Supratrochlear Neuralgia: A Prospective Case Series of 15 Patients

Pareja, Juan A.; López-Ruiz, Pedro; Mayo, Diego Cameno; Villar-Quiles, Rocío-Nur; Cárcamo, Alba; Gutiérrez-Viedma, Álvaro; Lastarria, Carlo P.; Romeral, María; J, Yangüela; Cuadrado, María‐Luz

doi:10.1111/head.13158

Cited by 21 publications

(17 citation statements)

References 33 publications

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“…To our knowledge, this is the first report of trigeminal nerve branch blocks as a treatment for chronic ocular pain. However, several studies have reported the use of separate supraorbital, supratrochlear, infraorbital, and infratrochlear nerve blocks for the treatment of migraine headaches, supratrochlear neuralgia, infraorbital neuralgia, and lacrimal neuralgia 19, 20, 21, 22. The majority of patients who underwent these peripheral nerve injections had several months of pain relief with no noted complications.…”

Section: Discussionmentioning

confidence: 99%

Resolution of pain with periocular injections in a patient with a 7-year history of chronic ocular pain

Duerr

Chang

Venkateswaran

et al. 2019

American Journal of Ophthalmology Case Reports

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Purpose We report a case of a male patient with chronic ocular pain that resolved completely following peripheral nerve blocks. Observations A 66-year-old male presented with a seven-year history of severe left eye pain and photophobia. The pain began after retinal detachment repair with scleral buckle placement. Previous treatments included topical (autologous serum tears, corticosteroids, diclofenac, cyclosporine) and oral (gabapentin, diclofenac) therapies with no pain relief. The patient's pain was so severe that he requested enucleation. After discussion, the decision was made to perform periocular nerve blocks. Prior to the procedure, the patient reported an average pain intensity of 8 out of 10 and photophobia daily. Following left supraorbital, supratrochlear, infraorbital and infratrochlear injections with bupivacaine and methylprednisolone, pain intensity and photophobia improved to 1–2 out of 10. One week later, repeat infraorbital and infratrochlear nerve blocks were given, after which time the patient reported complete resolution of symptoms that lasted for 7 months. Repeat nerve blocks were administered with repeat resolution of pain. There were no complications associated with the procedures. Conclusions and Importance Chronic ocular pain can be a debilitating condition. Periorbital nerve blocks can provide pain relief and should be considered as a potential treatment option after medical management has failed.

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Section: Discussionmentioning

confidence: 99%

Resolution of pain with periocular injections in a patient with a 7-year history of chronic ocular pain

Duerr

Chang

Venkateswaran

et al. 2019

American Journal of Ophthalmology Case Reports

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“…Baseline pain generally follows nerve topography involving the forehead, eyebrow and internal angle of the orbit that is constant with exacerbations experienced transiently as severe pain with a sharp, shock-like quality. Pain can be elicited with pressure at the supraorbital notch (supraorbital) (43), medial third of supraorbital rim (supratrochlear) (44), or internal angle of the orbit above medial canthus (infratrochlear) (45). A key difference from trochleodynia is lack of pain exacerbation with vertical eye movements or ophthalmoplegia.…”

Section: Diagnostic Considerationsmentioning

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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“…One neuralgia that is linked to the V1 branch, is supraorbital neuralgia, characterized by persistent pain over the supraorbital region and medial region forehead [119]. It may be differentiated from supratrochlear neuralgia based on the topography of the pain, which can be confirmed with anaesthetic blockade [120]. Lacrimal neuralgia, is pain localized to the orbital and periorbital area, and was first described in 2013 [121].…”

Section: Other Painful Conditionals Of the Trigeminal Nerve Branchesmentioning

confidence: 99%

The fifth cranial nerve in headaches

et al. 2020

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The fifth cranial nerve is the common denominator for many headaches and facial pain pathologies currently known. Projecting from the trigeminal ganglion, in a bipolar manner, it connects to the brainstem and supplies various parts of the head and face with sensory innervation. In this review, we describe the neuroanatomical structures and pathways implicated in the sensation of the trigeminal system. Furthermore, we present the current understanding of several primary headaches, painful neuropathies and their pharmacological treatments. We hope that this overview can elucidate the complex field of headache pathologies, and their link to the trigeminal nerve, to a broader field of young scientists.

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Supratrochlear Neuralgia: A Prospective Case Series of 15 Patients

Abstract: Supratrochlear neuralgia is an uncommon disorder causing pain in the medial region of the forehead. It may be differentiated from supraorbital neuralgia and other similar headaches and neuralgias based on the topography of the pain and the response to anesthetic blockade.

Cited by 21 publications

References 33 publications

Resolution of pain with periocular injections in a patient with a 7-year history of chronic ocular pain

Resolution of pain with periocular injections in a patient with a 7-year history of chronic ocular pain

Diagnosis and Management of Trochleodynia, Trochleitis, and Trochlear Headache

The fifth cranial nerve in headaches

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