Craniofacial neuralgias

Abstract

While non-headache, non-oral craniofacial neuralgia is relatively rare in incidence and prevalence, it can result in debilitating pain. Understanding the relevant anatomy of peripheral branches of nerves, natural history, clinical presentation, and management strategies will help the clinician better diagnose and treat craniofacial neuralgias. This article will review the nerves responsible for neuropathic pain in periorbital, periauricular, and occipital regions, distinct from idiopathic trigeminal neuralgia. The infratrochlear, supratrochlear, supraorbital, lacrimal, and infraorbital nerves mediate periorbital neuralgia. Periauricular neuralgia may involve the auriculotemporal nerve, the great auricular nerve, and the nervus intermedius. The greater occipital nerve, lesser occipital nerve, and third occipital nerve transmit occipital neuralgias. A wide range of treatment options exist, from modalities to surgery, and the evidence behind each is reviewed.

Nerve block as neuropathic pain treatment for the great auricular nerve neuropathy: A case report

“…It emerges through the posterior border of the sternocleidomastoid muscle 1 . The relatively superficial location makes it particularly vulnerable to cranial or cervical trauma and iatrogenic procedures 2 . As in other terminal branch neuralgias and neuropathies, pain is circumscribed to the territory of the terminal branch, and the pain is temporarily eased after selective anesthetic blockade of the nerve 3 .…”