Episode 107 The Neurological Examination
Summarised Transcript:
In this episode, Dr. Raquel Butler and Sophie Vandenberg explain why an equine neurological examination is different from a musculoskeletal or lameness assessment. A horse that trips, stumbles or behaves unpredictably may pass a lameness examination but still have difficulties involving the brain, spinal cord or peripheral nerves. The purpose of the neurological examination is to identify whether a neurological problem may be present and, where possible, help localise it anatomically.
The examination generally follows a head-to-tail approach and assesses mental status, posture, gait, sensation and motor function. Raquel and Sophie discuss cranial nerve testing, skin sensitivity, limb placement and tests of stability while standing and moving. They also describe how elevating the head, walking tight circles, travelling slowly on slopes and negotiating obstacles can challenge the horse's balance, coordination and awareness of limb position.
Potential warning signs include repeated tripping or falling, unusual standing positions, delayed or inaccurate foot placement, excessive or absent skin responses, abnormal facial or tongue movement, muscle wasting and sudden behaviours that are uncharacteristic of the horse. However, difficulty with one test does not confirm a neurological diagnosis. Findings need to be considered together with the horse's history, clinical signs and appropriate veterinary diagnostics.
The episode also emphasises safety and the importance of recognising instability early. Some neurological presentations may improve with treatment and rehabilitation, particularly in selected cases, but a horse should not return to ridden work unless it can pass a thorough neurological assessment reliably. If a horse falls unpredictably or cannot stabilise itself, continuing to ride or work beneath the horse may place both people and the horse at serious risk.
Chapters:
00:00 - Neurological versus musculoskeletal examinations
01:32 - What an equine neurological examination assesses
05:02 - Cranial nerve function and common abnormalities
07:06 - Skin sensitivity and the panniculus reflex
09:54 - Limb placement and body awareness
11:25 - Testing stability while standing and moving
16:50 - Walking with the head elevated
18:55 - Tight circles and coordination
21:44 - Slopes, obstacles and changes in visual input
23:26 - Unpredictable behaviour and neurological warning signs
28:42 - Safety concerns for handlers and farriers
30:35 - Treatment, rehabilitation and reassessment
36:28 - Key examination components and final takeaways
Key Takeaways:
* A neurological examination assesses different functions from a lameness or musculoskeletal examination, so a horse may pass one and not the other.
* The examination considers the brain, spinal cord and peripheral nerves through tests of sensation, movement, balance, coordination and body awareness.
* Cranial nerve function, skin sensitivity, limb placement, stability, head elevation, tight circles and slopes each provide different pieces of information.
* Tripping, falling, unusual limb positions, muscle changes and unpredictable behaviour can be signs that warrant veterinary neurological investigation.
* One abnormal response does not confirm a diagnosis; the full pattern of findings, history and diagnostics must be considered together.
* An unstable horse may be unable to protect itself, its handler or its rider, making safety a central part of assessment and decision-making.
* Some horses may improve with appropriate treatment and rehabilitation, but they should pass a thorough neurological reassessment before returning to ridden work.
Notable Quotes:
* "A neurological exam is different to a musculoskeletal examination."
* "It is not about one test or the other test."
* "An unstable horse does not feel safe in their own body."
* "They cannot save themselves, and they cannot save you."
* "They have to pass the neurological test with flying colours."
