Periorbital pain: A clinical review

Abstract

The objectives of this paper are: (1) to present a review of the clinical features and diagnostic criteria of a number of conditions involving paroxysmal, episodic or chronic periorbitalpain, (2) to relate the clinical facts with neuroanatomical findings, and (3) to argue a common pathophysiology. One general difficulty in this field is that much of the neuroanatomical data are obtained from animals, and we do not know how far they apply to man. Moreover, assuming that paroxysmal pain syndromes are found only in man, animal experiments are hardly applicable for testing pathogenic models or therapeutic strategies.It is concluded that most periorbital pain syndromes can be diagnosed on the basis of clinical information alone. However, further diagnostic procedures are called for to exclude treatable lifethreatening conditions.On the basis of current knowledge, periorbital pain is suggested to be of neurogenic origin, due to a disordered interganglionic ‘circuitry’ - interaction between sensory and sympathet...