Occipital Neuralgia

Occipital Neuralgia is a sub classification of headaches. In this condition usually occipital nerves i.e. GON (greater occipital nerve), LON (Lesser occipital nerve) and/or TON (Third occipital nerve) gets inflamed and causes headaches travelling with in their pathways usually upwards starting from the base of head to the side of scalp and behind the ears.

It is a rare condition in which patient would report sharp, stabbing headache with shock like sensation.

Causes- Occipital neuralgia is sub-classified into 2 types;-

1. Primary Occipital neuralgia-Primary neuralgia could be due to pinched nerve, muscular tightness or head and neck injury resulting into compression of GON , LON and/or TON.
2. Secondly Occipital neuralgia- Secondly occipital neuralgia usually present resulting to an underlying disease, I.E-

• • OA of upper cervical spine
  • secondry to direct trauma to occipital nerve/s
  • Degenerative disk resulting into compression of the nerve roots.
  • systemic conditions like Gout, Diabetes, infection, cancer, vascular inflamation

Symptoms-

usually patient reports intense severe symptoms like constant sharp, shocking and stabbing pain travelling from neck to the side of head and behind the ears, pain often reffres to behind the orbital socket on ipsilateral side of neural involvement and aggravates due to touch or combing/brushing the hair as well due to cutaneous supply of occipital nerves.

Patient reports pain symptoms alike migraines, Tension type or cluster headaches so good DD is a must to identify the cause.

Testing and Diagnosis;-