Bilateral Idiopathic Trochleitis as a Cause of Frontal Cephalgia

Zaragoza-Casares, Pablo; Gómez-Fernández, Teresa; Liaño, Miguel Ángel Zato Gómez de; Zaragoza-Garcia, Pablo

doi:10.1111/j.1526-4610.2008.01259.x

Cited by 11 publications

(7 citation statements)

References 2 publications

(1 reference statement)

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“…For unclear reasons, bilateral inflammation often presents sequentially with a variable delay between ipsilateral presentation and eventual bilateral involvement (6, 10). Bilateral idiopathic inflammation is rare and has only been reported once to our knowledge (20). Other etiologies of trochleodynia have been considered iatrogenic but still inflammatory in nature, for example, one case reported after optic nerve sheath meningioma resection and another case following orbital decompression for Grave's ophthalmopathy (6).…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and Management of Trochleodynia, Trochleitis, and Trochlear Headache

2019

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Migraine and tension-type headaches (TTHs) comprise a significant burden of neurological disease globally. Trochleodynia, also known as primary trochlear headache or trochleitis, may go unrecognized and contribute to worsening of these headache disorders. It may also present in isolation. We review the English literature on this under-recognized condition and describe what is known about the theorized pathophysiology, clinical presentation, and differential diagnosis. We also present a management algorithm for patients presenting with trochleodynia.

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Section: Introductionmentioning

confidence: 99%

Diagnosis and Management of Trochleodynia, Trochleitis, and Trochlear Headache

2019

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“…Initially, “Trochlear Migraine” has been described only in the adult age and no pediatric cases have been previously reported in the literature [ 7 , 8 ]. However, we have recently described a migraine child with trochlear localized pain, questioning the use of the term “Trochlear Migraine” to indicate the two co-occurring pathologies.…”

Section: Introductionmentioning

confidence: 99%

The Pediatric Trochlear Migraine: Diagnostic and Therapeutic Implications

Raieli¹,

Reina

D’Agnano³

et al. 2022

JCM

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Trochlear Migraine has been recently described as the concurrence of strictly unilateral migraine and ipsilateral trochleodynia with relief of migraine after successful treatment of trochleodynia. This disorder has been interpreted as “cluster-tic syndrome” or “seizure-triggered migraine”. Trochlear Migraine is unrecognized and rarely described in childhood. The aim of this study is to review the few cases of Trochlear Migraine reported in the literature in addition to the cases observed in our clinical experience. In particular, our cases showed recurrent attacks of severe and pulsating headache associated with nausea, vomiting, phonophobia, photophobia, and strict trochlear localization of pain. They often presented with alternating side attacks. Therefore, we suggest that the term “Trochlear Migraine” should be reserved for clinical migraine attacks strictly localized in the trochlear region, and we assume that the excessive increase in descriptions of new primary headache syndromes, according to the International Classification of Headache Disorders, can be probably be ascribed to the common physiopathological mechanisms characterizing these forms of migraine.

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“…Trochleitis is the result of an inflammatory process; however, patients do not appear to have eyelid swelling or erythema [6]. Although trochleitis is diagnosed mainly based on clinical findings, radiologic evidence of trochlear inflammation on ultrasonography, CT, or MRI usually confirms the diagnosis [7,8]. Laboratory tests, including routine blood work and serology, are frequently performed to rule out immunologic and rheumatic disorders, as an etiology of this condition [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

“…Although trochleitis is diagnosed mainly based on clinical findings, radiologic evidence of trochlear inflammation on ultrasonography, CT, or MRI usually confirms the diagnosis [7,8]. Laboratory tests, including routine blood work and serology, are frequently performed to rule out immunologic and rheumatic disorders, as an etiology of this condition [6][7][8]. Treatment is by local injection of corticosteroids in the trochlear region, which results in remarkable improvement within 48-72 hours in the majority of patients [1,6,9].…”

Section: Introductionmentioning

confidence: 99%

Pediatric Recurrent Unilateral Trochleitis in Association With Paranasal Sinusitis: A Case Report

Alnosair¹,

Alqasim²

2022

Cureus

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Trochleitis is an easily treatable condition; however, it is often misdiagnosed by many clinicians because of its rare incidence. We report the case of a 14-year-old Saudi male patient, known to have type 1 diabetes mellitus (DM) and pansinusitis, who presented to the emergency department with a one-day history of severe right periorbital pain exacerbated by upgaze and supraduction. There was intense point tenderness on palpation over the trochlear region of the orbit with no underlying swelling or redness. Both eyes had a corrected visual acuity of 0.8. Mildly limited elevation (-1) of the right eye was noted. All other extraocular movements were normal in both eyes. Contrast-enhanced CT of the head and orbits showed mild trochlear swelling, inflammation, and pansinusitis. He was treated with a single intratrochlear injection of steroids, which immediately and significantly improved the symptoms. To the best of our knowledge, this is the second case of trochleitis associated with paranasal sinusitis in children. This suggests that a possible, but rare, association between these two conditions may exist in the pediatric population.

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Bilateral Idiopathic Trochleitis as a Cause of Frontal Cephalgia

Cited by 11 publications

References 2 publications

Diagnosis and Management of Trochleodynia, Trochleitis, and Trochlear Headache

Diagnosis and Management of Trochleodynia, Trochleitis, and Trochlear Headache

The Pediatric Trochlear Migraine: Diagnostic and Therapeutic Implications

Pediatric Recurrent Unilateral Trochleitis in Association With Paranasal Sinusitis: A Case Report

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