This book describes Occipital Neuralgia, Diagnosis and Treatment and Related Diseases
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 patients 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
Causes
Occipital neuralgia happens when there is pressure or irritation to the occipital nerves due to:
- An injury,
- Tight muscles that entrap the nerves,
- Inflammation.
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.
Occipital neuralgia is also linked with: - Localized inflammation or infection,
- Gout,
- Diabetes,
- Blood vessel inflammation (vasculitis), and
- Frequent lengthy periods of keeping the head in a downward and forward position.
In many cases, however, no cause can be found.
Symptoms
Occipital neuralgia can cause intense pain that feels like a sharp, jabbing, electric shock in the back of the head and neck.
Other symptoms are: - Aching, burning, and throbbing pain that typically starts at the base of the head and goes to the scalp
- Pain on one or both sides of the head
- Pain behind the eye
- Sensitivity to light
- Tender scalp
- Pain when the neck is moved
The most frequent occipital neuralgia symptoms are: - Sudden, severe, and sharp head pain
- Pain that happens most frequently behind the eye, at the base of the head, and on one side of the head
- Blurry vision
- Dizziness
- Vertigo
- Slurred speech
- Nausea
- Vomiting
- Tightness and pain in the neck
- Dental pain
Diagnosis:
The doctor can diagnose this disorder by: - Reviewing the notes and potential triggers noted in the history
- Conducting a thorough physical exam, including palpation of the occipital nerve area
- Ordering other diagnostic tests as needed, such as MRIs, CT scans, X-rays, or blood tests
- Performing a diagnostic occipital nerve block
Treatments
Treatment starts with diagnosis, continues with preventative efforts, and includes both interventional and complementary therapies to treat pain.
The first thing is to relieve the pain.
Home treatment: - Apply gentle heat to the neck.
- Rest in a quiet room.
- Massage gently the tight and painful neck muscles.
- Take over-the-counter anti-inflammatory drugs, like naproxen or ibuprofen.
If those do not help to relieve the pain, the doctor may prescribe medications, such as: - Prescription muscle relaxants
- Anti-seizure drugs, such as carbamazepine and gabapentin
- Antidepressants
- Nerve blocks and short term steroid injections
A surgical operation is rarely advisable but it might be a choice if the pain does not get better with other treatments or recurs.
Possible surgery methods may be: - Micro-vascular decompression.
The doctor may be able to relieve pain by moving the blood vessels compressing the nerve. - Occipital nerve stimulation.
The doctor uses a device called a neuro-stimulator to stop pain messages to the occipital nerves.
TABLE OF CONTENT
Introduction
Chapter 1 Occipital Neuralgia
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Trigeminal Neuralgia
Chapter 8 Migraine Headaches
Epilogue
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