Skip to main content

Supraorbital Nerve Entrapment

  • Chapter

Abstract

Supraorbital neuralgia is an uncommon cause of extracranial headache that presents with symptoms of unilateral or bilateral intermittent forehead pain with tenderness over the distribution of the supraorbital nerve. Occasionally, patients may present with other symptoms, like blurred vision, nausea, and photophobia, thus confusing the diagnosis with other syndromes like migraine type headaches, cluster headaches, or sinusitis. However, the most common causes are trauma to the forehead and fluid retention, both leading to entrapment of the supraorbital nerve. Treatment varies and should be directed to the cause itself. Treatment involves removing the irritating stimulus, medications, local anesthetic blockade, neurolysis of the nerve, neuromodulation, and surgical decompression.

Keywords

  • Trigeminal neuralgia
  • Supraorbital neuralgia
  • Neuropathic pain
  • Postherpetic neuralgia
  • Headaches
  • Hemicrania continua
  • Cluster headaches
  • Nerve entrapment

This is a preview of subscription content, access via your institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   189.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   249.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   249.00
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Beyer TE. Idiopathic supraorbital neuralgia. Laryngoscope. 1949;59(11):1273–5.

    CrossRef  CAS  PubMed  Google Scholar 

  2. Agrawal SM, Kambalimath DH. Trigeminal neuralgia involving supraorbital and infraorbital nerves. Natl J Maxillofac Surg. 2010;1(2):179–82.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  3. Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders: 2nd edition. Cephalalgia. 2004;24(Suppl 1):9–160.

    Google Scholar 

  4. O’Brien Jr JC. Swimmer’s headache, or supraorbital neuralgia. Proc (Bayl Univ Med Cent). 2004;17(4):418–9.

    Google Scholar 

  5. Bastiaensen LAK. Supra-orbital neuralgia and its treatment. Neuro-Ophthalmology. 1996;16(4):225–7.

    CrossRef  Google Scholar 

  6. McGuire TP, Gomes PP, Clokie CM, Sandor GK. Fractures of the supraorbital rim: principles and management. Journal. 2006;72(6):537–40.

    Google Scholar 

  7. Janiri L, Gallo G, Nicoletti W. Calcium deficiency and supraorbital headache: a clinical study of adult subjects. Cephalalgia. 1986;6(4):211–8.

    CrossRef  CAS  PubMed  Google Scholar 

  8. Gennaro S, Secci F, Fiaschi P, Merciadri P. Supraorbital nerve entrapment neuropathy in Hansen’s disease. Neurol Sci. 2013;34(12):2243–4.

    CrossRef  PubMed  Google Scholar 

  9. Evans RW, Pareja JA. Expert opinion. Supraorbital neuralgia. Headache. 2009;49(2):278–81.

    CrossRef  PubMed  Google Scholar 

  10. Trescot AM. Cryoanalgesia in interventional pain management. Pain Physician. 2003;6(3):345–60.

    PubMed  Google Scholar 

  11. Guerrero AL, Herrero-Velazquez S, Penas ML, Mulero P, Pedraza MI, Cortijo E, et al. Peripheral nerve blocks: a therapeutic alternative for hemicrania continua. Cephalalgia. 2012;32(6):505–8.

    CrossRef  PubMed  Google Scholar 

  12. Sjaastad O, Petersen HC, Bakketeig LS. Supraorbital neuralgia. Vaga study of headache epidemiology. Cephalalgia. 2005;25(4):296–304.

    CrossRef  CAS  PubMed  Google Scholar 

  13. Andersen NB, Bovim G, Sjaastad O. The frontotemporal peripheral nerves. Topographic variations of the supraorbital, supratrochlear and auriculotemporal nerves and their possible clinical significance. Surg Radiol Anat. 2001;23(2):97–104.

    CrossRef  CAS  PubMed  Google Scholar 

  14. Janis JE, Ghavami A, Lemmon JA, Leedy JE, Guyuron B. The anatomy of the corrugator supercilii muscle: part II. Supraorbital nerve branching patterns. Plast Reconstr Surg. 2008;121(1):233–40.

    CrossRef  CAS  PubMed  Google Scholar 

  15. Fallucco M, Janis JE, Hagan RR. The anatomical morphology of the supraorbital notch: clinical relevance to the surgical treatment of migraine headaches. Plast Reconstr Surg. 2012;130(6):1227–33.

    CrossRef  CAS  PubMed  Google Scholar 

  16. Klein DS, Schmidt Jr RE. Chronic headache resulting from postoperative supraorbital neuralgia. Anesth Analg. 1991;73(4):490–1.

    CrossRef  CAS  PubMed  Google Scholar 

  17. Yangüela J, Pareja J, Lopez N, Sáchez del Ríos M. Trochleitis and migraine headache. Neurology. 2002;58:802–5.

    CrossRef  PubMed  Google Scholar 

  18. Sharma RR, Pawar SJ, Lad SD, Netalkar AS, Musa MM. Frontal intraosseous cryptic hemangioma presenting with supraorbital neuralgia. Clin Neurol Neurosurg. 1999;101(3):215–9.

    CrossRef  CAS  PubMed  Google Scholar 

  19. Guerrero AL, Herrero-Velazquez S, Penas ML, Mulero P, Pedraza MI, Cortijo E, et al. Peripheral nerve blocks: a therapeutic alternative for hemicrania continua. Cephalalgia. 2012;32(6):505–8.

    Google Scholar 

  20. Tijssen C, Schoemaker K, Visser L. Supraorbital neuralgia caused by nerve entrapment visualized on ultrasonography. Headache. 2013;53(2):376–7.

    CrossRef  PubMed  Google Scholar 

  21. Ettl A, Kramer J, Daxer A, Koornneef L. High resolution magnetic resonance imaging of neurovascular orbital anatomy. Ophthalmology. 1997;104(5):869–77.

    CrossRef  CAS  PubMed  Google Scholar 

  22. Matharu MS, Goadsby PJ. Persistence of attacks of cluster headache after trigeminal nerve root section. Brain J Neurol. 2002;125(Pt 5):976–84.

    CrossRef  Google Scholar 

  23. Waldman SD. Supraorbital nerve block. In: Waldman SD, editor. Atlas of pain management injection techniques. 3rd ed. Philadelphia: Saunders Elsevier; 2013. p. 4–5.

    CrossRef  Google Scholar 

  24. Caputi CA, Firetto V. Therapeutic blockade of greater occipital and supraorbital nerves in migraine patients. Headache. 1997;37(3):174–9.

    CrossRef  CAS  PubMed  Google Scholar 

  25. Spinner D, Kirschner JS. Accuracy of ultrasound-guided superficial trigeminal nerve blocks using methylene blue in cadavers. Pain Med. 2012;13(11):1469–73.

    CrossRef  PubMed  Google Scholar 

  26. Weyker P, Webb C, Mathew L. Radiofrequency ablation of the supra-orbital nerve in the treatment algorithm of hemicrania continua. Pain Physician. 2012;15(5):E719–24.

    PubMed  Google Scholar 

  27. Wilkinson HA. Trigeminal nerve peripheral branch phenol/glycerol injections for tic douloureux. J Neurosurg. 1999;90(5):828–32.

    CrossRef  CAS  PubMed  Google Scholar 

  28. Ramamurthy S, Walsh NE, Schoenfeld LS, Hoffman J. Evaluation of neurolytic blocks using phenol and cryogenic block in the management of chronic pain. J Pain Symptom Manag. 1989;4(2):72–5.

    CrossRef  CAS  Google Scholar 

  29. Persaud R, Garas G, Silva S, Stamatoglou C, Chatrath P, Patel K. An evidence-based review of botulinum toxin (botox) applications in non-cosmetic head and neck conditions. JRSM Short Rep. 2013;4(2):10.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  30. Trescot AM. Headache management in an interventional pain practice. Pain Physician. 2000;3(2):197–200.

    CAS  PubMed  Google Scholar 

  31. Asensio-Samper JM, Villanueva VL, Perez AV, Lopez MD, Monsalve V, Moliner S, et al. Peripheral neurostimulation in supraorbital neuralgia refractory to conventional therapy. Pain Pract. 2008;8(2):120–4.

    CrossRef  PubMed  Google Scholar 

  32. Amin S, Buvanendran A, Park KS, Kroin JS, Moric M. Peripheral nerve stimulator for the treatment of supraorbital neuralgia: a retrospective case series. Cephalalgia. 2008;28(4):355–9.

    CrossRef  CAS  PubMed  Google Scholar 

  33. Verrills P, Rose R, Mitchell B, Vivian D, Barnard A. Peripheral nerve field stimulation for chronic headache: 60 cases and long-term follow-up. Neuromodulation. 2014;17:54–9.

    CrossRef  PubMed  Google Scholar 

  34. Hann S, Sharan A. Dual occipital and supraorbital nerve stimulation for chronic migraine: a single-center experience, review of literature, and surgical considerations. Neurosurg Focus. 2013;35(3):E9.

    CrossRef  PubMed  Google Scholar 

  35. Narouze SN, Kapural L. Supraorbital nerve electric stimulation for the treatment of intractable chronic cluster headache: a case report. Headache. 2007;47(7):1100–2.

    CrossRef  PubMed  Google Scholar 

  36. Johnson MD, Burchiel KJ. Peripheral stimulation for treatment of trigeminal postherpetic neuralgia and trigeminal posttraumatic neuropathic pain: a pilot study. Neurosurgery. 2004;55(1):135–41.

    CrossRef  PubMed  Google Scholar 

  37. Vaisman J, Markley H, Ordia J, Deer T. The treatment of medically intractable trigeminal autonomic cephalalgia with supraorbital/supratrochlear stimulation: a retrospective case series. Neuromodulation. 2012;15(4):374–80.

    CrossRef  PubMed  Google Scholar 

  38. Guyuron B, Reed D, Kriegler JS, Davis J, Pashmini N, Amini S. A placebo-controlled surgical trial of the treatment of migraine headaches. Plast Reconstr Surg. 2009;124(2):461–8.

    CrossRef  CAS  PubMed  Google Scholar 

  39. Sjaastad O, Stolt-Nielsen A, Pareja JA, Fredriksen TA, Vincent M. Supraorbital neuralgia. On the clinical manifestations and a possible therapeutic approach. Headache. 1999;39(3):204–12.

    CrossRef  CAS  PubMed  Google Scholar 

  40. Poggi JT, Grizzell BE, Helmer SD. Confirmation of surgical decompression to relieve migraine headaches. Plast Reconstr Surg. 2008;122(1):115–22.

    CrossRef  CAS  PubMed  Google Scholar 

  41. Chepla KJ, Oh E, Guyuron B. Clinical outcomes following supraorbital foraminotomy for treatment of frontal migraine headache. Plast Reconstr Surg. 2012;129(4):656e–62.

    CrossRef  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Rafael Justiz MD, MS, DABA/PM, FIPP, DABIPP .

Editor information

Editors and Affiliations

Electronic Supplementary Material

Below is the link to the electronic supplementary material.

Physical exam of the supraorbital nerve (MOV 33642 kb)

Landmark-guided injection of the supraorbital nerve (MOV 45745 kb)

Rights and permissions

Reprints and Permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Justiz, R., Trescot, A.M. (2016). Supraorbital Nerve Entrapment. In: Trescot, A.M. (eds) Peripheral Nerve Entrapments. Springer, Cham. https://doi.org/10.1007/978-3-319-27482-9_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-27482-9_14

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-27480-5

  • Online ISBN: 978-3-319-27482-9

  • eBook Packages: MedicineMedicine (R0)