Treatment of idiopathic headshaking with an injection of glycerol into the trigeminal ganglion in a 5 year old Warmblood mare

Therapie des idiopathischen Headshaking durch Injektionvon Glycerol in das Ganglion trigeminale bei einer 5-jährigen Warmblutstute

Uhlendorf F, Müller J M V, Winter J C, Feige K

DOI: 10.21836/PEM20110602
Year: 2011
Volume: 27
Issue: 6
Pages: 585-588

According 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.