Face / Head / Neck

Supra-orbital Neuralgia

Definition

Supra-orbital neuralgia is a neurological disorder of the supra-orbital nerve due to a lesion and/or dysfunction of this nerve.

Aetiology

Possible causes are: trauma (orbital fractures), infection (sinusitis) and idiopathic.

Signs and symptoms

The main complaint is usually unilateral pain of the forehead and eye. The pain can be provoked by touching and is neuropathic in character.

Diagnostics

Physical Examination

General physical and neurological examination followed by ENT examination is necessary.

Additional Somatic Diagnostics

The diagnosis can be carried out based on medical history and exclusion of other ENT causes.

CT scan of the cranial sinuses, MRI scans when there is a suspicion of primary nerve tumours. A diagnostic test block of the supra-orbital nerve will confirm the diagnosis.

Additional Psycho-cognitive Diagnostics

  • RAND-36 (quality of life)
  • VAS-Pain (maximal, minimal, actual, average/week)
  • PCS (catastrophising)
  • HADS (fear and depression)

Multidisciplinary Treatment

Whether or not somatic treatment is indicated is based on the pain diagnosis.  Based on the findings of the pain questionnaires, additional diagnostics and/or multidisciplinary treatment comprising various non-somatic treatments may be necessary.

Non-somatic Treatment

Somatic Treatment

Pharmacological treatment:

  • Tricyclic antidepressants
  • Anticonvulsives: carbamazepine, oxcarbazepine, gabapentine en pregabaline.

Interventional Pain Treatments