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

Gadient PM, Smith JH. The neuralgias: diagnosis and management. Curr Neurol Neurosci Rep. 2014;14(7):459. [View Abstract on OvidMedline]

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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