Skip to main content

8. Occipital Neuralgia

Buy Article:

$43.00 plus tax (Refund Policy)

Abstract

Occipital neuralgia is defined as a paroxysmal shooting or stabbing pain in the dermatomes of the nervus occipitalis major and/or nervus occipitalis minor. The pain originates in the suboccipital region and radiates over the vertex. A suggestive history and clinical examination with short-term pain relief after infiltration with local anesthetic confirm the diagnosis. No data are available about the prevalence or incidence of this condition. Most often, trauma or irritation of the nervi occipitales causes the neuralgia. Imaging studies are necessary to exclude underlying pathological conditions. Initial therapy consists of a single infiltration of the culprit nervi occipitales with local anesthetic and corticosteroids (2 C+). The reported effects of botulinum toxin A injections are contradictory (2 C±). Should injection of local anesthetic and corticosteroids fail to provide lasting relief, pulsed radio-frequency treatment of the nervi occipitales can be considered (2 C+). There is no evidence to support pulsed radio-frequency treatment of the ganglion spinale C2 (dorsal root ganglion). As such, this should only be done in a clinical trial setting. Subcutaneous occipital nerve stimulation can be considered if prior therapy with corticosteroid infiltration or pulsed radio-frequency treatment failed or provided only short-term relief (2 C+).
No References
No Citations
No Supplementary Data
No Article Media
No Metrics

Keywords: complications; evidence-based medicine; interventional pain management; occipitalis neuralgia; treatment algorithm

Document Type: Research Article

Affiliations: 1: Department of Anatomy and Embryology, Maastricht University, Maastricht, The Netherlands; 2: Feinberg School of Medicine, Northwestern University Chicago, Illinois, USA; 3: Department of Pain Management, Cleveland Clinic, Cleveland, Ohio, U.S.A.;

Publication date: 2010-03-01

  • Access Key
  • Free content
  • Partial Free content
  • New content
  • Open access content
  • Partial Open access content
  • Subscribed content
  • Partial Subscribed content
  • Free trial content
Cookie Policy
X
Cookie Policy
Ingenta Connect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more