Background & Aims

Management of supraorbital neuralgia with standard radio frequency ablation of supra orbital nerve.

Methods

A 60-year-old female had been experiencing persistent left-sided supraorbital pain accompanied by headaches for the past four years. Over the last month, she had noted a significant escalation in the intensity and frequency of the pain. The nature of the pain was described as sharp and shooting, often resembling a shock-like sensation in the supraorbital region. The pain worsened during activities such as talking, swallowing, and exposure to a gust of wind. The patient had a history of hypertension and was undergoing treatment with antihypertensive medications. Following unsuccessful relief from pharmacotherapy, the patient underwent a planned procedure for left supraorbital nerve radiofrequency ablation guided by ultrasound. Positive sensory and negative motor confirmation preceded the actual radiofrequency ablation of the supraorbital nerve, utilizing a 22-gauge RF needle with a 2 mm active tip at 70 degrees Celsius for a duration of 90 seconds. The procedure was uneventful.

Results

USG guided RFA is the most effective minimally invasive technique for treating supraorbital neuralgia. It has been recognized for its safety, efficacy, success rate, and patient satisfaction compared to balloon and microvascular decompression.

Conclusions

The ophthalmic nerve root is located deep in the Gasserian ganglion, resulting in difficult puncture, high risk, and difficulty in reaching the target, and radiofrequency ablation of the ophthalmic nerve root in the Gasserian ganglion is prone to cause corneal ulcers. Hence radiofrequency ablation of peripheral nerves (supraorbital nerves) is the best first approach to treat the patient.

References

. Pareja JA, Caminero AB. Supraorbital neuralgia. Curr Pain Headache Rep. 2006 Aug;10(4):302-5. doi: 10.1007/s11916-006-0036-9. PMID: 16834946.
2. Ren H, Shen Y, Luo F. Treatment of supraorbital neuralgia using ultrasound-guided radiofrequency thermocoagulation of the supraorbital nerve: a retrospective study. J Pain Res. 2020;13:251-259.
3.Lee JY, Sim WS, Kim DK, Park HJ, Oh MS, Lee JE. Ultrasound-guided pulsed radiofrequency treatment for postherpetic neuralgia of supraorbital nerve: a case report. Anesth Pain Med. 2014;9(2):103–105.

Presenting Author

Sinduja Vairamuthu

Poster Authors

SINDUJA VAIRAMUTHU

MD

DY PATIL UNIVERSITY

Lead Author

Topics

  • Models: Chronic Pain - Neuropathic