## Overview Headshaking syndrome (trigeminal-mediated headshaking) is characterized by sudden, violent, involuntary head jerks, nose flicking, and snorting without an obvious external stimulus. It is linked to hyperexcitability of the trigeminal nerve and often worsens in sunlight or wind. It affects roughly 1 percent of horses. ## Causes Trigeminal nerve sensitization. Triggers include bright light, wind, and exercise. The exact initiating factor is unknown. ## Diagnosis Clinical history and observation. Other causes of headshaking (dental, ear, ocular, tack) must be excluded. Response to certain diagnostic tests supports the diagnosis. ## Treatment Nose nets, cyproheptadine or other medications, magnesium supplementation, and in refractory cases surgical or neuromodulatory procedures. Management is often multimodal and incomplete. ## Recovery and Prognosis Variable. Some horses are managed successfully; others remain severely affected and may be retired. ## Prevention None specific. Avoid known triggers when possible.
sudden violent head jerks; nose rubbing on legs; snorting; nose flicking; worse in sunlight or wind; seasonal pattern
## Overview Headshaking syndrome (trigeminal-mediated headshaking) is characterized by sudden, violent, involuntary head jerks, nose flicking, and snorting without an obvious external stimulus. It is linked to hyperexcitability of the trigeminal nerve and often worsens in sunlight or wind. It affects roughly 1 percent of horses. ## Causes Trigeminal nerve sensitization. Triggers include bright light, wind, and exercise. The exact initiating factor is unknown. ## Diagnosis Clinical history and observation. Other causes of headshaking (dental, ear, ocular, tack) must be excluded. Response to certain diagnostic tests supports the diagnosis. ## Treatment Nose nets, cyproheptadine or other medications, magnesium supplementation, and in refractory cases surgical or neuromodulatory procedures. Management is often multimodal and incomplete. ## Recovery and Prognosis Variable. Some horses are managed successfully; others remain severely affected and may be retired. ## Prevention None specific. Avoid known triggers when possible.
sudden violent head jerks; nose rubbing on legs; snorting; nose flicking; worse in sunlight or wind; seasonal pattern