Pathological classification of equine recurrent laryngeal neuropathy

J Vet Intern Med. 2018 Jul;32(4):1397-1409. doi: 10.1111/jvim.15142. Epub 2018 Apr 24.


Recurrent Laryngeal Neuropathy (RLN) is a highly prevalent and predominantly left-sided, degenerative disorder of the recurrent laryngeal nerves (RLn) of tall horses, that causes inspiratory stridor at exercise because of intrinsic laryngeal muscle paresis. The associated laryngeal dysfunction and exercise intolerance in athletic horses commonly leads to surgical intervention, retirement or euthanasia with associated financial and welfare implications. Despite speculation, there is a lack of consensus and conflicting evidence supporting the primary classification of RLN, as either a distal ("dying back") axonopathy or as a primary myelinopathy and as either a (bilateral) mononeuropathy or a polyneuropathy; this uncertainty hinders etiological and pathophysiological research. In this review, we discuss the neuropathological changes and electrophysiological deficits reported in the RLn of affected horses, and the evidence for correct classification of the disorder. In so doing, we summarize and reveal the limitations of much historical research on RLN and propose future directions that might best help identify the etiology and pathophysiology of this enigmatic disorder.

Keywords: axonopathy; bilateral mononeuropathy; horse; larynx; myelinopathy; polyneuropathy; recurrent laryngeal neuropathy.

Publication types

  • Review

MeSH terms

  • Animals
  • Cranial Nerve Diseases / classification
  • Cranial Nerve Diseases / pathology
  • Cranial Nerve Diseases / veterinary*
  • Horse Diseases / classification*
  • Horse Diseases / pathology
  • Horses
  • Recurrent Laryngeal Nerve / pathology*