Supraorbital and supratrochlear neuralgia
Gabapentin (800–2400 mg/d) or pregabalin (150 mg/d) is helpful for some 1).
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 2) or with radiofrequency ablation.
Persistent cases may require exploration and decompression of the nerve by lysing bands overly- ing the supraorbital notch, 3) or, ultimately, to neurectomy which provides an average of 33.2 months relief 4).
1)
Caminero AB, Pareja JA. Supraorbital neuralgia: a clinical study. Cephalalgia. 2001; 21:216–223
2)
Stookey B, Ransohoff J. Trigeminal Neuralgia: Its
History and Treatment. Springfield, IL: Charles C
Thomas; 1959
3)
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
4)
Grantham EG, Segerberg LH. An evaluation of palliative surgical procedures in trigeminal neuralgia. J Neurosurg. 1952; 9:390–394