Clinical Outcomes of Pulsed Radiofrequency Neuromodulation for the Treatment of Occipital Neuralgia

Pediatric patients with ventriculoperitoneal shunts commonly present with headaches. We report 7 children with ventriculoperitoneal shunts and occipital headaches who received occipital nerve blocks. Eighty-six percent of patients had a history of at least 1 ventriculoperitoneal shunt revision. Headaches improved in every patient after the block. Two patients (29%) were symptom free 11 and 12 months after the block. Four patients (57%) required repeat occipital nerve blocks. Two underwent pulsed radiofrequency ablation. No complications were noted. When patients with ventriculoperitoneal shunts present with headaches, a detailed physical examination is necessary. Persistent occipital headaches with tenderness and radiation in the path of the occipital nerves can be indicative of occipital neuralgia resulting from the shunt having crossed over the path of the greater or lesser occipital nerve. Occipital nerve blocks can help as both diagnostic and therapeutic interventions in these patients.

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Randomized, double-blind, comparative-effectiveness study comparing pulsed radiofrequency to steroid injections for occipital neuralgia or migraine with occipital nerve tenderness

Pain ◽

10.1097/j.pain.0000000000000373 ◽

2015 ◽

Vol 156 (12) ◽

pp. 2585-2594 ◽

Cited By ~ 35

Author(s):

Steven P. Cohen ◽

B. Lee Peterlin ◽

Larry Fulton ◽

Edward T. Neely ◽

Connie Kurihara ◽

...

Keyword(s):

Comparative Effectiveness ◽

Effectiveness Study ◽

Occipital Neuralgia ◽

Pulsed Radiofrequency ◽

Double Blind ◽

Steroid Injections ◽

Occipital Nerve ◽

Comparative Effectiveness Study

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Occipital Neuralgia after Hair Transplantation and Its Treatment

Case Reports in Neurological Medicine ◽

10.1155/2015/428413 ◽

2015 ◽

Vol 2015 ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

Jason Siefferman ◽

Yury Khelemsky

Keyword(s):

Physical Activity ◽

Botulinum Toxin ◽

Severe Pain ◽

Complete Relief ◽

Occipital Neuralgia ◽

Pulsed Radiofrequency ◽

Full Thickness ◽

Hair Transplantation ◽

The Right ◽

Botulinum Toxin Injections

While undergoing full thickness tissue harvest from the posterior scalp, a 72-year-old man experienced immediate severe pain in the right occiput and was unable to complete the procedure. The pain was constant “sharp” and “shocking” with numbness in the distribution of the lesser occipital nerve, exacerbated by physical activity, and local anesthetic blocks provided temporary complete relief. After numerous treatments over several years, including oral analgesics, botulinum toxin injections, and acupuncture, proved ineffective, pulsed radiofrequency neuromodulation provided greater than 80% relief for 5 months.

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Cooled Radiofrequency Ablation for Bilateral Greater Occipital Neuralgia

Case Reports in Neurological Medicine ◽

10.1155/2014/257373 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Tiffany Vu ◽

Akhil Chhatre

Keyword(s):

Radiofrequency Ablation ◽

Side Effects ◽

Medical Literature ◽

Current Medical ◽

Occipital Neuralgia ◽

Pulsed Radiofrequency ◽

Occipital Nerve ◽

Greater Occipital Nerve ◽

History Of

This report describes a case of bilateral greater occipital neuralgia treated with cooled radiofrequency ablation. The case is considered in relation to a review of greater occipital neuralgia, continuous thermal and pulsed radiofrequency ablation, and current medical literature on cooled radiofrequency ablation. In this case, a 35-year-old female with a 2.5-year history of chronic suboccipital bilateral headaches, described as constant, burning, and pulsating pain that started at the suboccipital region and radiated into her vertex. She was diagnosed with bilateral greater occipital neuralgia. She underwent cooled radiofrequency ablation of bilateral greater occipital nerves with minimal side effects and 75% pain reduction. Cooled radiofrequency ablation of the greater occipital nerve in challenging cases is an alternative to pulsed and continuous RFA to alleviate pain with less side effects and potential for long-term efficacy.

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