title: Infratrochlear neuralgia: A prospective series of seven patients treated with infratrochlear nerve blocks.
abstract: Background Infratrochlear neuralgia is a recently described painful cranial neuropathy that causes pain in the internal angle of the orbit and the medial upper eyelid, the upper bridge of the nose and/or the lacrimal caruncle. We aim to present seven new cases of infratrochlear neuralgia treated with anaesthetic nerve blocks. Methods Over an 18-month period, we prospectively identified seven cases of infratrochlear neuralgia among the patients attending the Headache Unit in a tertiary hospital. Anaesthetic blocks were performed by injecting 0.5 cc of bupivacaine 0.5% at the emergence of the nerve above the internal canthus. Results All patients were women, and the mean age was 49.1 years (standard deviation, 17.9). The pain appeared at the internal angle of the orbit and/or the medial upper eyelid in six cases, and the whole territory of the infratrochlear nerve in one case. Six patients had continuous pain and one had episodes lasting 8-24 hours. All patients showed sensory disturbances within the painful area and tenderness upon palpation of the infratrochlear nerve. Nerve blocks resulted in complete and long-lasting relief in four patients and short-lasting relief in the other three patients. Conclusions Infratrochlear neuralgia should be considered among the neuralgic causes of orbital and periorbital pain. Anaesthetic blocks may assist clinicians in the diagnosis and may also be an effective therapy.
authors.affiliation: 1 Department of Neurology, Hospital Clínico San Carlos, Madrid, Spain.|2 Department of Medicine, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain.
authors.forename: Rocío-Nur
authors.initials: RN
authors.lastname: Villar-Quiles
authors.affiliation: 1 Department of Neurology, Hospital Clínico San Carlos, Madrid, Spain.|3 Department of Molecular Neuroscience, University College London (UCL), London, UK.
authors.forename: Héctor
authors.initials: H
authors.lastname: García-Moreno
authors.affiliation: 1 Department of Neurology, Hospital Clínico San Carlos, Madrid, Spain.|2 Department of Medicine, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain.
authors.forename: Diego
authors.initials: D
authors.lastname: Mayo
authors.affiliation: 1 Department of Neurology, Hospital Clínico San Carlos, Madrid, Spain.|2 Department of Medicine, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain.
authors.forename: Álvaro
authors.initials: Á
authors.lastname: Gutiérrez-Viedma
authors.affiliation: 4 Department of Psychiatry, Hospital Clínico San Carlos, Madrid, Spain.
authors.forename: María-Isabel
authors.initials: MI
authors.lastname: Ramos
authors.affiliation: 5 Department of Neurology, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Casas-Limón
authors.affiliation: 1 Department of Neurology, Hospital Clínico San Carlos, Madrid, Spain.|2 Department of Medicine, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain.
authors.forename: María-Luz
authors.initials: ML
authors.lastname: Cuadrado
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000627:therapeutic use; D002045:Bupivacaine / Q000627:therapeutic use; D005156:Facial Neuralgia / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D014321:Trochlear Nerve / Q000187:drug effects
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine
keywords: Infratrochlear nerve; infratrochlear neuralgia; nerve block; terminal branch neuralgia; trigeminal nerve; trochlear pain