occipital neuralgia

Introduction

a chronic pain disorder

Etiology

• irritation or injury to the occipital nerve
• physical stress, trauma, or repeated contraction of the muscles of the neck may contribute

Clinical manifestations

• chronic disorder
• pain originating at the nape of the neck
  • pain in the distribution of the occipital nerve
    • may be said to spread up & around the forehead & scalp
    • may be unilateral base of the skull to the vertex
  • throbbing & migraine-like
    • recurrent, paroxysmal
    • sharp or stabbing pain
    • associated with allodynia or dysesthesia & scalp tenderness
  • worsened when supine or brushing hair

Diagnostic procedures

• response to occipital nerve block may support diagnosis
  • lack of response would suggest another diagnosis

Management

• treatment is symptomatic: includes massage & rest
• antidepressants may be useful when the pain is severe
• local nerve blocks & injections of steroids directly into the affected area may be diagnostic as well as therapeutic
• occipital nerve stimulation

Prognosis:

• pain is generally eliminated or reduced with treatment & does not interfere with daily activities

More general terms

• peripheral nerve disease; peripheral neuropathy
• neuralgia
• headache

Additional terms

• occipital nerve

Patient information

occipital neuralgia patient information