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Occipital neuralgia is caused by damage to the occipital nerves, which can arise from trauma (usually concussive or cervical), physical stress on the nerve, repetitive neck contraction, flexion or extension, and/or as a result of medical complications (such as osteochondroma, a benign bone tumour).
[1] [7] [8] [9] However, it is thought that the majority of NTS cases are due to genetics, in which loose ligaments cause temporary misalignments with the atlanto-axial joint while the neck is rotating. [3] Subsequently, numbness of the tongue is due to either subluxation of the atlanto-axial joint or restriction of the second cervical nerve. [2]
[9] Attacks hit the patient many times a day, from 5 times a day up to 40 times a day with an average of 11 a day. Mild background pain can persist between attacks. They come in bouts that last from 7 days to 1 year separated by remission periods that can last more than 3 months in episodic patients, or less than 3 months in chronic patients.
A study on occipital neuralgia in 2017 found that there was not enough data to make a determination. [47] A study on Meralgia Paraesthetica found higher success rates for nerve resection and that most patients were not bothered by numbness following the procedure.
Under the general heading of neuralgia are trigeminal neuralgia (TN), atypical trigeminal neuralgia (ATN), occipital neuralgia, glossopharyngeal neuralgia and postherpetic neuralgia (caused by shingles or herpes). The term neuralgia is also used to refer to pain associated with sciatica and brachial plexopathy. [2]
[9] [12] Greater occipital nerve (GON) block comprising 40 mg Depomedrone and 10 mls of 1% Lignocaine injected into the affected nerve is effective, up to a period of approximately three months. Changing the 'cocktail' to include (for example) 10 mls of .5% Marcaine and changing to 2% Lignocaine, whilst in theory should increase the longevity ...
In most cases, a trial (test) lead placement is performed in order to assess whether the stimulation will work as expected. [8] Local anesthetic is applied to the back of the neck and a Tuohy needle is advanced towards the location of the greater occipital nerve and lesser occipital nerve under fluoroscopic guidance.
Occipital cryoneurolysis is a procedure used to treat nerve pain generated by peripheral nerves (nerves located outside of the spinal column and skull) commonly due to the condition occipital neuralgia. [1] A probe (no larger than a small needle) is carefully placed adjacent to the specific nerve.