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Occipital Neuralgia

Ellen Anderson Penno, MD, MS Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Occipital neuralgia (ON) is one of several described cranial neuralgias. ON is characterized by paroxysmal stabbing pain that follows the distribution of the greater or lesser occipi...

DIAGNOSIS

HISTORY

International Classification of Headache Disorders (ICHD) criteria (3)[A
  • Most often unilateral or bilateral pain fulfilling criteria B to E

  • Pain is located in the distribution of the ...

TREATMENT

GENERAL MEASURES

Rest, warm or cold compresses, and physical therapy can mitigate ON in many cases (4)[C]. 

MEDICATION

First Line

NSAIDs and muscle relaxants 

Second Line

  • Antiepileptic drugs (AEDs...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Follow-up plans are determined by the treatment needed, efficacy of selected treatments, and need for coordinated care for physical therapy or psychological care....

REFERENCES

1
Gadient PM, Smith JH. The neuralgias: diagnosis and management. Curr Neurol Neurosci Rep.  2014;14(7):459. [View Abstract on OvidMedline]
2
Vincent MB. Headache and neck. Curr Pain Head...

CODES

ICD10

  • M54.81 Occipital neuralgia

  • R20.8 Other disturbances of skin sensation

ICD9

  • 723.8 Other syndromes affecting cervical region

  • 782.0 Disturbance of skin sensation

SNOMED

  • 71760005 Cervico-occipital ne...

CLINICAL PEARLS

  • Diagnosis of ON is determined by characteristic symptoms in the distribution of the greater or lesser occipital nerves or of the 3rd occipital nerve.

  • Diagnosis of ON requires response t...

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