Retro-orbital tumour--an uncommon cause of headache in pregnancy.
Retro-orbital tumour was the cause of headache and neuropathic facial pain in a 31-year-old pregnant woman. The diagnosis had been overlooked as a result of a long history of migraine. There was exacerbation of the pain throughout the pregnancy, particularly in the third trimester. Pharmacological agents commonly used to manage neuropathic pain states were relatively contraindicated due to potential adverse effects on the fetus. Cognisant of such limitations imposed by pregnancy, we used multimodal therapy in an attempt to control the pain. This included morphine, paracetamol, amitriptyline, ketamine and psychological support. The management challenges are described.
Roberts
L J
LJ
Western Australian Pain Management Centre, Perth, Western Australia.
Goucke
C R
CR
D000328:Adult; D000639:Amitriptyline / Q000627:therapeutic use; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000627:therapeutic use; D005260:Female; D006261:Headache / Q000209:etiology*; D006392:Hemangioma, Cavernous / Q000150:complications* / Q000628:therapy; D006801:Humans; D007649:Ketamine / Q000627:therapeutic use; D009918:Orbital Neoplasms / Q000150:complications* / Q000628:therapy; D010147:Pain Measurement; D010166:Palliative Care / Q000379:methods*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic; D004561:Transcutaneous Electric Nerve Stimulation
D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000639:Amitriptyline; D007649:Ketamine