Supraorbital neuralgia: a clinical study

A series of 18 patients suffering from supraorbital neuralgia have been stu died through a seven year period. Appropriate investigations ruled out othe r headaches. There was a female (67%) preponderance. Mean age at onset was 51.6 years. The mean headache duration was 5.9 years. Five patients had a h istory of ipsilateral forehead trauma. The main areas of pain were the fore head and orbit. The pain was dull with short sharp or burning exacerbations . The temporal pattern was either remitting (n = 7) or chronic continuous ( n=11). Autonomic accompaniments were generally lacking. Neurological assess ment was normal in all but 4 patients who were found to have signs/symptoms of sensory dysfunction in the forehead of the symptomatic side. Trials of different drugs, including migraine and anti-neuralgic drugs, only provided slight relief. Anaesthetic nerve blocks of the supraorbital nerve provided an absolute but transitory relief of pain. Although aetiology and pathogenesis of supraorbital neuralgia is largely un known, entrapment of the supraorbital nerve at its outlet and successful de compressive surgery have been previously reported. This and other pathogeni c hypotheses are discussed.