{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T00:11:46Z","timestamp":1771632706655,"version":"3.50.1"},"reference-count":13,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2015,4,8]],"date-time":"2015-04-08T00:00:00Z","timestamp":1428451200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"The Langford Trust for Animal Health and Welfare"}],"content-domain":{"domain":["beva.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Equine Veterinary Journal"],"published-print":{"date-parts":[[2016,3]]},"abstract":"Summary<\/jats:title>\n \n Reasons for performing study<\/jats:title>\n \n There are no consistently safe and effective methods for the treatment of trigeminal\u2010mediated headshaking in horses. In affected horses, the trigeminal nerve is sensitised, appearing to result in neuropathic pain. Percutaneous electrical nerve stimulation (\n PENS<\/jats:styled-content>\n ) therapy is a minimally invasive neuromodulatory treatment used in people to manage neuropathic pain.\n <\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n \n To determine whether\n PENS<\/jats:styled-content>\n therapy is safe, tolerated and effective for the management of trigeminal\u2010mediated headshaking in horses.\n <\/jats:p>\n <\/jats:sec>\n \n Study design<\/jats:title>\n Descriptive case series.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Seven horses diagnosed with trigeminal\u2010mediated headshaking and currently showing clinical signs were studied. All procedures were carried out in sedated horses with a needle\u2010prick sized area of skin desensitised with local anaesthetic to facilitate probe insertion.\n A<\/jats:styled-content>\n disposable\n PENS<\/jats:styled-content>\n probe was advanced subcutaneously adjacent to the nerve, rostral to the infraorbital foramen under ultrasonographic guidance. The nerve was stimulated for 25\u2009min following a protocol of alternating frequencies and a perception threshold based on human clinical data. The probe was removed and the procedure repeated on the contralateral side. The protocol used comprised a series of 3 or 4 treatments, with treatments being repeated when signs of headshaking recurred.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n All horses tolerated the procedure well. Three horses developed a haematoma at the site on one occasion and 2 had increased clinical signs for up to 3 days following first treatment. Six horses demonstrated a positive response to their first treatment, returning to ridden work at the same level as prior to onset of headshaking, with 5 continuing to respond. Median remission time for first treatment was 3.8 days (range 0\u20138 days, n = 7), second treatment 2.5 weeks (0\u20138 weeks, n = 7), third treatment 15.5 weeks (0\u201324 weeks, n = 5) and fourth treatment 20 weeks (12\u201328 weeks ongoing, n = 2).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Percutaneous electrical nerve stimulation therapy is a safe, well tolerated, minimally invasive, repeatable management option for trigeminal\u2010mediated headshaking, with encouraging efficacy for amelioration of clinical signs in the short\u2010 to medium term.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/evj.12394","type":"journal-article","created":{"date-parts":[[2014,12,8]],"date-time":"2014-12-08T17:17:01Z","timestamp":1418059021000},"page":"201-204","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Neuromodulation using percutaneous electrical nerve stimulation for the management of trigeminal\u2010mediated headshaking: A safe procedure resulting in medium\u2010term remission in five of seven horses"],"prefix":"10.1111","volume":"48","author":[{"given":"V. L. H.","family":"Roberts","sequence":"first","affiliation":[{"name":"School of Veterinary Sciences University of Bristol Somerset UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N. K.","family":"Patel","sequence":"additional","affiliation":[{"name":"Institute of Neurosciences Southmead Hospital Bristol UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W. H.","family":"Tremaine","sequence":"additional","affiliation":[{"name":"School of Veterinary Sciences University of Bristol Somerset UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,4,8]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/vr.152.2.41"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.2042-3306.1999.tb03184.x"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.2746\/042516400776563617"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.2460\/javma.2001.219.334"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.2042-3306.2012.00553.x"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jvim.12191"},{"key":"e_1_2_10_8_1","unstructured":"UK Department of Health(2013)National Institute for Health and Care Excellence Guidelines.http:\/\/guidance.nice.org.uk\/IPG450."},{"key":"e_1_2_10_9_1","unstructured":"Anon (2014)Percutaneous Electrical Stimulation Therapy.The Christie NHS Foundation Patient Information Service.http:\/\/www.christie.nhs.uk\/booklets\/772.pdf."},{"key":"e_1_2_10_10_1","unstructured":"Bhaskar A. Patel K. White A.andEngland J.(2011)Trigeminal field stimulation using Percutaneous Electrical Nerve Stimulation (PENS) Therapy \u2010 preliminary case series of 8 patients. Poster. International Neuromodulation Society 10th World Congress Neuromodulation: Technology at the Neural Interface London."},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2011.01215.x"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tvjl.2014.05.006"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tvjl.2014.03.031"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.2042-3306.2012.00618.x"}],"container-title":["Equine Veterinary Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fevj.12394","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/beva.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/evj.12394","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T07:55:14Z","timestamp":1762070114000},"score":1,"resource":{"primary":{"URL":"https:\/\/beva.onlinelibrary.wiley.com\/doi\/10.1111\/evj.12394"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,4,8]]},"references-count":13,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2016,3]]}},"alternative-id":["10.1111\/evj.12394"],"URL":"https:\/\/doi.org\/10.1111\/evj.12394","archive":["Portico"],"relation":{},"ISSN":["0425-1644","2042-3306"],"issn-type":[{"value":"0425-1644","type":"print"},{"value":"2042-3306","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,4,8]]},"assertion":[{"value":"2014-09-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-11-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-04-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}