Abstract:
Lacrimal hyperalgesia is a rare type of periorbital neuralgia triggered by tear production. Two female patients in their mid-forties underwent orbital surgery and, several weeks following their procedures, developed pain when they produced tears. The symptom was described as a sharp, debilitating, and transient periocular pain. A possible mechanism for this lacrimal hyperalgesia is through the formation of an artificial synapse along the superolateral aspect of the orbit. Two mechanisms for this type of hyperalgesia are described herein, which include potential mechanical compression or direct disruption of the normal nerve pathways and microvascular disruption causing ischemic nerve injury. Currently, there is no accepted treatment for this aberrant neuropathic pain caused by lacrimation. Gabapentin therapy was trialed in one of these two patients, who experienced partial improvement with nightly use. In this case series, we describe the clinical and radiographic features associated with this unique type of neuralgia, emphasizing the importance of recognizing it as a complication following orbital surgery.
摘要:
泪腺痛觉过敏是一种罕见的由泪液产生引发的眶周神经痛。两名四十多岁的女性患者接受了眼眶手术,手术后几周,当他们产生眼泪时疼痛。症状被描述为尖锐的,衰弱,和短暂的眼周疼痛。这种泪腺痛觉过敏的可能机制是通过沿着轨道的上外侧形成人工突触。本文描述了这种类型的痛觉过敏的两种机制。其中包括潜在的机械压迫或对正常神经通路的直接破坏以及导致缺血性神经损伤的微血管破坏。目前,对于这种由流泪引起的异常神经性疼痛,目前尚无公认的治疗方法。加巴喷丁疗法在这两名患者中的一名中进行了试验,在夜间使用中经历了部分改进。在这个系列中,我们描述了与这种独特类型的神经痛相关的临床和影像学特征,强调认识到它是眼眶手术后并发症的重要性。