Infra-Orbital Neuralgia and Surgical Management

Abstract

Trigeminal Neuralgia (TN) is characterized by excruciating, paroxysmal, shock like pain attacks located in the somatosensory distribution of the trigeminal nerve. It is also called Tic Douloreux and is a debilitating syndrome consisting mainly of unilateral short bursts of lancinating pain in one or more branches of the trigeminal nerve. The most common disorders involved in the differential diagnosis include bursts of headaches, dental pain, gaint cell arteritis, glossopharyngeal nerve neuralgia, intracranial tumour, migraine, multiple sclerosis, otoitis media, sinusitis and temporomandibular joint syndrome. The TN is by far the most frequently diagnosed form of neuralgia with mean incidence of 4 per 1, 00,000 populations and mean age of 50 at the time of examination. In general, TN is unilateral affecting the maxillary (35%), mandibular (30%), both (20%), ophthalmic and maxillary (10%) and ophthalmic (4%) branches and all branches of the TN (1%). The treatment options are varied from medical to surgical therapy. The peripheral neurectomy is the oldest and least invasive therapy with few complications. We present a case of 68 year old female patient with unilateral infraorbital neuralgia treated by invasive procedure. Following neurectomy the patient was free of symptoms in six years period of follow-up.