What Is Occipital Nerve Stimulation?

Small occipital nerve: one of the branches of the cervical plexus of the small occipital nerve. This nerve runs along the posterior edge of the sternocleidomastoid muscle to the skin of the pillow. Such nerve damage causes impaired sensory function of the occipital skin.

Small occipital nerve: one of the branches of the cervical plexus of the small occipital nerve. This nerve runs along the posterior edge of the sternocleidomastoid muscle to the skin of the pillow. Such nerve damage causes impaired sensory function of the occipital skin.

Chinese name

Occipital nerve

Foreign name

lesser occipital nerve

Overview of the small occipital nerve :

1. Great occipital nerve:

The posterior branch of the second cervical nerve is called the great occipital nerve. This nerve penetrates the trapezius tendon to the skin, and is distributed on the skin of the occipital region, and is a mixed nerve. Such nerve damage can impair the movement and sensation of its dominated area.

Small occipital nerve anatomy:

Small occipital nerve: The small occipital nerve is the fiber from the 2nd and 3rd cervical nerves, or from the neural crest in between. It is the uppermost branch of the cervical plexus, rising along the posterior edge of the sternocleidomastoid muscle, to the side of the head, and distributed in the skin behind the auricle, which dominates the posterior upper part of the auricle, the mastoid area, and the lateral area of the occipital area. At the same time, it is connected to the posterior auricular branch of the great auricular nerve, the occipital nerve and the facial nerve.

Diseases related to the occipital nerve:

1. Occipital neuralgia:

(I. Overview:

Occipital neuralgia is a collective term for occipital great neuralgia and small occipital neuralgia, which can be caused by stimulation of one or more nerves from the neck segment to IV. The main clinical symptoms are posterior occipital and posterior neck Department of pain. This disease is more common in adults.

Occipital neuralgia is pain under the occipital bone and the back of the head. The main causes are trauma to the major occipital nerve or small occipital nerve, osteoarthritis of the upper cervical spine compresses the occipital nerve or the upper cervical nerve root, and tumors in the spinal canal press C2 and 3 nerve roots. Pain is often persistent or exacerbated. The pain starts from the suboccipital region and radiates to the back of the scalp.

Influenza, infections, occipital trauma, and cervical disease of the first to fourth vertebrae such as vertebral arthritis, spinal tuberculosis, tumors, tumors in the occipital lobe and spinal cord cervical spinal cord and meningitis adhesions can invade or oppress the pillow Nerve, causing pain in the area it governs.

Modern medical treatment of this disease is mainly based on etiology treatment, analgesia, and closed treatment, such as indomethacin, ibuprofen, and procaine closed treatment.

(B) the main points of diagnosis:

(1) This disease is more common in adults. It is paroxysmal or persistent pain in one or both of the posterior occipital regions, with paroxysmal aggravation, and it can be radiated to the top or neck of the head. Head movement, cold, cough or sneezing May trigger or exacerbate pain. [1]

(2) There is obvious tenderness at the exit of the greater occipital nerve (about 3 cm outside the midpoint of the line between the two mastoid processes), which may be accompanied by hypersensitivity or mild hypothyroidism in the occipital nerve distribution area.

(3) There is no abnormality in the auxiliary examination. Corresponding examination abnormalities can be seen in those secondary to other diseases.

(4) The disease must be distinguished from migraine and intracranial infectious headache.

(3) Drug summary:

(1) Yanhusuo B injection: Yanhusuo contains 15 kinds of alkaloids, among which Yanhusuo A and B both have analgesic and sedative effects, especially Levo Yanhusuo B has obvious analgesic and sedative effects. It is a central inhibitor. Inhibits the reticular structure of the midbrain and the evoked potential in the lower thalamus, thereby reducing the pain threshold, and has the effects of promoting blood circulation and dissipating blood stasis, regulating qi and analgesics, and has good analgesic effect on pain caused by nerves.

(2) Procaine: Procaine is the most commonly used ester local anesthetic. The drug is quickly absorbed after being injected into the tissue and is non-irritating to the tissue. The drug is used for local infiltration, nerve block anesthesia, epidural anesthesia, spinal anesthesia, and can also be used for local closure.

2. Occipital and Occipital Nerve Blocks:

Definition: Occipital and small occipital nerve blocks are applicable to occipital and small occipital neuralgia and occipital myofascial pain syndrome.

(1) Applied Anatomy:

The occipital nerve consists of the main branch of the posterior branch of the C2 spinal nerve and the branch of the posterior branch of the C3 spinal nerve. This nerve penetrates a deep fascia at the level of the superior line, between the sternocleidomastoid muscle and the trapezius muscle, and is distributed on the skin behind and on the top of the pillow. The small occipital nerve is composed of the anterior branches of the C2 and 3 spinal nerves, which is a branch of the cervical plexus. It rises to the head along the upper posterior edge of the sternocleidomastoid muscle and penetrates the deep fascia. Laterally, it is distributed on the skin behind the ear pillow.

(Two) expansion method

Posture: The patient rides on the treatment chair, flexes his head forward, puts his forehead on the arms overlapping the back of the treatment chair, or takes a prone position, with a thin pillow on his chest.

Puncture method:

(1) Great occipital nerve block: At the midpoint of the line connecting the posterior occipital nodule and the mastoid tip, press with the tip of your thumb to find the radiation pain points to the top of the head and forehead, which is the puncture point. For conventional skin disinfection, use a No. 5 ball to insert the needle vertically into the skin. After reaching the occipital bone or when a radiation sensation occurs, draw back no blood and inject 3 to 5 ml of analgesic solution.

(2) Small occipital nerve block: fixed at the trailing edge of the sternocleidomastoid muscle attachment point behind the mastoid, the rest is the same as the large occipital nerve block. [2]

(Three) matters needing attention:

Avoid looking for nerve damage when looking for a different feeling.