Abstract. Parasitic granulomatous eosinophilic inflammation was observed in the central nervous system (CNS) of a 6-month-old Arabian colt from New York state. Inflammation was associated with eggs, larvae, and adult nematodes in the cerebellum. Nematodes had histological characteristics of the superfamily Metastrongyloidea. The presence of dorsal-spined larvae in the CNS was further indicative of infection with a nematode in the family Protostrongylidae. Infections were most compatible with Parelaphostrongylus tenuis but specific diagnosis was not possible. This is the first definitive report of a protostrongylid nematode infection in a horse.Key words: CNS; dorsal-spined larvae; histopathology; horses; Metastrongyloidea; nematodes; parasitic encephalomyelitis; Parelaphostrongylus tenuis.Parasitic migratory encephalomyelitis is a rare but important cause of neurologic disease in horses. Metazoan parasites identified from the equine central nervous system (CNS) include nematodes (Strongylus vulgaris, S. equinus, Angiostrongylus cantonensis, Halicephalobus gingivalis, Setaria spp., and Draschia megastoma) and fly larvae (Hypoderma spp.). 9 We identified parasitic nematodes in the CNS of a young horse in New York state. Nematode morphology and its occupation of the CNS were most compatible with the meningeal worm, Parelaphostrongylus tenuis. The northeastern USA has a high density of white-tailed deer (Odocoileus virginianus) that have a high prevalence of P. tenuis infection. This neurotropic nematode causes a debilitating neurologic disease in cervids, 1,6 ovids, 1 bovids, 1,5,12 and camelids.1 Recently, Van Biervliet et al. identified a Metastrongyloidea nematode in the CNS of a horse, 11 but specific identification of the parasite was not possible. Here we present the first definitive report of protostrongylid nematodes in the CNS of a horse.A 6-month-old male Arabian horse had acute onset of an abnormal gait and held its head to the right. There was no history of pyrexia or systemic illness. The colt was born in New York state and had not traveled to other states. Clinical signs persisted following treatment with dexamethasone, and the horse was referred to the Cornell University Hospital for Animals. Clinical examination revealed marked spastic tetraparesis and ataxia in all four limbs. The head and neck were held to the right side. A C1 to C5 lesion was suspected. Cerebrospinal fluid contained mildly increased protein (116 mg/dl, normal range 5-100 mg/dl) and 1200 cells/ml (58% lymphocytes, 40% neutrophils, 2% macrophages, and a few eosinophils and erythrocytes). Cervical radiographs were suspicious for subluxation at the atlanto-occipital joint. Computed tomography (CT) examinations were normal except for a mild atlantooccipital joint subluxation, and a light weight cast was applied as treatment for the subluxation. The foal was unable to stand on recovery from anesthesia for the CT scan and struggled violently to attempt to stand. The patient was humanely euthanized and a necropsy was performed.Necropsy e...