What Is Occipital Neuralgia?

Occipal neuralgia is paroxysmal severe pain, located in the occipital and posterior neck, radiating to the top of the head (large occipital nerve), mastoid process (small occipital nerve), and external ear (large auricular nerve), along the nerve The traveling upper neck is occasionally tender. The nature of the pain is mostly persistent dull pain, with paroxysmal aggravation, and intermittent episodes. Head and neck movements, pain during coughing and sneezing.

Basic Information

English name

occiptal neuralgia

Visiting department

Neurology

Common causes

Caused by large occipital and small occipital nerves

Common symptoms

Paroxysmal severe pain in the occipital and back neck, radiating to the top of the head, mastoid process, and outer ear

Causes of occipital neuralgia and common diseases

Occipital neuralgia is caused by large occipital and small occipital nerves. Occasionally, it can be caused by damage to the large auricular nerve, cervical cutaneous nerve, or supraclavicular nerve. It can also be caused by upper cervical spondylosis, intraspinal lesions, congenital malformations of the occipital region, and spinal tuberculosis , Spinal cord tumors, osteoarthritis, metastatic tumors, upper respiratory infections, tonsillitis, influenza, rheumatism and diabetes.

Differential diagnosis of occipital neuralgia

Third occipital nerve headache (thirdoccipitalnerveheadache) is unilateral occipital and suboccipital pain, which is the main symptom of patients with neck pain, especially the neck pain that occurs after whiplash-like injury, the incidence rate can reach 27%. Bogduk and Marsland (1986) believe that this headache is caused by C ₂ -C ₃ degenerative joint disease or post-traumatic joint disease that compresses the C ₃ nerve branch.

Occipital neuralgia examination

1. There are often tenderness under the occipital bulge, tenderness of the occipital and small occipital nerve pathways, and occipital nerve distribution area may have hypersensitivity or mild loss of sensation, other neurological signs are rare.

2. X-ray imaging, CT, MRI and other imaging examinations are helpful to determine the cervical occipital region lesions.

Occipital neuralgia treatment principles

Drug treatment

With vitamin B drugs, carbamazepine or phenytoin sodium can be used in cases of obvious pain.

2. Closed treatment

Symptoms can be relieved if 1% to 2% nuevocaine plus vitamin B12 is closed at the supraorbital notch.

3. Physical therapy

Acupuncture treatment is available, using traditional acupoints or tender points. Local physiotherapy, such as infrared therapy, ultra-short wave therapy, hot medicine and so on. Patients with mild cervical trauma or proliferative cervical spondylosis can be treated with cervical traction.

4. Chinese medicine treatment

According to the cause of the disease, a combination of dialectical identification and dialectical methods is used, which is orally taken with proprietary Chinese medicine or decoction.

5. Surgery

Suitable for severe cases, but the success rate of surgery is not high.