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Definition of Occipital
Neuralgia
is a term used to describe a cycle of pain-spasm-pain
originating from the suboccipital area (base) of the skull
that often radiates to the back, front, and side of the
head, as well as behind the eyes.
Description of Occipital Neuralgia
The occipital nerves are two pairs of nerves that originate
in the area of the second and third vertebrae of the neck.
While most people's nerve roots originate in similar places
on the spine, cadaver studies show a wide variety of differences
between individuals as to the course of the nerves once
they leave the spinal column. Often the nerves follow
a curving course that passes through various muscles in
the upper back, neck and head.
These nerves supply areas of the skin along the base of
the skull and partially behind the ear. While the occipital
nerves do not directly connect with structures within
the skull itself, they do interconnect with other nerves
outside of the skull and form a continuous neural network
that can affect any given area through which any of the
main nerves or their branch fibers pass.
Causes and Risk Factors of Occipital
Neuralgia
It occurs more often in women than men. It can have many
causes such as trauma (a direct blow or "whiplash");
spinal column compression; nerve lesions; localized infections
or inflammation; blood vessel inflammation; and local
tumors.
Commonly, the nerves are inflamed and sensitive because
they are trapped within the muscles through which they
pass. Muscle spasm and pain are often associated with
nerve entrapment, which causes localized pain, spasm and
muscle cramping.
Symptoms of Occipital Neuralgia
Symptoms include the following:
Headaches that are localized or following a "ram's
horn" pattern on the side of the
head,
often starting in the upper neck or base of the skull.
It can be one-sided or on
both
sides.
Scalp that is tender to the touch, often hypersensitive.
Even brushing your hair can be a
painful
experience.
Pain or pressure behind the eyes. Eyes are very sensitive
to light especially when the
is
present.
Treatment of Occipital Neuralgia
Treatment may involve oral medications that are designed
to reduce inflammation and spasms, localized therapeutic
injections, physical therapy, massage, and heat. Occasionally
implanted peripheral nerve stimulators are used for refractory
cases.
Occipital Nerve Block
These are simple local anesthetic blocks that can be performed
in the doctors office. These are excellent for diagnostic
purposes and can often provide profound short term relief
of severe headache pain. A small amount of bupivicaine,
usually mixed with some triamcinolone, is injected under
the skin at the back of the head off to one side. This
will usually cause transient numbness of the side of the
forehead on which it is injected. If this is accompanied
by relief of the headache then a diagnosis of occipital
neuralgia is made. |
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