Terrell A. Holliday

Juvenile idiopathic Epilepsy in Egyptian Arabian foals: 22 cases (1985-2005)

BACKGROUND Epilepsy is relatively uncommon in horses compared with other species and limited information is available. HYPOTHESIS The objectives of the study were to describe the age of onset, clinical signs, clinicopathologic data, electroeticephalographic findings, treatment, and outcome, including long-term prognosis in Arabian foals with idiopathic epilepsy. ANIMALS Twenty-two foals were included in the study. MATERIALS AND METHODS Medical records from 1985 to 2005 were reviewed. RESULTS The age of onset of affected foals ranged from 2 days to 6 months. Seizures were characterized by generalized tonic and clonic motor activity, staring, and loss of consciousness. The most common postictal signs were transient blindness and abnormal mental status. The interictal neurologic examination was otherwise normal. Clinicopathologic data and imaging diagnostics were normal except in 4 foals that developed complications. Electroencephalography revealed epileptiform activity in 9 of 13 foals. Foals were treated with benzodiazepines for the short-term; whereas phenobarbital was used over the long-term. Potassium bromide was added in 3 foals in which seizures were multiple, frequent, and difficult to control. The long-term prognosis was favorable with cessation of seizures by 1 year of age. The most common complication was head trauma. The most common concurrent disease was pneumonia. CONCLUSIONS AND CLINICAL IMPORTANCE Juvenile idiopathic epilepsy of Egyptian Arabian foals has an early clinical onset but appears to be self-limiting. Information obtained from this study strongly suggests a heritable condition that merits further investigation.

Brainstem Auditory-Evoked Responses in Horses with Temporohyoid Osteoarthropathy

BACKGROUND Facial and vestibulocochlear nerve dysfunction occurs commonly in horses with temporohyoid osteoarthropathy (THO); however, auditory dysfunction has not been thoroughly assessed. OBJECTIVE To determine if auditory abnormalities occur in horses with THO. ANIMALS Eleven diseased and 8 control horses. METHODS This is a prospective study in which brainstem auditory-evoked responses (BAER) were recorded in 11 horses diagnosed with THO through neurologic, endoscopic, radiographic, or computed tomographic examinations. BAER findings were compared with those recorded from 8 adult control horses. RESULTS All horses with THO were found to have BAER abnormalities that included complete unilateral BAER loss (82%, n=9/11), partial unilateral BAER loss (18%, n=2/11) on the most affected side, and contralateral partial BAER loss (46%, n=5/11). Nine horses had bilateral THO based on diagnostic imaging findings; of these, 5 (56%) horses also had bilateral BAER abnormalities. The complete absence of BAER in affected horses was most consistent with peripheral sensorineural hearing loss. There was a significant association between complete BAER loss and neurologic and diagnostic abnormalities. CONCLUSIONS AND CLINICAL IMPORTANCE Auditory abnormalities such as complete or partial BAER loss are common in horses with THO. The BAER test is an objective diagnostic tool that can aid along with other diagnostic modalities in the assessment, management, and follow-up of horses with THO. Furthermore, BAER studies may help to elucidate the pathophysiology of THO in horses.

Sensory Nerve Conduction and Somatosensory Evoked Potentials of the Trigeminal Nerve in Horses with Idiopathic Headshaking

BACKGROUND Idiopathic headshaking (HSK) in horses is a distressing disorder in which the etiology and pathophysiology are unknown. HYPOTHESIS Differences in sensory function of the trigeminal nerve exist between healthy and affected horses. ANIMALS Six healthy mature geldings and 6 mature geldings with idiopathic HSK. METHODS Prospective study. Sensory nerve action and somatosensory evoked potentials studies were performed. The stimulus site comprised the gingival mucosa dorsal to the maxillary canine. A pair of recording electrodes was placed along the sensory pathway of the trigeminal complex at the infraorbital nerve (R1), maxillary nerve (R2), spinal tract of trigeminal (R3), and somatosensory cortex (R4). Sensory nerve action potential latency (ms), amplitude (μV), duration (ms), area under the curve (μVms), and conduction velocity (m/s) were calculated. RESULTS Threshold for activation of the infraorbital branch of the trigeminal nerve was significantly different between 5 affected (≤ 5 mA) and 6 control horses (≥ 10 mA). After initiation of an action potential, there were no differences in all parameters measured and no differences between left and right sides. A horse with seasonal HSK tested during a time of no clinical manifestations showed a threshold for activation similar to control horses. CONCLUSIONS AND CLINICAL IMPORTANCE This study confirms involvement of the trigeminal nerve hyperexcitability in the pathophysiology of disease. Further, results might support a functional rather than a structural alteration in the sensory pathway of the trigeminal complex that can be seasonal. The horse could serve as a natural animal model for humans with idiopathic trigeminal neuralgia.

Electrodiagnostic Examination: Somatosensory Evoked Potentials and Electromyography

The anatomic/physiologic basis and uses of somatosensory evoked potential recordings are presented. A brief summary of the use of electromyography in spinal cord diseases is included.

Qualitative and quantitative characteristics of the electroencephalogram in normal horses after sedation.

BACKGROUND The administration of certain sedatives has been shown to promote sleep in humans. Related agents induce sleep-like behavior when administered to horses. Interpretation of electroencephalograms (EEGs) obtained from sedated horses should take into account background activity, presence of sleep-related EEG events, and the animals behavior. HYPOTHESIS Sedatives induce states of vigilance that are indistinguishable on EEGs from those that occur naturally. ANIMALS Six healthy horses. METHODS Digital EEG with video was recorded after administration of 1 of 4 sedatives (acepromazine, butorphanol, xylazine, or detomidine). Serum drug concentrations were measured. Recordings were reviewed, states were identified, and representative EEG samples were analysed. These data were compared with data previously obtained during a study of natural sleep. RESULTS Butorphanol was associated with brief episodes resembling slow wave sleep in 1 horse. Acepromazine led to SWS in 3 horses, including 1 that also exhibited rapid eye movement sleep. Periods of SWS were observed in all horses afer xylazine or detomidine administration. Normal sleep-related EEG events and heart block, occurred in association with SWS regardless of which sedative was used. Spectral data varied primarily by state, but some differences were observed between sedative and natural data. CONCLUSIONS AND CLINICAL IMPORTANCE Qualitatively, EEG findings appeared identical whether sedation-induced or naturally occurring. The startle response and heart block associated with some sedatives may be related to sleep. Alpha(2) agonists can be used to obtain high quality EEGs in horses, but acepromazine does not promote a relaxed state in all animals.

Brainstem auditory evoked responses in an equine patient population: part I--adult horses.

Background Brainstem auditory evoked response has been an underused diagnostic modality in horses as evidenced by few reports on the subject. Hypothesis/Objectives To describe BAER findings, common clinical signs, and causes of hearing loss in adult horses. Animals Study group, 76 horses; control group, 8 horses. Methods Retrospective. BAER records from the Clinical Neurophysiology Laboratory were reviewed from the years of 1982 to 2013. Peak latencies, amplitudes, and interpeak intervals were measured when visible. Horses were grouped under disease categories. Descriptive statistics and a posthoc Bonferroni test were performed. Results Fifty‐seven of 76 horses had BAER deficits. There was no breed or sex predisposition, with the exception of American Paint horses diagnosed with congenital sensorineural deafness. Eighty‐six percent (n = 49/57) of the horses were younger than 16 years of age. The most common causes of BAER abnormalities were temporohyoid osteoarthropathy (THO, n = 20/20; abnormalities/total), congenital sensorineural deafness in Paint horses (17/17), multifocal brain disease (13/16), and otitis media/interna (4/4). Auditory loss was bilateral and unilateral in 74% (n = 42/57) and 26% (n = 15/57) of the horses, respectively. The most common causes of bilateral auditory loss were sensorineural deafness, THO, and multifocal brain disease whereas THO and otitis were the most common causes of unilateral deficits. Conclusions and Clinical Importance Auditory deficits should be investigated in horses with altered behavior, THO, multifocal brain disease, otitis, and in horses with certain coat and eye color patterns. BAER testing is an objective and noninvasive diagnostic modality to assess auditory function in horses.

Brainstem Auditory Evoked Responses in an Equine Patient Population. Part II: Foals

Background Reports of the use of brainstem auditory evoked response (BAER) as a diagnostic modality in foals have been limited. Hypothesis/Objectives To describe BAER findings and associated causes of hearing loss in foals. Animals Study group 18 foals (15 neonatal, 3 nonneonatal), control group (5 neonatal foals). Methods Retrospective. BAER records from the Clinical Neurophysiology Laboratory were reviewed from the years of 1982 to 2013. Peak latencies, amplitudes, and interpeak intervals were measured when visible. Clinical data were extracted from the medical records. Foals were grouped under disease categories. Descriptive statistics were performed. Results Ten neonatal foals had complete absence of BAER bilaterally and 5 had findings within reference range. Abnormalities were associated with common neonatal disorders such as sepsis, neonatal encephalopathy, neonatal isoerythrolysis, and prematurity. BAER loss also was observed in foals with specific coat color patterns such as completely or mostly white with blue irides or lavender with pale yellow irides. An American Miniature foal with marked facial deformation also lacked BAER bilaterally. One nonneonatal foal with an intracranial abscess had no detectable BAER peaks bilaterally, and 2 older foals, 1 with presumed equine protozoal myeloencephalitis and the other with progressive scoliosis and ataxia, had BAER within normal limits. Conclusions and Clinical Importance In neonatal foals, BAER deficits commonly are complete and bilateral, and associated with common neonatal disorders and certain coat and eye color patterns. Sepsis, hypoxia, bilirubin toxicity, and prematurity should be investigated as potential causes of auditory loss in neonatal foals.

Qualitative and Quantitative Characteristics of the Electroencephalogram in Normal Horses during Administration of Inhaled Anesthesia.

Background The effects of anesthesia on the equine electroencephalogram (EEG) after administration of various drugs for sedation, induction, and maintenance are known, but not that the effect of inhaled anesthetics alone for EEG recording. Objective To determine the effects of isoflurane and halothane, administered as single agents at multiple levels, on the EEG and quantitative EEG (qEEG) of normal horses. Animals Six healthy horses. Methods Prospective study. Digital EEG with video and quantitative EEG (qEEG) were recorded after the administration of one of the 2 anesthetics, isoflurane or halothane, at 3 alveolar doses (1.2, 1.4 and 1.6 MAC). Segments of EEG during controlled ventilation (CV), spontaneous ventilation (SV), and with peroneal nerve stimulation (ST) at each MAC multiple for each anesthetic were selected, analyzed, and compared. Multiple non‐EEG measurements were also recorded. Results Specific raw EEG findings were indicative of changes in the depth of anesthesia. However, there was considerable variability in EEG between horses at identical MAC multiples/conditions and within individual horses over segments of a given epoch. Statistical significance for qEEG variables differed between anesthetics with bispectral index (BIS) CV MAC and 95% spectral edge frequency (SEF95) SV MAC differences in isoflurane only and median frequency (MED) differences in SV MAC with halothane only. Conclusions and Clinical importance Unprocessed EEG features (background and transients) appear to be beneficial for monitoring the depth of a particular anesthetic, but offer little advantage over the use of changes in mean arterial pressure for this purpose.