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Occipital Neuralgia

Occipital Neuralgia

What is occipital neuralgia?

Occipital Neuralgia is a condition that affects the occipital nerves that run from the top of the spinal cord up through the scalp causing an intense piercing, throbbing, or electric-shock, headache-like chronic pain usually on one side of the scalp.

Emerging from the spine are two occipital nerves, one on each side of the head, and these transmit sensations from the back and top of the head to the brain. In some people they extend nearly as far forward as the forehead, but do not cover the face or the area near the ears; these areas are supplied by other nerves.

What causes occipital neuralgia?

Occipital neuralgia may be caused by:

  • A pinched or compressed nerve root in the neck (from another condition such as osteoarthritis)
  • Frequent and long periods of keeping the head in a downward and forward position
  • Medical conditions that may cause nerve inflammation, such as gout, diabetes, or vasculitis
  • Prior injury
  • Surgery
  • Tight muscles at the back of the neck entrapping nerves
  • Trauma to the back of the head
  • Tumors or other lesions in the neck
  • No identifiable cause.

What are the symptoms of occipital neuralgia?

Symptoms may include:

  • A shooting, zapping, electric, or tingling pain on one side of the scalp
  • Pain affects the upper neck, back of the head, behind the eyes or ears, usually unilaterally
  • Pain usually starts in the neck then spreads upwards
  • Sometimes the pain can also shoot forward (radiate) toward one eye, but generally, the rest of the face is not affected
  • The scalp may become extremely sensitive to even the lightest touch
  • Light sensitivity
  • Numbness in the affected area
  • Pain or tenderness at the back of the head or base of the skull.

How is occipital neuralgia diagnosed?

If you have symptoms of occipital neuralgia, see your doctor. Your doctor will ask you questions about your symptoms and then perform a physical examination which includes applying pressure along the occipital nerve to find areas of tenderness.

The diagnosis is confirmed if an anesthetic nerve block results in a positive response (relief from pain).

How is occipital neuralgia treated?

In people who respond well to a temporary nerve block, your doctor may consider a more permanent procedure.

Other treatment options include:

  • Medications, such as anticonvulsants or steroid injections
  • Botulinum toxin
  • Surgery
  • Ablation therapy.