Occipital neuralgia is a distinct type of headache
characterized by piercing, throbbing, or electric-shock-like
chronic pain in the upper neck, back of the head,
and behind the ears, usually on one side of the head.
Typically, the pain of occipital neuralgia begins
in the neck and then spreads upwards. Some individuals
will also experience pain in the scalp, forehead,
and behind the eyes. Their scalp may also be tender
to the touch, and their eyes especially sensitive
to light. The location of pain is related to the areas
supplied by the greater and lesser occipital nerves,
which run from the area where the spinal column meets
the neck, up to the scalp at the back of the head.
The pain is caused by irritation or injury to the
nerves, which can be the result of trauma to the back
of the head, pinching of the nerves by overly tight
neck muscles, compression of the nerve as it leaves
the spine due to osteoarthritis, or tumors or other
types of lesions in the neck. Localized inflammation
or infection, gout, diabetes, blood vessel inflammation
(vasculitis), and frequent lengthy periods of keeping
the head in a downward and forward position are also
associated with occipital neuralgia. In many cases,
however, no cause can be found. A positive response
(relief from pain) after an anesthetic nerve block
will confirm the diagnosis.
Treatment is generally symptomatic and includes massage
and rest. In some cases, antidepressants may be used
when the pain is particularly severe. Other treatments
may include local nerve blocks and injections of steroids
directly into the affected area.
In some patients that do not improve with conservative
managements, surgery may be considered. Two procedures
are available to help treat this painful condition.
Occipital nerve stimulation involved placement od
a small electrode overlying the nerve. An electrical
current is applied which may to maks the pain in this
region. Other patients may undergo resection of this
nerve. Both procedures may be very helpful in reducing
pain and disability.
Neurological Surgery,
P.C. of Long Island, New York and New York
City (Queens) is one of the largest private
practices for neurological surgery in the
NYC and NY/NJ/CT Tri-State area, offering
patients the most advanced treatments of
brain and spine disorders, using minimally
invasive procedures like Gamma Knife, Cyber
Knife, Microdiscectomy, Spinal Stimulators, Kyphoplasty, X-Stop,
Carotid Stenting, Aneurysm Coiling and Interventional
Pain Management.
