ISSN 2398-2977      

Percutaneous electrical nerve stimulation

pequis

Synonym(s): PENS


Introduction

  • Trigeminal mediated headshaking is an idiopathic facial pain syndrome in equids.
  • The condition carries a poor prognosis with medical therapy having limited success.
  • PENS therapy offers an alternative and successful therapy for the treatment of trigeminal mediated headshaking.
  • PENS is a minimally invasive neuromodulation therapy that has applications in the human field for neuropathic pain.

Uses

  • Sole use for the treatment of trigeminal mediated headshaking Behavior: headshaking and no other conditions.

Advantages

  • Better success rate than the majority of other medical treatments.
  • Intermittent treatment required rather than continuous medication.
  • Tolerated well with most horses.

Disadvantages

  • Incomplete understanding of the etiopathogenesis and therefore treatment success can be limited.
  • Lack of response following treatment in a number of cases.
  • Complication rate of 8.8%, most commonly a transient neuritis usually resolving in 3 days.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Remission after the initial course occurred in 53% of horses.
  • Median time of remission was 9.5 weeks (2 days to 156 weeks ongoing so this may prove to be longer)
  • When signs recurred, most horses would go into a period of remission with repeat treatment.
  • No predictors for outcome were found.

Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMedResource.
  • Roberts V L H, Bailey M, Equipens™ group et al (2020) The safety and efficacy of neuromodulation using percutaneous electrical nerve stimulation for the management of trigeminal-mediated headshaking in 168 horses. Equine Vet J 52 (2), 238-243 PubMed.
  • Devereux S (2019) Electroacupuncture as an additional treatment for headshaking in six horses. Equine Vet Educ 31 (3), 137-146 VetMedResource.
  • Roberts V L H, Patel N K & Tremaine W H (2016) Neuromodulation using percutaneous electrical nerve stimulation for the management of trigeminal-mediated headshaking: a safe procedure resulting in medium-term remission in five of seven horses. Equine Vet J 48 (2), 201-204 PubMed.
  • Mills D S & Taylor K (2003) Field study of the efficacy of three types of nose net for the treatment of headshaking in horses. Vet Rec 152 (2), 41-44 PubMed.

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