What is the role of occipital neuralgia in the etiology of facial pain and headache?

Updated: Jan 29, 2020
  • Author: Tejas Raval, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

Answer

This occurs in the suboccipital region following the distribution of the greater or lesser occipital nerves. It can occur secondary to trauma to the nerves, arthritic changes to the cervical spine, or compression from tumor. Anticonvulsants, antidepressants, local nerve blocks, and surgical cervical root sectioning have all been described as treatments for idiopathic cases. [29, 35]  

A study by Hoffman et al found that at 1 month postprocedure, patients who underwent thermal radiofrequency ablation for occipital neuralgia reported a mean 76.3% pain relief, with reduction in pain lasting a mean 6.5 months. [36]

A study by Martínez-Pías et al of patients visiting a tertiary hospital’s headache outpatient clinic found that out of 5515 patients, just 68 (1.2%) were diagnosed with occipital neuralgia. The investigators also found the latency period between symptom onset and diagnosis of this condition to be 27.7 ± 56.1 (1-360) months, indicating a need for increased awareness of occipital neuralgia. [37]


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