Supraorbital and supratrochlear neuralgia [Neurosurgery Wiki]

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====== Supraorbital and supratrochlear neuralgia ======

[[Gabapentin]] (800–2400 mg/d) or [[pregabalin]] (150 mg/d) is helpful for some
((Caminero AB, Pareja JA. Supraorbital neuralgia: a clinical study. Cephalalgia. 2001; 21:216–223)).

Topical [[capsaicin]] applied to the symptomatic area may help.

Refractory cases may respond to rhizotomy with alcohol (providing an average of 8.5 months
relief
((Stookey B, Ransohoff J. Trigeminal Neuralgia: Its
History and Treatment. Springfield, IL: Charles C
Thomas; 1959))
or with radiofrequency ablation.

Persistent cases may require exploration and decompression of the nerve by lysing bands overly-
ing the supraorbital notch,
((Sjaastad O, Stolt-Nielsen A, Pareja JA, et al.
Supraorbital neuralgia: on the clinical manifestations and a possible therapeutic approach. Headache. 1999; 39:204–212))
or, ultimately, to neurectomy which provides an average of 33.2 months relief
((Grantham EG, Segerberg LH. An evaluation of palliative surgical procedures in trigeminal neuralgia. J Neurosurg. 1952; 9:390–394)).