Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-745bb68f8f-d8cs5 Total loading time: 0 Render date: 2025-01-11T09:56:04.487Z Has data issue: false hasContentIssue false

Chapter 14 - Occipital Neuralgia

from Part III - Chronic Pain Conditions Head and Neck

Published online by Cambridge University Press:  01 December 2023

By
Noushad Mamun
Edited by
Omar Viswanath  and
Ivan Urits
Omar Viswanath
Affiliation:
Creighton University, Omaha
Ivan Urits
Affiliation:
Southcoast Brain & Spine Center, Wareham
Get access

Summary

Occipital neuralgia (ON) is a rare headache disorder mainly affecting the posteriorupper neck and posterior head region. By definition, ON is characterized by paroxysmal shooting or stabbing, sudden-onset pain that has frequent recurrence, lasting for a few minutes at a time. This pain syndrome is related to the nerve distribution that involves spinal nerves emerging from the upper cervical region that traverse to the base of the neck and run up the posterior scalp. It involves compression, injury, or trauma to greater occipital nerve (GON), lesser occipital nerve (LON), and then rarely due to third occipital nerve (TON). Conceptually, nerve entrapment between anatomical structures have been hypothesized to be a large contributing factor to the pathophysiology of ON. Most cases of ON are idiopathic with no clear etiology that is structurally identifiable. It is hypothesized that the pain from ON is due to compression, injury, or irritation (e.g. chronic instability, entrapment, trauma, inflammation) of the greater occipital nerve, lesser occipital nerve, and/or the third occipital nerve. Treatment can be conservative or interventional modalities.

Keywords

occipital neuralgiaheadachepainchronic painthird occipital nerve
Type
Chapter
Information
Cambridge Handbook of Pain Medicine , pp. 86 - 94
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Djavaherian, DM, Guthmiller, KB. Occipital Neuralgia – StatPearls – NCBI Bookshelf. (n.d.). Retrieved August 22, 2022, from www.ncbi.nlm.nih.gov/books/NBK538281/.Google Scholar
Vanelderen, P, Lataster, A, Levy, R et al. 8. Occipital neuralgia. Pain Pract.: Off. J World Inst. Pain. n.d.;10(2):137–144. https://doi.org/10.1111/j.1533-2500.2009.00355.x.CrossRefGoogle Scholar
Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders, 3rd ed. Cephalalgia. 2018;38(1):1–211. https://doi.org/10.1177/0333102417738202.CrossRefGoogle Scholar
Swanson, D, Guedry, R, Boudreaux, M et al. An update on the diagnosis, treatment, and management of occipital neuralgia. Journal of Craniofacial Surgery, 2022;33(3):779–783. https://doi.org/10.1097/SCS.0000000000008360.CrossRefGoogle ScholarPubMed
Choi, I, Jeon, SR. Neuralgias of the head: Occipital neuralgia. J. Korean Med. Sci. 2016;31(4):479–488. https://doi.org/10.3346/jkms.2016.31.4.479.CrossRefGoogle ScholarPubMed
Dougherty, C. Occipital neuralgia. Curr Pain Headache Rep. 2014;18(5):411. https://doi.org/10.1007/s11916-014-0411-x.CrossRefGoogle ScholarPubMed
Koopman, JSHA, Dieleman, JP, Huygen, FJ et al. Incidence of facial pain in the general population. Pain. 147(1–3):122–127. https://doi.org/10.1016/j.pain.2009.08.023.CrossRefGoogle Scholar
Magnússon, T, Ragnarsson, T, Björnsson, A. Occipital nerve release in patients with whiplash trauma and occipital neuralgia. Headache. 1996; 36: 32–36.CrossRefGoogle ScholarPubMed
Cohen, SP, Plunkett, AR, Wilkinson, I et al. Headaches during war: Analysis of presentation, treatment, and factors associated with outcome. Cephalalgia. 2012; 32:94–108.CrossRefGoogle ScholarPubMed
Cornely, C, Fischer, M, Ingianni, G, Isenmann, S. Greater occipital nerve neuralgia caused by pathological arterial contact: Treatment by surgical decompression. Headache. 2011;51(4):609–612. https://doi.org/10.1111/j.1526-4610.2010.01802.x.CrossRefGoogle ScholarPubMed
Elias, WJ, Burchiel, KJ. Trigeminal neuralgia and other neuropathic pain syndromes of the head and face. Curr Pain Headache Rep. 2002;6(2):115–124. https://doi.org/10.1007/s11916-002-230007-238.CrossRefGoogle ScholarPubMed
Ural, A, Ceylan, A, Inal, E, Celenk, F. A case of greater occipital nerve schwannoma causing neuralgia. Kulak Burun Bogaz Ihtisas Dergisi: KBB = Ear Nose Throat J. n.d.;18(4):253–256.Google Scholar
Ballesteros-Del Rio, B, Ares-Luque, A, Tejada-Garcia, J, Muela-Molinero, A. Occipital (Arnold) neuralgia secondary to greater occipital nerve schwannoma. Headache. n.d.;43(7):804–807. https://doi.org/10.1046/j.1526-4610.2003.03142.x.Google Scholar
Yu, M, Wang, S-M. Anatomy, head and neck, occipital nerves. StatPearls. 2021, www.ncbi.nlm.nih.gov/books/NBK542213/.Google Scholar
de Araújo Lucas, G, Laudanna, A, Chopard, RP, Raffaelli, E. Anatomy of the lesser occipital nerve in relation to cervicogenic headache. Clin Anat. 1994;7(2):90–96. https://doi.org/10.1002/ca.980070207.CrossRefGoogle Scholar
Hunter, CR, Mayfield, FH. Role of the upper cervical roots in the production of pain in the head. Am. J. Surg. 1949;78(5):743–751. https://doi.org/10.1016/0002–9610(49)90316–5 .CrossRefGoogle ScholarPubMed
Bogduk, N, Marsland, A. On the concept of third occipital headache. J. Neurol. Neurosurg. Psychiatry. 1986;49(7):775–780. https://doi.org/10.1136/jnnp.49.7.775.CrossRefGoogle ScholarPubMed
Narouze, S. Occipital neuralgia diagnosis and treatment: The role of ultrasound. Headache. 2016;56(4):801–807. https://doi.org/10.1111/head.12790.CrossRefGoogle ScholarPubMed
Ehni, G, Benner, B. Occipital neuralgia and the C1-2 arthrosis syndrome. J. Neurosurg. 1984;61(5):961–965. https://doi.org/10.3171/jns.1984.61.5.0961.CrossRefGoogle ScholarPubMed
Kapoor, V, Rothfus, WE, Grahovac, SZ, Amin Kassam, SZ, Horowitz, MB. Refractory occipital neuralgia: preoperative assessment with CT-guided nerve block prior to dorsal cervical rhizotomy. AJNR. Am. J. Neuroradiol. n.d.;24(10):2105–2110.Google Scholar
Finiels, P-J, Batifol, D. The treatment of occipital neuralgia: Review of 111 cases. Neuro-Chirurgie. 2016;62(5):233–240.CrossRefGoogle ScholarPubMed
Manolitsis, N, Elahi, F. Pulsed radiofrequency for occipital neuralgia. Pain Physician. n.d.;17(6):E709-E717.Google Scholar
Kastler, A, Attyé, A, Maindet, C et al. Greater occipital nerve cryoneurolysis in the management of intractable occipital neuralgia. J. Neuroradiol. 2018;45(6):386–390. https://doi.org/10.1016/j.neurad.2017.11.002.CrossRefGoogle ScholarPubMed
Ilfeld, BM, Preciado, J, Trescot, AM. Novel cryoneurolysis device for the treatment of sensory and motor peripheral nerves. Expert Rev. Med. Devices. 2016;13(8):713–725. https://doi.org/10.1080/17434440.2016.1204229.CrossRefGoogle ScholarPubMed
Hsu, M, Stevenson, FF. Wallerian degeneration and recovery of motor nerves after multiple focused cold therapies. Muscle & Nerve. 2015;51(2):268–275. https://doi.org/10.1002/mus.24306CrossRefGoogle ScholarPubMed
Vanelderen, P, Rouwette, T, de Vooght, P et al. Pulsed radiofrequency for the treatment of occipital neuralgia: a prospective study with 6 months of follow-up. Reg. Anesth. & and Pain Med. n.d.;35(2):148–151. https://doi.org/10.1097/aap.0b013e3181d24713.CrossRefGoogle Scholar
Jose, A, Nagori, SA, Chattopadhyay, PK, Roychoudhury, A. Greater occipital nerve decompression for occipital neuralgia. J. Craniofac. Surg. 2018;29(5):e518–e521. https://doi.org/10.1097/SCS.0000000000004549.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×