Trochleitis and migraine headache.

Idiopathic trochleitis is a cause of superimposed ocular pain in patients with migraine. Trochleitis usually presents as an orbital pain without obvious ocular signs. Like greater occipital neuralgia, trochleitis may sustain or trigger the pain of chronic migraine. Diagnosis is confirmed by peritrochlear steroid injection, which produces a quick relief of periocular symptoms and may improve headache control.