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
- Psychological Treatment
- Depression Treatment
- Cognitive-Behavioural Treatment
- Rehabilitation Treatment
Somatic Treatment
Pharmacological treatment:
- Tricyclic antidepressants
- Anticonvulsives: carbamazepine, oxcarbazepine, gabapentine en pregabaline.
Interventional Pain Treatments