Imaging Diagnosis — Unilateral Trigeminal Neuritis Mimicking Peripheral Nerve Sheath Tumor in a Horse

Beltrán, Elsa; Grundon, Rachael A.; Stewart, Jennifer; Biggi, Marianna; Holloway, Andrew; Freeman, Courtenay

doi:10.1111/vru.12272

Cited by 15 publications

(13 citation statements)

References 14 publications

(15 reference statements)

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“…The current literature makes strong comparisons of headshaking with trigeminal neuritis in humans and there is sustained interest in an associated etiology of headshaking as a facial pain syndrome. However, the exact location of change in horses is still unknown (trigeminal nerve, maxillary branch, infraorbital nerve, or posterior ethmoidal nerve) . The findings of diagnostic analgesia and targets of therapy are varied in practice and the literature .…”

Section: Discussionmentioning

confidence: 99%

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Morphological variations of the infraorbital canal during CT has limited association with headshaking in horses

Edwards

Hermans

Veraa

2019

Vet Radiology Ultrasound

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Headshaking is a common problem in horses. The etiology is unknown but thought to involve sensory input from branches of the trigeminal nerve, some of which are within the infraorbital canal.The objective of this retrospective cross-sectional study was to describe the CT anatomy and variations of the infraorbital canal in horses with local disease processes and normal horses, and to examine associations between those findings and headshaking. Computed tomography scans were reviewed and morphological changes of the infraorbital canal were described. Presence of changes was then tested for association with headshaking prevalence, presence of disease processes in the region of the infraorbital canal, age, and sex. Nonparametric tests were used and a P-value of .05 was considered significant. A total of 218 horses were included, 9% of which had headshaking and 45% had CT lesions in the region of the infraorbital canal. Morphological changes to the bone of the infraorbital canal were found in 121 horses (56%) and included the following: increased mineralization 39 (18%), decreased mineralization 89 (41%), deformed shape 51 (23%), displaced position 43 (20%), and disruption 11 (5%). All changes of the infraorbital canal significantly increased in frequency with the presence of adjacent disease. Increased mineralization and disruption of the infraorbital canal were significantly associated with headshaking in horses with adjacent disease; the latter only reached significance after exclusion of dentally immature horses.No other changes were significantly associated with the presence of headshaking. No association was found between headshaking and the age or sex of the horse. K E Y W O R D Sequine head, maxillary, neurological, sinusitis, trigeminal nerve

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Section: Discussionmentioning

confidence: 99%

“…Hence, headshaking has been suggested to be due to neuropathic pain. There is a long‐standing comparison between idiopathic headshaking and trigeminal neuralgia, a neuropathic pain syndrome in humans; compression of the trigeminal nerve as seen on MRI in human patients is a commonly stated cause of trigeminal neuritis …”

Section: Introductionmentioning

confidence: 99%

Morphological variations of the infraorbital canal during CT has limited association with headshaking in horses

Edwards

Hermans

Veraa

2019

Vet Radiology Ultrasound

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“…Although previously published imaging criteria were used, diagnoses were not confirmed by histopathology. It has been determined previously that histopathology is required for accurate diagnosis because the MRI appearance of TNST can be mimicked by nonneoplastic conditions such as trigeminal neuritis . Assessment of outcome was complicated by the fact that some clients elected euthanasia without attempting further treatment, by variation in treatment protocols for the remaining dogs, by variable clinical presentations, and by different imaging findings among dogs within the same diagnosis category.…”

Section: Discussionmentioning

confidence: 99%

Clinical findings and outcome of dogs with unilateral masticatory muscle atrophy

Milodowski

Amengual-Batle

Beltrán

et al. 2018

Veterinary Internal Medicne

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Background Little is known about the spectrum of underlying disorders in dogs with unilateral masticatory muscle (MM) atrophy. Objectives To evaluate the clinical presentation, magnetic resonance imaging (MRI) findings, and outcome of dogs with unilateral MM atrophy. Animals Sixty‐three client‐owned dogs. Methods The medical database was retrospectively reviewed for dogs that underwent MRI for evaluation of unilateral MM atrophy. Imaging studies were reviewed and follow‐up information was obtained from telephone interviews. Results Presumptive trigeminal nerve sheath tumor (pTNST) was diagnosed in 30 dogs (47.6%); survival time varied from 1 day to 21 months (median, 5 months). Other extra‐axial mass lesions were observed in 13 dogs (20.6%); survival time varied from 6 days to 25 months (median, 2.5 months). In 18 dogs (28.6%), no abnormalities were observed on MRI; neurological signs only progressed in 1 dog. Diagnosis had a significant influence on the type of neurological abnormalities, with additional neurological deficits observed in most dogs with pTNST and in all dogs with other extra‐axial mass lesions. Diagnosis had a significant effect on euthanasia at the time of diagnosis and likelihood of neurological deterioration. Dogs with mass lesions were more likely to be euthanized or experience neurological deterioration, whereas these outcomes occurred less often in dogs in which no causative lesion could be identified. Conclusions and Clinical Importance Trigeminal nerve sheath tumors should not be considered the only cause of unilateral MM atrophy. Our results illustrate the importance of performing a neurological examination and MRI when evaluating dogs with unilateral MM atrophy.

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“…The first is of clinical importance as lesions of the infraorbital nerve can be associated with headshaking (Roberts et al 2009;Fiske-Jackson et al 2012). However, mild changes within the nerve are difficult to detect on CT images, whereas MRI will potentially show them (Beltran et al 2016). Computed tomography can also delineate the osseous anatomy of the nasolacrimal duct and it is possible to assess the patency of its lumen by injecting contrast medium (dacryocystography) (Nykamp et al 2004).…”

Section: Imaging Of the Nasal Passages And Paranasal Sinusesmentioning

confidence: 99%

Application and indications of magnetic resonance imaging and computed tomography of the equine head

Manso‐Díaz

Taeymans²,

García‐López

et al. 2019

Equine Veterinary Education

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The equine head is an anatomically highly complex area affected by a range of disorders, making the diagnosis of head conditions challenging. Imaging techniques play a crucial role in the diagnostic work-up of head disorders. Tomographic imaging methods, such as computed tomography (CT) and magnetic resonance imaging (MRI) are particularly useful in avoiding problems associated with superimposition of multiple structures in this highly complex region. Both techniques are becoming more widely available in equine medicine. However, the choice between CT and MRI for imaging the equine head is not always straightforward. Each modality has advantages and disadvantages in terms of practicality, costs and diagnostic value for particular problems. The aim of this review is to describe the application of CT and MRI for imaging the equine head and to provide a practical guide for their use in different anatomical structures and clinical indications. This should allow the equine practitioner to make an informed decision on which modality to choose. Magnetic resonance imaging Magnetic resonance imaging images are the result of the stimulation of magnetised tissues by radio waves and capturing the returning radio waves from the stimulated tissues. Depending on the type of emitted radio wave (duration,

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Imaging Diagnosis — Unilateral Trigeminal Neuritis Mimicking Peripheral Nerve Sheath Tumor in a Horse

Cited by 15 publications

References 14 publications

Morphological variations of the infraorbital canal during CT has limited association with headshaking in horses

Morphological variations of the infraorbital canal during CT has limited association with headshaking in horses

Clinical findings and outcome of dogs with unilateral masticatory muscle atrophy

Application and indications of magnetic resonance imaging and computed tomography of the equine head

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