Posting for Lolane.

Patient: 68-year-old female

Chief Complaint:

• Left-sided periorbital neuralgia for approximately 2 years.
• No history of trauma or identifiable mechanism of onset.

Symptoms:

• Random, sharp “zapping” sensations both superior and inferior to the left orbit.
• Episodes are brief but frequent and bothersome.
• Pain can occur spontaneously without any apparent trigger.

Mechanical Triggers:
Palpation or light touch can reliably reproduce symptoms in several areas, including:

• Along the nasolabial fold
• Frontal sinus/supraorbital region
• Above the left eye

Activities of daily living that commonly trigger the pain include:

• Washing her face
• Touching her face
• Brushing her teeth
• Rubbing alongside her nose
• Occasionally blinking

Treatment Attempted:
Thus far I have tried:

• Upper quarter perfusion techniques
• Temporalis treatment
• Facial nerve treatment
• Motor point needling of the periocular musculature
• Craniosacral therapy
• Fascial release of the temporal, maxillary, and frontal regions

Response:
She has experienced mild improvement in the frequency of the “zaps,” but the symptoms remain persistent and continue to significantly affect daily activities.

@Exstoreman any advice on this?