal nerve which suggests that a glycerol injection produces the desired effects. As the glycerol injection has been performed only in healthy horses, the actual effect on headshaking horses cannot be verified yet and has to be examined in further investigations. Especially with regard to the fact that so far, no therapy for headshaking in the horse at the trigeminal nerve level exists, the present study can be considered as a basis for a minimally invasive therapy at the trigeminal ganglion.Keywords: Horse / trigeminal nerve / headshaking / glycerol / neuropathy
Untersuchung zur Wirkungsweise einer Glyzerolinjektion an das Ganglion trigeminale als Grundlage einer Behandlung des Headshakings beim PferdDie Therapie des equinen idiopathischen Headshakings ist derzeit...