A spinal tap, in which a long needle is inserted through the back and into the spinal canal, will be necessary. The blood test alone, while useful, is inconclusive as it may indicate exposure to the organism but not whether the disease has attacked the central nervous system. A positive blood test only means the horse has been exposed to the parasite, not that it has or will develop clinical disease. Prompt, accurate diagnosis is essential and treatment should begin immediately. Sixty to 70 percent of EPM cases aggressively treated show significant or complete reversal of symptoms.
Many horses are able to return to normal activity.
Supplementation with vitamin E, an antioxidant, is often recommended to aid healing of nervous tissue. Average duration of treatments is 3-6 months, but can sometimes be longer. Current Practice is to extend treatment 30-60 days beyond the elimination of symptoms or until a negative CSF test is obtained. Long-term treatments can be costly. Although complications are rare, treatments may affect stallion fertility and may pose certain health risks to unborn foals.