Occipital neuralgia

A process of shooting or burning pain storing in the back of the head and radiating over the crown of the scalp, and sometimes to the forehead. 



Patients commonly complaining of pain behind the eyes, sometimes associated with photophobia.



The pain can be continuous, intermittent, or both. 



Patient may have tenderness over the effective distribution of the scalp, and pain can be triggered by neck range of motion. 



Pain follows the distribution of the greater and lesser occipital nerves. 



The greater occipital nerve is formed by the C2 dorsal ramus and the lesser occipital nerve by the ventral rami of C2 and C3.



Causes of occipital neuralgia include: myofascial pain of the neck, cervical osteoarthritis, neck injury, or other neck lesions. 



Risk factors include: gout, diabetes, and vasculitis.



Management includes physical therapy, nonsteroidal anti-inflammatory drugs, muscle relaxants, and antiepileptic drugs.



High cervical blocks can be used in intractable cases and surgical intervention with microvascular decompression of the occipital nerves along with peripheral neurostimulator can be utilized.


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