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Parameters for the accuracy of clinical diagnosis of neurologic diseases in the horse were determined from 210 horses in which a definitive pathologic diagnosis was confirmed. The overall efficiency of diagnosis for all diseases was 0.95 although the validity varied from 0.79 to 1.00, the sensitivity varied from 0.73 to 0.95, and the specificity varied from 0.88 to 1.00 for individual disease categories. Equine protozoal myeloencephalitis was overdiagnosed, whereas Eastern equine encephalomyelitis, equine degenerative myeloencephalopathy, and traumatic neurologic disease were underdiagnosed. The use of such measurements of accuracy of diagnosis parameters in clinical practice will allow new diagnostic techniques to be objectively evaluated, resulting in greater efficiency of diagnosis and therapy.

The responses of apparently healthy newborn foals to neurologic testing differ significantly from those of adult horses. These responses and the diagnostic techniques pertinent to neurologic problems are reviewed as a basis for evaluation of the compromised neonatal foal. The more frequently encountered neurologic diseases are discussed in a problem-oriented format. These clinical problems include behavioral abnormalities, convulsions, changes in consciousness, blindness, ataxia without loss of strength, ataxia with weakness and paralysis, and the floppy foal.