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Trigeminal Terminal Branch Neuralgias in a Headache Unit: A 15-Year Series
Isabel Ros González1, Andrea Recio García2, Álvaro Sierra Mencía2
1Neurology Department, Hospital Infanta Elena, Madrid, Spain.
Introduction:
ICHD-3 integrates neuralgias affecting trigeminal terminal branches within broader trigeminal pain categories rather than defining them as distinct entities. In this context, their frequency and clinical characteristics remain poorly characterized. We aimed to describe their frequency and clinical characteristics in a headache unit registry.
Methods:
We conducted a retrospective, descriptive cohort study based on a prospective registry initiated in January 2008 at a headache unit. Patients diagnosed between January 2008 and January 2023 who fulfilled ICHD-2 criteria for nasociliary (code 13.5), supraorbital (13.6), or other terminal branch neuralgias (13.7) were included. Demographic and clinical data were collected and analyzed.
Results:
Among 8728 patients evaluated during the study period, 108 (1.2%) met inclusion criteria; 71 (65.7%) were women. Mean age at symptom onset was 47.4 ± 18.7 years (range 6-89), and mean time from onset to diagnosis was 34.4 ± 68.5 months (range 1-420). The most frequent neuralgias were supraorbital (39.8%) and auriculotemporal (25.9%), followed by supratrochlear (8.3%), infraorbital (7.4%), lacrimal (7.4%), mental (5.6%), nasociliary (4.6%), and infratrochlear (0.9%).
Conclusion:
Trigeminal terminal branch neuralgias represent a small but consistent clinical presentation defined by topographic distribution and sensory features. Recognition of these features supports anatomically guided evaluation and peripheral interventions.
