Occipital Neuralgia

2018 ◽  
pp. 287-292
Author(s):  
Armin Deroee ◽  
Jianguo Cheng
Keyword(s):  
Nerve Block ◽  
Primary Headache ◽  
Headache Disorder ◽  
Cervicogenic Headache ◽  
Occipital Neuralgia ◽  
Occipital Nerve ◽  
Primary Headache Disorder ◽  
Greater Occipital Nerve ◽  
Occipital Nerve Block ◽  
Injection Pulse

Occipital neuralgia is a primary headache disorder characterized by intermittent, sharp stabbing occipital pain. Diagnosis is made by history, clinical examination, and positive response to anesthetic block of the greater occipital nerve. Occipital neuralgia should be differentiated from cervicogenic headache, migraines, and other causes of headaches as some of them may manifest with similar symptoms, including occipital pain and allodynia, and may also respond to occipital nerve block. Conservative treatment with physical therapy and low-dose antiepileptics or tricyclic antidepressants can be effective. Refractory cases may respond to occipital nerve block, Botox injection, pulse radiofrequency, or occipital nerve stimulation.

Case report of an alleviation of pain symptoms in hypnic headache via greater occipital nerve block

Cephalalgia ◽  
2016 ◽  
Vol 37 (10) ◽  
pp. 998-1000 ◽  
Author(s):  
Robert Rehmann ◽  
Martin Tegenthoff ◽  
Christian Zimmer ◽  
Philipp Stude
Keyword(s):  
Primary Headache ◽  
Headache Disorder ◽  
Oral Medication ◽  
Hypnic Headache ◽  
Occipital Nerve ◽  
Primary Headache Disorder ◽  
Greater Occipital Nerve Block ◽  
Greater Occipital Nerve ◽  
Pain Symptoms ◽  
Control Pain

Background Hypnic headache is a rare primary headache disorder with a few hundred described cases so far. Due to the fact that this headache disease is rare, there are no placebo-controlled oral medication studies. After all reported oral medication failed to control pain symptoms of a hypnic headache disease, we were able to reduce pain intensity and frequency via two greater occipital nerve (GON) blocks. Case We report on a 74-year-old patient diagnosed with hypnic headache in our headache outpatient department two years ago. Over a course of nine months none of the recommended oral drugs had an effect in pain alleviation and we decided to try an occipital nerve injection therapy. Two GON-blocks then led to a stable and significant pain reduction over the course of six months during monthly follow-ups. Conclusion GON block can be a successful therapeutic approach for the treatment of hypnic headache when oral medication fails.

scholarly journals The efficacy of ultrasound-guided multifidus cervicis plane block versus greater occipital nerve block for cervicogenic headache

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Zenat Eldadamony Mohamed ◽  
Carmen Ali Zarad ◽  
Mohamed E. Flifel ◽  
Ali A. Abou Elmaaty
Keyword(s):  
Nerve Block ◽  
Cervicogenic Headache ◽  
Invasive Technique ◽  
Ultrasound Guided ◽  
Occipital Nerve ◽  
Median Reduction ◽  
Greater Occipital Nerve Block ◽  
Greater Occipital Nerve ◽  
Significant Difference ◽  
Occipital Nerve Block

Abstract Introduction Traditionally, non-invasive and invasive techniques were used for the treatment of cervicogenic headache (CH). Greater occipital nerve block is the most frequent peripheral nerve block invasive technique used for the management of cervicogenic headache. The purpose of this prospective, double-blinded study was to compare the efficacy of two different techniques: multifidus cervicis plane block and greater occipital nerve block in the treatment of refractory cervicogenic headache by using ultrasound. Methods Sixty patients with cervicogenic headache were recruited and diagnosed according to the ICHD-III beta version. The patients were divided into two groups, one group was for greater occipital nerve block and the other group was for multifidus cervicis plane block with ultrasound-guided. Results Visual analog scale (VAS) was 2.09% in the multifidus cervicis plane block (MCPB) group and was 2.22% in the greater occipital nerve block (GONB) group with a median reduction of − 4.33 and − 3.048, respectively, at 2-week visits with a statistically significant difference better in the MCPB group (P < 0.001). At 4 weeks visits, VAS scale was better in the MCPB group than in the GONB group (3.79 and 4.44, respectively) with a median reduction in VAS scale (− 3.27 and − 3.095, respectively) and statistically significant differences between both groups (P = 0.020). Conclusion Both the ultrasound-guided multifidus cervicis plane block and greater occipital nerve block are effective as intervention techniques in the treatment of refractory cervicogenic headache. These techniques are simple, safe, more reliable with less side effects, and often reduce the requirements of analgesic drugs.

Greater occipital nerve block modulates nociceptive signals within the trigeminocervical complex

2021 ◽  
pp. jnnp-2021-326433
Author(s):  
Jan Hoffmann ◽  
Jan Mehnert ◽  
Elena M Koo ◽  
Arne May
Keyword(s):  
Nerve Block ◽  
Clinical Effects ◽  
Double Blind ◽  
Occipital Nerve ◽  
Randomised Study ◽  
In Vivo Experiments ◽  
Greater Occipital Nerve Block ◽  
Greater Occipital Nerve ◽  
Occipital Nerve Block

IntroductionThe pharmacological block of the greater occipital nerve has been proven effective in numerous headache and facial pain syndromes. This clinical effect supports the hypothesis of a strong functional interaction between the occipital and trigeminal nerves which has been proposed in neurophysiological in vivo experiments in rodents. Although it is likely that the interaction has to occur in the central nervous system, the exact site and the mechanisms of the interaction remain largely unknown.MethodsFocusing on these questions we investigated in a double-blind, placebo-controlled, randomised study the influence of an occipital nerve block with lidocaine 1% on neuronal activation in the trigeminocervical complex using high-resolution functional magnetic resonance on a 3T scanner. In order to investigate potential clinical effects on the trigeminal nerve, we further performed quantitative sensory testing and analysed a potential shift in thermal detection and pain thresholds.ResultsThe pharmacological block of the greater occipital nerve induced an occipital anaesthesia ipsilateral to the block. Functional imaging revealed that the occipital injection of lidocaine but not placebo significantly reduced nociceptive trigeminal activation.ConclusionsThese data suggest that the functional inhibition of the occipital nerve block on trigeminal nociceptive activity is likely to occur at the C2 level where the occipital nerve enters the trigeminocervical complex and converges on the same central nuclei before the signal crosses the midline at that level and is then transmitted to higher processing centres.

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