Occipital Neuralgia

What is Occipital Neuralgia?

Occipital neuralgia is pain that affects the occipital nerves. These nerves are located on each side of the head and are responsible for transmitting sensations from the top and back of the head. There are two occipital nerves and they run from the cervical bones at the top of the neck to the scalp. If the occipital nerves become irritated or damaged, this can cause a sudden pain, tingling sensation or electric-shock type feeling on one side of the scalp.

What is the cause of occipital neuralgia?

Most cases of occipital neuralgia are spontaneous, but pain may also result from a trapped nerve in the neck, underlying conditions (such as arthritis) or previous injury to the skull. In some cases, tightness in the muscles can result in an increased risk of nerve compression.

How common is occipital neuralgia?

Occipital neuralgia is rare. However, headaches and migraines, which can have an effect on the occipital nerves, are much more common. In cases where migraines contribute to pain on one side of the scalp, it can be difficult to reach a diagnosis. However, the patient is usually diagnosed with migraines that implicate the greater occipital nerve, rather than occipital neuralgia.

Diagnosing and treating occipital neuralgia

Occipital neuralgia is usually diagnosed using a procedure called an occipital nerve block, which also provides temporary treatment. If the patient responds well to the procedure, a more permanent solution may be recommended. The aim of the procedure is to cut the nerve and heat it using radio-wave energy.

It is common for the procedure to produce a loss of sensation in the scalp when the nerve is deadened. However, it is possible to avoid permanent numbness by adapting the procedure to decompress the nerves and any involved muscle tissue to ease symptoms whilst also preserving the occipital nerve. It may also be possible to fit a device similar to a pacemaker to help stimulate activity without causing any pain.

Surgical treatment for occipital neuralgia involves risks and any potential risks of procedures should be clearly outlined before the patient agrees to go ahead with treatment. In some cases, it may be preferential to try medication to suppress nerve activity before opting for surgical treatment.

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