Trigeminal nerve mediated headshaking in the US

[Chestnut24]

Thank you for posting this update. But very sorry to hear you haven’t had improvement, he is such a lovely horse!

I must admit being a bit alarmed to see the video, in that my horse is sometimes doing this (itchy nose, squiggling the nostrils, rubbing them on a rail during/after riding). It’s usually not dramatic, just a bit of a tick, but I have suspected something trigeminal nerve related. May I ask: how did your horse react when riding, and what testing was used to determine the trigeminal nerve factor?

My note certainly doesn’t help your plight. In the video he does have a peaceful expression, I wonder if he is experiencing pain or something more akin to irritation… Unfortunately he can’t tell us.

[Trekkie]

@Chestnut24

how did your horse react when riding, and what testing was used to determine the trigeminal nerve factor

During exercise/being ridden the flicks of his head vertically became more sudden and violent with him flicking so high it made me worry he would lose his balance, and also much snorting as if he had just gotten a bee up his nose. This has now been going on for so many years I wonder if he has acclimated somewhat to a chronic pain state and so he can still look relaxed and peaceful. I do wonder about the FFWS and a chronic state of stress due to low level pain.
At UPenn they tested CSF, did a CT myelogram, scoped him to check for gutteral pouch issues, did head and neck radiographs. He also had bloodwork to check for Vit E levels and electrolyte abnormalities at my regular vet. Everything was negative along with his dental work. With all else ruled out and all his symptoms presenting the way they do they diagnosed him with TNMH. Dr Johnson at UPenn was concerned based on his symptoms that he is indeed experiencing chronic pain. My horses all get itchy head after riding. This is different and presents all the time, day in day out no matter the weather, season etc. I have many many videos of him jerking and snorting and rubbing. Some days seem to be better than others.

[Trekkie]

@Chestnut24 here are some under saddle videos from when he first became symptomatic.

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[Chestnut24]

Thanks a lot, this is so helpful. Such a great horse… Wish you well in deciding the next steps.