Occipital Neuralgia
Occipital Neuralgia is a condition characterized by chronic pain originating from the occipital nerves, which run from the base of the skull to the scalp. These nerves transmit sensory information, and when they become irritated or inflamed, it results in sharp, shooting pain, usually at the back of the head and neck, but sometimes extending to the scalp, forehead, or behind the eyes.
ICHD3 diagnostic criteria
https://ichd-3.org/13-painful-cranial-neuropathies-and-other-facial-pains/13-4-occipital-neuralgia/
Description:
Unilateral or bilateral paroxysmal, shooting or stabbing pain in the posterior part of the scalp, in the distribution(s) of the greater, lesser and/or third occipital nerves, sometimes accompanied by diminished sensation or dysaesthesia in the affected area and commonly associated with tenderness over the involved nerve(s).
Diagnostic criteria:
Unilateral or bilateral pain in the distribution(s) of the greater, lesser and/or third occipital nerves and fulfilling criteria B-D
Pain has at least two of the following three characteristics: Recurring in paroxysmal attacks lasting from a few seconds to minutes severe in intensity shooting, stabbing or sharp in quality.
Pain is associated with both of the following: dysaesthesia and/or allodynia apparent during innocuous stimulation of the scalp and/or hair either or both of the following:
- a) tenderness over the affected nerve branches
- b) trigger points at the emergence of the greater occipital nerve or in the distribution of C2
Pain is eased temporarily by local anaesthetic block of the affected nerve(s)
Not better accounted for by another ICHD-3 diagnosis.
Symptoms:
Radiating Pain: The pain may radiate toward the scalp, forehead, or behind the eyes.
Tender Scalp: The scalp may be extremely sensitive to touch, making it painful to brush hair or even wear a hat.
Other Symptoms:
Pain Triggered by Movement: Neck movements, especially turning or bending the head, can exacerbate the pain.
Throbbing, Aching Pain: In addition to the sharp pain, some patients may experience a more constant aching or throbbing sensation in the base of the skull or upper neck.
Sensitivity to Light: In some cases, bright lights may increase the discomfort, similar to a migraine.
Causes:
- Nerve Compression: The occipital nerves can become compressed or irritated by surrounding muscles or tissues, especially in the upper neck.
- Neck Tension or Strain: Tight or strained neck muscles, often due to poor posture, prolonged computer use, or repetitive motions, can put pressure on the occipital nerves.
- Injury or Trauma: Head or neck injuries, such as whiplash from a car accident, can damage or irritate the occipital nerves.
- Cervical Arthritis or Disc Degeneration: Osteoarthritis or other degenerative changes in the cervical spine may affect the occipital nerves.
- Nerve Inflammation: Inflammation due to conditions like diabetes, infections, or vasculitis can lead to occipital neuralgia.
- Tumors or Lesions: In rare cases, tumors or lesions near the occipital nerves may be the cause of the pain.
Other Conditions
