A Review on Treatment of Supraorbital and Supratrochlear Neuralgia

Supraorbital and supratrochlear neuralgias are rare forms of neuropathic pain caused by damage or trauma to the supraorbital or supratrochlear nerves. Treatment options include oral medications, nerve block treatment, peripheral nerve stimulation, neuroma resection, endoscopic nerve decompression, pulsed radiofrequency, ultrasound-guided radiofrequency thermocoagulation, manual therapy, and cognitive behavioral therapy. Oral medications include drugs like carbamazepine, topiramate, gabapentin, clonazepam, and amitriptyline. Nerve block treatment involves injections of drugs to block nerves causing neuralgia. Peripheral nerve stimulation is a safe, reversible treatment for headaches caused by supraorbital neuralgia. Pulsed radiofrequency has shown long-term pain relief, while ultrasound-guided radiofrequency thermocoagulation has shown total pain relief within one month. Emerging therapeutic approaches include cryoneurotomy, trigger point therapy, and acupuncture with semi-conductive laser therapy. Combining ultrasound guidance with RFT could decrease recurrence rates and side effects. This review discusses about the anatomy, symptoms, causes, treatment options, comparative analysis, efficacy, limitations, side-effects, and novel therapeutic approaches for treatment of supraorbital and supratrochlear neuralgias