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Infratrochlear neuralgia.

Juan A Pareja1, Ignacio Casanova2, Andrea Arbex3

  • 1Neurology Department, University Hospital Quirón Madrid, Pozuelo de Alarcón, Madrid, Spain Neurology Department, University Hospital Fundación Alcorcón, Alcorcón, Madrid, Spain japareja@fhalcorcon.es.

Cephalalgia : an International Journal of Headache
|March 20, 2015
PubMed
Summary
This summary is machine-generated.

Infratrochlear neuralgia, a condition affecting the infratrochlear nerve, can cause orbital pain. This study identifies it as a distinct cause of facial pain, treatable with medication or nerve blocks.

Keywords:
Infratrochlear nerveinfratrochlear neuralgianerve blockadeterminal branch neuralgiatrigeminal nervetrochlear pain

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Area of Science:

  • Neurology
  • Ophthalmology
  • Pain Medicine

Background:

  • The infratrochlear nerve innervates the medial upper eyelid, nose, and lacrimal caruncle.
  • While implicated in trochlear pain, infratrochlear neuralgia has not been recognized as a specific pain syndrome.
  • This study investigates patients with unexplained pain in the internal orbital angle.

Purpose of the Study:

  • To identify infratrochlear neuralgia as a distinct cause of orbital pain.
  • To characterize the clinical presentation of infratrochlear neuralgia.
  • To evaluate treatment outcomes for this condition.

Main Methods:

  • A 10-year recruitment of patients experiencing pain in the internal angle of the orbit without trochlear pain features.
  • Clinical assessment of pain location, characteristics, and triggers.
  • Evaluation of treatment response to gabapentin and anesthetic nerve blockade.

Main Results:

  • Seven patients (6 female, 1 male; mean age 46.1) presented with pain in the infratrochlear nerve territory.
  • Pain was paroxysmal (5-30 seconds), spontaneous or triggered, with local allodynia between attacks.
  • Six patients achieved complete relief with gabapentin; one had lasting relief from infratrochlear nerve blockade.

Conclusions:

  • Infratrochlear neuralgia is a distinct clinical entity.
  • It should be considered in the differential diagnosis of pain in the internal angle of the orbit.
  • Gabapentin and infratrochlear nerve blockade are effective treatments.