How to: Manage Headshaking

Background
Headshaking is a clinical sign where horses show repeated vertical or horizontal movements of the head and neck. There are many conditions or problems which may cause these clinical signs, for example bad riding. An important consideration is whether the horse is suffering facial pain. If the horse is suffering facial pain then this may be due to detectable pathology, for example dental disease. However in 98% cases (Lane and Mair 1987) no pathology is found. In these cases, a diagnosis of headshaking due to facial pain from an idiopathic trigeminal neuropathy is likely.

Idiopathic trigeminal neuropathy
Average age of onset for trigeminal neuropathy is 8–12 years (Roberts et al. 2009) and the condition may be more common in geldings (Madigan and Bell 2001). Headshaking is predominantly vertical (Roberts et al. 2009) and often larger movements are accompanied by sharp, vertical twitches/flicks. Headshaking is often accompanied by signs of nasal irritation such as snorting, rubbing the nose and striking at the nose (Newton et al. 2000; Roberts et al. 2009). [...]