Presentation
[…] guez-Borrego MA 2018 12 Cervical myelitis presenting as occipital neuralgia. ( 29124999 ) Noh S.M....Kang H.G. 2017 13 Modified posterior C1 lateral mass screw insertion for type II odontoid process fractures using intraoperative CT-based spinal navigation [malacards.org]
Abstract The primary purpose of this case report is to outline the diagnosis, intervention and clinical outcome of a patient presenting with occipital neuralgia. [ncbi.nlm.nih.gov]
J Neurol 2002 ; 249 ( 10 ): 1464 – 5. 7 Greater occipital neuralgia: An unusual presenting feature of neurosyphilis. Headache 1987 ; 27 : 552 – 4. 8 C2 myelitis presenting with neuralgiform occipital pain. [academic.oup.com]
On physical examination, a positive Tinel sign may be present with tenderness to percussion or palpation along the course of the occipital nerves. [practicalneurology.com]
Entire Body System
- Pain
and referred fronto-orbital pain. [practicalneurology.com]
In: Pain-Clinicl Aspects and Therapeutical Issues. Part I, Eds: B. Kepplinger. [pain-manage.org.tw]
Diagnostic criteria: Unilateral or bilateral pain in the distribution(s) of the greater, lesser and/or third occipital nerves and fulfilling criteria B-D Pain has at least two of the following three characteristics: recurring in paroxysmal attacks lasting [ichd-3.org]
Cervico-Occipital Neuralgia Pain Treatment in Indianapolis & Columbus Safe, Effective Treatments for Pain A type of headache called cervico-occipital pain, or occipital neuralgia, is characterized by piercing, throbbing, or shock-like sensations in the [americanpainconsortium.com]
The pain might be one-sided or bilateral (located on both sides of the head). The pain might be sharp or stabbing, or feel like an electric shock along the nerve. Sometimes that pain is a dull aching or throbbing. [medicinenet.com]
- Epilepsy
Chief Editor Jonathan P Miller, MD Director, Functional and Restorative Neurosurgery, Director of Epilepsy Surgery, Attending Neurosurgeon, University Hospitals Cleveland Medical Center; Director, Functional and Restorative Neurosurgery Center, UH Cleveland [emedicine.medscape.com]
Soon, following the introduction of carbamazepine for treatment of epilepsy, controlled trials were published showing its superiority over placebo in trigeminal neuralgia. [medlink.com]
They are given in doses similar to used for epilepsy, but more leeway is given to the patient in adjusting the dose up and down, depending on the amount of activity of the neuralgia. Sodium Valproate has also been used for this purpose. [dizziness-and-balance.com]
- Fever
Both of these causes can be serious, so it is important for people to talk to their doctors if they find a lump on their neck or throat, or if they have persistent fever with trouble swallowing and a sore throat that isn’t going away. [verywellhealth.com]
Workers in paints and metal-workers are also quite likely to attacks of neuralgia, while rheumatism, gout, chronic nephritis, diabetes, and the infectious fevers favor neuralgia. [henriettes-herb.com]
"Red flags" Sudden onset of a new severe headache; A worsening pattern of a pre-existing headache in the absence of obvious predisposing factors; Headache associated with fever, neck stiff ness, skin rash, and with a history of cancer, HIV, or other systemic [physio-pedia.com]
- Anemia
[…] to have some influence in giving rise to neuralgia, it frequently occurring in hysterical and epileptic families; in fact, the general physical condition predisposes to neuralgia, and persons reduced by sickness, severe physical or mental exertion, anemia [henriettes-herb.com]
Today the diagnosis is similar to that of unspecified anemia. We are unfortunately forced to live with this poorly defined d iagnosis until further research clarifies matters. [usdoctor.com]
- Chills
It is predisposed to acute attacks of pain since minor overstretching, overuse or chilling of the muscle may suffice to reactivate it. Both latent and active trigger points cause dysfunction, but only active trigger points cause pain. [usdoctor.com]
Ears
- Tinnitus
The pain was sometimes associated with tearing of the eye and nasal congestion on the left side but no tinnitus. [pain-manage.org.tw]
Additional symptoms of ON include: Light sensitivity Dizziness and lightheadedness Vertigo (a sensation of spinning) Tender scalp Slurred speech Nausea and/or vomiting Tightness and/or stiffness in the neck Dental pain Blurry vision Nasal congestion Tinnitus [verywellhealth.com]
Cervical instability wears many disguises Did you know there is a cluster of symptoms including migraines, facial pain, ear pain, vertigo, tinnitus, loss of voice, hoarseness, neck pain, and severe fatigue that can often be attributed to cervical instability [swfhealthandwellness.com]
Eagle syndrome occurs when an elongated styloid process or calcified stylohyoid ligament serves to irritate the tonsillar bed, classically resulting in cervicofacial pain, dysphagia, tinnitus, and otalgia precipitated by talking, yawning, or swallowing [ajnr.org]
Musculoskeletal
- Neck Pain
Thus, it appears that subsequent four sessions of DN over two weeks, our patient experienced meaningful improvement in her neck pain and headaches. [ncbi.nlm.nih.gov]
Coding for Neck Pain Neck pain (Cervicalgia), along with Back and Low Back Pain, Shoulder Pain, and Knee Pain, is a very common chief complaint for orthopedic patient’s. [icd10orthocoder.com]
Shared clinical features include occipital headache, neck pain, and fronto-orbital pain. Local anesthetic blocks have a dual role in providing diagnostic support and therapeutic relief. [practicalneurology.com]
Patients with this type of headache may have increased pain when moving their neck. [medicinenet.com]
Figure 1 Headaches and neck pain If you have neck pain followed by a tension or migraine headache, then the source may very well be coming from your neck. Lax ligaments in the neck can lead to instability of the spine. [swfhealthandwellness.com]
Face, Head & Neck
- Tenderness of the Scalp
Some people may also have pain in forehead, scalp, and behind eyes and there maybe tenderness in the scalp and eyes become sensitive to light. [epainassist.com]
Some migraines or cluster headaches Spondylosis of the cervical facet joints A tender or painful scalp, which may be a sign of an inflamed nerve The Occipital Nerve Block Procedure The animation below shows an occipital nerve block being done. [cedars-sinai.edu]
Neurologic
- Neuralgia
[…] occipital nerve: An uncommon cause of occipital neuralgia. ( 26752925 ) 2015 47 Cryoablation for the treatment of occipital neuralgia. ( 26000683 ) 2015 48 Nurse-led treatment for occipital neuralgia. ( 26455130 ) 2015 49 Occipital neuralgia as a sequela [malacards.org]
neuralgia and additional synonyms M54.81 Occipital neuralgia Synonyms: Cervico-occipital neuralgia|Cervico-occipital neuralgia (finding) All content of the ICD-10 CM Search is based on the classifications and codes of the Centers for Medicare and Medicaid [averbis.com]
Discussion Several authors have described the clinical syndrome of occipital neuralgia. Occipital neuralgia is not an uncommon cause of protracted or severe intractable headache. [pain-manage.org.tw]
Clinical Features Occipital Neuralgia Occipital neuralgia, as defined by the International Classification of Headache Disorders 3rd edition (ICHD-3),1 is described as unilateral or bilateral paroxysmal pain in the distribution of the greater, lesser, [practicalneurology.com]
- Headache
Occipital neuralgia and cervicogenic headache are causes of posterior-predominant headache treated in the outpatient setting. [practicalneurology.com]
Headache classification Committee of the International Headache Society. Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia 1988;8:61-71 4. Ehni G, Benner B. [pain-manage.org.tw]
The purpose of Chronic Daily Headache for Clinicians is to provide a practical guide for clinicians to both understand and manage patients with frequent headache. [books.google.com]
This book covers all you need to know in order to understand: The causes and treatment approaches for the various different types of headaches including migraines, tension headaches, cluster headaches Different types of neuralgias including Trigeminal [bokus.com]
- Dizziness
Other symptoms can include dizziness and nausea. Occipital neuralgia is the neck/head pain that results from injury or irritation to the occipital nerves. [treatingpain.com]
All patients experienced transient nausea and dizziness in the several days following surgery. One patient had an incisional cerebrospinal fluid leak. [link.springer.com]
Side effects most commonly encountered include dizziness, lightheadedness, and injection site soreness. For cases that are difficult to control, pulsed radiofrequency and occipital nerve stimulation are procedures that have shown some benefit. [americanmigrainefoundation.org]
Additional symptoms of ON include: Light sensitivity Dizziness and lightheadedness Vertigo (a sensation of spinning) Tender scalp Slurred speech Nausea and/or vomiting Tightness and/or stiffness in the neck Dental pain Blurry vision Nasal congestion Tinnitus [verywellhealth.com]
- Aura
You can call the headache whatever you like - migraines without aura, CH, George - the names are irrelevant. [peledplasticsurgery.com]
Cervicogenic headache, migraine without aura and tension-type headache. Diagnostic blockade of greater occipital and supra-orbital nerves. Pain 1992; 51: 43-48. 10) Gawel MJ, Rothbart PJ. [pathos-journal.com]
Tension Bilateral Mild-Moderate >15day/mo, >3 mo Hours-continuous Pressing, tightening Migraine without aura Unilateral: Frontotemporal in adults, Occipital in children Moderate-Severe >14 days/month 4-72 hours Flickering lights/spots in vision, pulsating [physio-pedia.com]
She had a positive past medical history for migraine without aura. In March 2005, two weeks after a neck soft tissue trauma, she started experiencing daily headache attacks without periodicity. [scielo.br]
- Vertigo
Additional symptoms of ON include: Light sensitivity Dizziness and lightheadedness Vertigo (a sensation of spinning) Tender scalp Slurred speech Nausea and/or vomiting Tightness and/or stiffness in the neck Dental pain Blurry vision Nasal congestion Tinnitus [verywellhealth.com]
Cervical instability wears many disguises Did you know there is a cluster of symptoms including migraines, facial pain, ear pain, vertigo, tinnitus, loss of voice, hoarseness, neck pain, and severe fatigue that can often be attributed to cervical instability [swfhealthandwellness.com]
Some patients with occipital neuralgia also have dizziness, presumably due to a variant of cervical vertigo. See our cervical vertigo page for more about this complicated subject. [dizziness-and-balance.com]
Vasculitis, or blood vessel inflammation Overuse injuries caused by keeping the head in a down or forward position Occipital neuralgia symptoms include: Chronic headaches Pain behind the eye, on one side of the head Blurry vision Dental pain Dizziness Vertigo [paindoctor.com]
Workup
Which is why Parker stressed the need for a medical workup first to eliminate any causes that require medical procedures first, such as tumors, vascular diseases, or infections. "And then they need to come see us," he added. [birminghammedicalnews.com]
Key points • For several cranial neuralgias, the diagnostic workup should include structural imaging with MRI with and without contrast to evaluate for evidence of inflammation or space-taking lesions, vascular imaging consisting of either MRA or CTA [medlink.com]
Treatment
[…] of occipital neuralgia for nonsurgical candidates. ( 28517492 ) 2017 23 Occipital Nerve Stimulation for the Treatment of Refractory Occipital Neuralgia: A Case Series. ( 28634063 ) 2017 24 The treatment of occipital neuralgia: Review of 111 cases. [malacards.org]
Occipital Nerve Stimulation for the Treatment of Patients With Medically Refractory Occipital Neuralgia. [aans.org]
Treatments for occipital neuralgia and trigeminal neuralgia Many treatments focus on pain management, although there are surgical treatments that can possibly provide more lasting relief. [paindoctor.com]
Some people may need more aggressive treatments, but surgery is rarely the right treatment option for ON. [verywellhealth.com]
Prognosis
Occipital headaches have a good prognosis and treatments have proved to work in even the severest cases. [bokus.com]
Group II is typically a painful postganglionic Homer syndrome with a self-limited course and excellent prognosis ( Salvesen 1999 ). Burning mouth syndrome. [medlink.com]
Etiology
Headaches should have a temporal relationship to the cervical spine disorder and improve in parallel with treatment of the underlying etiology. [practicalneurology.com]
Etiology It is usually idiopathic in nature. [practicalpainmanagement.com]
Evans RW, Garibay A, Foroozan R Etiology and Treatment Modalities of Occipital Artery Aneurysms. [medicbind.com]
Using “pattern recognition”, many headache etiologies can be quickly identified, and then treated with ultrasound-guided injections that diagnose and treat the underlying condition. [apicareonline.com]
Etiology .— Predisposing Causes .—Neuralgia is a disease of middle life, being very rare in children or persons of extreme age, and occurs in men more frequently than in women, though females of a neurotic temperament are quite often affected. [henriettes-herb.com]
Epidemiology
Epidemiology of occipital neuralgia. Occipital neuralgia is very uncommon, at least as compared to migraine. [dizziness-and-balance.com]
Epidemiology/Etiology Of all chronic headaches, the incidence of cervicogenic headache has been estimated to be 14-18%, though in a recent population-based study a 2.2% prevalence was found [7]. [physio-pedia.com]
Vaga study of headache epidemiology. Cephalalgia. 2005;25(4):296-304. [PubMed] [Free full text] Andersen NB, Bovim G, Sjaastad O. The frontotemporal peripheral nerves. [apicareonline.com]
Pathophysiology
Pathophysiology of Occipital Neuralgia or C2 Neuralgia The pathophysiology of Occipital Neuralgia or C2 Neuralgia is unknown although it may by secondary to whiplash injuries as well as systemic or local diseases. [epainassist.com]
Since occipital neuralgia is pathophysiologically seen as a cervico-occipito-trigeminal complex, C2 spinal ganglion block therefore is an effective interventional procedure to differentiate the complicated causes of occipital pain including C1-C3 root [pain-manage.org.tw]
Treatment should be targeted to the underlying pathophysiology and may require nonpharmacologic therapies, medical management, and interventional and surgical measures. ACY reports no disclosures [practicalneurology.com]
So rather than performing destructive procedures such as cutting the nerve which leads to numbness, this new innovative procedure addresses the underlying pathophysiology and removes whatever may be pressing on the C-2 nerve root. [drjho.com]
Cervicogenic headache: anatomic basis and pathophysiologic mechanisms. Curr Pain Headache Rep. 2001; 5 :382–386. [ PubMed ] [ Google Scholar ] 23. Le Doaré K, Akerman S, Holland PR, Lasalandra MP, Bergerot A, Classey JD, Knight YE, Goadsby PJ. [ncbi.nlm.nih.gov]
Prevention
Treatable - 0% Emergent - ED Care Needed - Preventable/Avoidable - 0% Emergent - ED Care Needed - Not Preventable/Avoidable - 0% Primary diagnosis of injury 0% Primary diagnosis of mental health problems 0% Primary diagnosis of substance abuse 0% Primary [medicbind.com]
Nerve block injections may help to prevent pain associated with ON. A physical therapist can teach individuals exercises to help prevent occurrences and for getting through painful and symptomatic episodes of ON. [verywellhealth.com]
Nonetheless, the condition can be quite debilitating and can prevent sufferers from maintaining employment as a result. [disability-benefits-help.org]
Can occipital neuralgia headache be prevented? In many cases, the cause of occipital neuralgia is not found so it's difficult to determine how to prevent this condition. [medicinenet.com]
Preventive monotherapies (verapamil, valproate and steroids) previously prescribed by other physicians had been ineffective. [scielo.br]