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Turk J Med Sci 2020 Dec 28. Epub 2020 Dec 28.

Background /aim: In this study we aimed to compare the efficacy of greater occipital nerve (GON) block alone and GON combined with supraorbital nerve (SON) block was evaluated in the treatment of medication overuse headache (MOH) .

Material And Methods: 82 patients were divided into two groups; 41 patients were administered bilateral GON block and the other 41 patients GON + SON block. Nerve blocks were administered every 10 day for total 5 sessions. Read More

J Korean Neurosurg Soc 2020 Nov 27;63(6):814-820. Epub 2020 Oct 27.

Department of Neurosurgery, School of Medicine, Kyung Hee University, Seoul, Korea.

Objective: Trigeminal neuralgia (TN) is a severe neuropathic condition that affects several elderly patients. It is characterized by uncontrolled pain that significantly impacts the quality of life of patients. Therefore, the condition should be treated as an emergency. Read More

Anesth Prog 2020 09;67(3):164-169

Department of Anesthesiology, Asahi General Hospital, Chiba, Japan.

Head and neck reconstructive surgery involving tissue flaps is often complex requiring the development of an individualized anesthetic plan. The following case report describes the anesthetic management of an 87-year-old man considered at high risk for postoperative delirium due to advanced age and blindness undergoing general anesthesia for resection of squamous cell carcinoma of the right side of the nose and reconstructive surgery with a scalping forehead flap. Ultrasound-guided local anesthetic maxillary and supraorbital nerve blocks were successfully used perioperatively to reduce the need for alternative analgesics associated with higher risks of complications such as postoperative nausea, vomiting, and delirium. Read More

NeuroRehabilitation 2020 ;47(3):299-314

Physical Medicine and Rehabilitation, Indiana University School of Medicine, Rehabilitation Hospital of Indiana, 4141 Shore Drive, Indianapolis, IN, USA.

While non-headache, non-oral craniofacial neuralgia is relatively rare in incidence and prevalence, it can result in debilitating pain. Understanding the relevant anatomy of peripheral branches of nerves, natural history, clinical presentation, and management strategies will help the clinician better diagnose and treat craniofacial neuralgias. This article will review the nerves responsible for neuropathic pain in periorbital, periauricular, and occipital regions, distinct from idiopathic trigeminal neuralgia. Read More

Ophthalmic Plast Reconstr Surg 2020 Jun 17. Epub 2020 Jun 17.

Plastic Eye Surgery Associates, Houston, Texas, U.S.A.

Purpose: To identify the relationship between thyroid eye disease (TED) and supraorbital neuralgia (SON) and establish a reliable approach to the diagnosis and management of TED-associated SON.

Methods: This retrospective study included 1,126 patients. Demographics, active and inactive phase status and duration, and reactivation rate were noted. Read More

Aesthet Surg J 2020 07;40(8):887-891

Pennsylvania State University, University Park, PA.

Background: Microfocused ultrasound with visualization has become one of the more popular nonsurgical facial rejuvenation therapies available. Although the treatment has gained wide acceptance, providing adequate pain relief during the procedure can be challenging.

Objectives: The aim of this study was to test our hypothesis that nerve blocks prior to treatment would be well tolerated and significantly reduce patient discomfort. Read More

Medicine (Baltimore) 2019 Aug;98(31):e16484

Department of Neurology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.

Introduction: Paroxysmal hemicrania (PH) is a chronic headache disorder characterized by unilateral pain attacks accompanied by cranial autonomic symptoms and responds to indomethacin completely. There are few alternative treatment options for the patients who cannot tolerate indomethacin. Studies exploring the effects of repetitive peripheral cranial nerve blocks in the management of chronic PH are limited. Read More

BMC Neurol 2019 Jun 22;19(1):136. Epub 2019 Jun 22.

Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University Rof Rome Polo Pontino, Latina, Italy.

Background: A short ketogenic diet (KD) treatment can prevent migraine attacks and correct excessive cortical response. Here, we aim to prove if the KD-related changes of cortical excitability are primarily due to cerebral cortex activity or are modulated by the brainstem.

Methods: Through the stimulation of the right supraorbital division of the trigeminal nerve, we concurrently interictally recorded the nociceptive blink reflex (nBR) and the pain-related evoked potentials (PREP) in 18 migraineurs patients without aura before and after 1-month on KD, while in metabolic ketosis. Read More

Eye Contact Lens 2020 May;46(3):174-181

Department of Ophthalmology (L.R.S., A.G., E.R.F., R.C.L., C.D.S.), Bascom Palmer Eye Institute, University of Miami, Miami, FL; Ophthalmology, Miami Veterans Administration Medical Center (A.G.), Miami, FL; Physical Medicine and Rehabilitation (E.R.F.), University of Miami, Miami, FL; Department of Anesthesiology, Perioperative Medicine and Pain Management (D.B.H., R.C.L., C.D.S.), University of Miami Miller School of Medicine, Miami, FL; John P. Hussman Institute for Human Genomics (R.C.L.), University of Miami Miller School of Medicine, Miami, FL; and John T Macdonald Foundation Department of Human Genetics (R.C.L.), University of Miami Miller School of Medicine, Miami, FL.

Purpose: There is a recognition that nerve dysfunction can contribute to chronic ocular pain in some individuals. However, limited data are available on how to treat individuals with a presumed neuropathic component to their ocular pain. As such, the purpose of this study was to examine the efficacy of our treatment approaches to this entity. Read More

J Vet Dent 2019 Mar;36(1):40-45

1 Rood and Riddle Equine Hospital, Lexington, KY, USA.

Regional anesthesia of the equine head is commonly performed to allow oral extraction of diseased teeth in the standing horse. The use of 4 blocks (infraorbital nerve, maxillary nerve, mental nerve, and mandibular nerve) is well documented for desensitization of dental quadrants for oral surgery for exodontia, but descriptions of associated complications are limited. A total of 270 regional nerve blocks were performed on 162 equine patients in a second opinion referral hospital setting. Read More

Cephalalgia 2019 Oct 13;39(12):1488-1499. Epub 2019 May 13.

Headache Group, Institute of Neurology and The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.

Background: Multiple cranial nerve blocks of the greater and lesser occipital, supraorbital, supratrochlear and auriculotemporal nerves are widely used in the treatment of primary headaches. We present efficacy and safety data for these procedures.

Methods: In an uncontrolled open-label prospective study, 119 patients with chronic cluster headache, chronic migraine, short lasting unilateral neuralgiform attack disorders, new daily persistent headaches, hemicrania continua and chronic paroxysmal hemicrania were examined. Read More

Expert Rev Neurother 2019 06 13;19(6):509-533. Epub 2019 May 13.

a Department of Neurology, Faculty of Medicine, Interdisciplinary Excellence Centre , University of Szeged , Szeged , Hungary.

: Acute and preventive treatment of primary headache disorders is not completely resolved with regard to efficacy, safety, and tolerability. Hence, peripheral and central neuromodulation can provide therapeutic alternatives in drug-resistant cases. Peripheral targets of neuromodulation include invasive and non-invasive neurostimulation and electrical and chemical nerve and ganglion blockades. Read More

Clin Med Insights Ear Nose Throat 2019 15;12:1179550619834949. Epub 2019 Mar 15.

Department of Otorhinolaryngology - Head and Neck Surgery, Center for Facial Plastic and Reconstructive Surgery, Diakonessen Hospital, Utrecht, The Netherlands.

Entrapment neuropathy is a known cause of neurological disorders. In the head and neck area, this pathophysiological mechanism could be a trigger for headache. Over the last few decades, injection of botulinum toxin type A in the muscles that are causing the compression as well as surgical decompression have proved to be effective treatment methods worldwide for large numbers of patients with daily headaches. Read More

Curr Med Res Opin 2019 05 31;35(5):909-915. Epub 2018 Oct 31.

c Department of Neurology , Gaziosmanpaşa Taksim Training and Research Hospital , Istanbul , Turkey.

Objective: Nerve injections have been used for the acute and preventive treatment of migraine in recent decades. Most of these injections focused on greater occipital nerve (GON) blockade. However, few studies were placebo controlled, and only a few of them investigated GON and supraorbital nerve (SON) blockade together. Read More

J Pain Res 2018 8;11:1497-1501. Epub 2018 Aug 8.

Department of Anesthesiology and Pain Management, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, People's Republic of China,

Pulsed radiofrequency is an effective, safe, and nondestructive pain treatment technique that has been insufficiently reported in the treatment of supraorbital neuralgia. We report the successful use of pulsed radiofrequency to alleviate acute severe supraorbital neuralgia in a post-craniotomy patient. A 52-year-old female, who had acute severe supraorbital neuralgia after having received a right frontal craniotomy and with poor efficacy in response to medication and a nerve block, was subjected to ultrasound-guided pulsed radiofrequency treatment and experienced complete pain relief, as a result of which the patient stopped taking all analgesic drugs. Read More

Am J Emerg Med 2018 11 8;36(11):2058-2060. Epub 2018 Aug 8.

Department of Anesthesiology, New York-Presbyterian Hospital/Weill Cornell Medicine, 525 East 68th Street, Box 124, New York, NY 10065, United States of America.

Objective: After medication failure, patients with refractory trigeminal neuralgia (TGN) often present urgently and seek more potent or invasive therapies such as opioids or surgical options. Peripheral nerve blocks, safe and simple, may offer extended pain relief prior to opioid use or more invasive ganglion level procedures.

Methods: We report a retrospective case-series (urgent care, at a large urban medical center, over a 2 year period) of nine patients with intractable primary TGN who underwent peripheral trigeminal nerve blocks after failing conservative medical therapy. Read More

Can Vet J 2018 07;59(7):763-769

Elders Equine Veterinary Service, Box 66047, 3665 Portage Avenue, Winnipeg, Manitoba (Bell, Torske); Royal University Hospital, University of Saskatchewan, Saskatoon, Saskatchewan (Hnenny).

A 5-year-old Hannovarian warmblood gelding was presented for recurrent headshaking exacerbated with exercise. The horse displayed clinical signs of repetitive vertical head movements, face rubbing on the forelimbs and on the ground, repetitive sneezing, and striking the muzzle with his forelimbs. The clinical signs resulted in a horse that could not be ridden and was dangerous. Read More

Pain Res Manag 2018 2;2018:5480728. Epub 2018 Apr 2.

Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Bei-Hu Branch, Taipei, Taiwan.

Orofacial myofascial pain is prevalent and most often results from entrapment of branches of the trigeminal nerves. It is challenging to inject branches of the trigeminal nerve, a large portion of which are shielded by the facial bones. Bony landmarks of the cranium serve as important guides for palpation-guided injections and can be delineated using ultrasound. Read More

Anat Cell Biol 2018 Mar 28;51(1):19-24. Epub 2018 Mar 28.

Department of Basic Sciences, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka.

Significant variations exist in the occurrence, form, and position of supraorbital nerve exits through the frontal bone. Detailed knowledge of the positional variations of supraorbital exits is important to ensure safe and successful regional anesthesia, and to avoid iatrogenic nerve injuries during surgery of the orbitofacial region. Supraorbital nerve exits from 116 sides of 58 dry intact adult skulls (37 male and 21 female) in a Sri Lankan population were examined to determine the morphological features and the precise position in relation to the facial midline, temporal crest of frontal bone, and frontozygomatic suture. Read More

Agri 2018 Jan;30(1):28-30

Department of Neurology, Training and Research Hospital, Istanbul, Turkey.

Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) is a rare, primary headache syndrome, which is classified as a subtype of trigeminal autonomic cephalalgias. Although SUNCT is usually refractory to treatment, several antiepileptic drugs have recently shown promising results for its treatment. However, there is a lack of evidence regarding the course of SUNCT during pregnancy and the available treatment options. Read More

Dermatol Surg 2018 May;44(5):760-761

Plastic & Hair Restorative Surgery, Hair Transplant Institute, Islamabad, Pakistan.

Headache 2017 Oct 18;57(9):1433-1442. Epub 2017 Aug 18.

Headache Unit, Department of Neurology, Hospital Clínico San Carlos, Madrid, Spain.

Objective: The aim of this study was to describe clinical features unique to supratrochlear neuralgia.

Background: The supratrochlear nerve supplies the medial aspect of the forehead. Due to the intricate relationship between supraorbital and supratrochlear nerves, neuralgic pain in this region has been traditionally attributed to supraorbital neuralgia. Read More

Headache 2016 Nov 12;56(10):1597-1607. Epub 2016 Oct 12.

Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, OH, USA.

Objective: To describe current patterns of use of nerve blocks and trigger point injections for treatment of pediatric headache.

Background: Peripheral nerve blocks are often used to treat headaches in adults and children, but the available studies and practice data from adult headache specialists have shown wide variability in diagnostic indications, sites injected, and medication(s) used. The purpose of this study was to describe current practice patterns in the use of nerve blocks and trigger point injections for pediatric headache disorders. Read More

Neurologia 2018 Apr 25;33(3):160-164. Epub 2016 Jul 25.

Unidad de Cefalea, Servicio de Neurología, Hospital Universitari Vall d'Hebron, Grupo de Investigación en Cefalea, VHIR, UAB, Barcelona, España.

Anaesthetic blocks, whether used alone or combined with other treatments, are a therapeutic resource for many patients with headaches. However, usage patterns by different professionals show significant heterogeneity.

Material And Methods: The Headache Study Group of the Spanish Society of Neurology (GECSEN) designed a self-administered cross-sectional survey and sent it to all group members through the SEN's scientific area web platform in February 2016. Read More

Dermatol Surg 2016 Aug;42(8):992-8

*Department of Anatomy, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea; †Department of Ophthalmology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.

Background: Blocking the supraorbital nerve (SON) and supratrochlear nerve (STN) by injecting anesthetic distal to the surgical site has the advantage in upper eyelid surgery that avoids obscuring the surgical landmarks and compromising the levator function.

Objective: To identify the emerging points of the SON and STN in the supraorbital margin with reference to the lacrimal caruncle.

Methods: Forty-nine orbits from 27 embalmed Korean cadavers were dissected. Read More

Cephalalgia 2017 Aug 12;37(9):864-872. Epub 2016 Jun 12.

4 Department of Preventive Medicine, Instituto de Investigación Sanitaria San Carlos, Hospital Clínico San Carlos, Madrid, Spain.

Background Greater occipital nerve (GON) blocks are widely used for the treatment of headaches, but quality evidence regarding their efficacy is scarce. Objective The objective of this article is to assess the short-term clinical efficacy of GON anaesthetic blocks in chronic migraine (CM) and to analyse their effect on pressure pain thresholds (PPTs) in different territories. Participants and methods The study was designed as a double-blind, randomised, placebo-controlled clinical trial. Read More

Vet Surg 2016 May 4;45(4):494-8. Epub 2016 Apr 4.

College of Veterinary Medicine, Lincoln Memorial University, Harrogate, Tennessee.

Objective: To describe the anatomical location of the ethmoidal nerve in the equine periorbital region and to determine the accuracy of a technique used to deposit local anesthetic solution adjacent to the nerve.

Study Design: Prospective experimental study.

Animals: Adult equine cadaver heads (n=6 for preliminary dissection; n=15 [30 nerve sites] for evaluation of injection technique). Read More

Arch Craniofac Surg 2016 Mar 21;17(1):9-13. Epub 2016 Mar 21.

Department of Plastic and Reconstructive Surgery, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea.

Background: Position of the facial foramina is important for regional block and for various maxillofacial surgical procedures. In this study, we report on anthropometry and morphology of these foramina using three-dimensional computed tomography (3D-CT) data.

Methods: A retrospective review was performed for all patients who have undergone 3D-CT scan of the facial skeleton for reasons other than fracture or deformity of the facial skeleton. Read More