2009-11-13 14:41:08 -

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Episodes of pain may occur in the back of the head and upper neck. When these are related to tenderness or inflammation of the nerves supplying this area, the greater and lesser occipital nerves, the condition of occipital neuralgia may occur.

Causes of Occipital Neuralgia


Irritation of the occipital nerves may occur as the nerve emerges from underneath the neck muscles. These

same nerves may also be compressed at their origin in the neck, most commonly the C2 nerve roots.

Signs and Symptoms of Occipital Neuralgia


Occipital neuralgia produces pain in the back of the head. It may radiate forward or into the neck. Although the pain is episodic, it may last for extended periods of time.


Treatment is usually a mix of the following approaches:

1. Anti-inflammatory medicines
* Indomethacin
* Diclofenac
* Ibuprofen
* Cox-II inhibitors
2. Anti-convulsants
* Gabapentin
* Pregabalin
* Carbamazepine (Tegretol)
3. Nerve block injection

A nerve block usually consists of a mix of 40-80 mg of methylprednisolone and lidocaine or bupivicaine which is injected around the entry points of the greater occipital nerves. Local hair loss is the only commonly reported side-effect (about 2% risk). If the person with occipital neuralgia symptoms has diabetes, their blood sugar may increase in the week following methylprednisolone injection.

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