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General Medicine

Occipital Neuralgia

Robert Baldor, md Reviewed 04/2024
 


BASICS

DESCRIPTION

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

DIAGNOSIS

HISTORY

International Classification of Headache Disorders (ICHD) criteria include the following (4)[A]: 

  • Most often unilateral or bilateral pain

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

TREATMENT

GENERAL MEASURES

Rest, warm or cold compresses, and physical therapy can mitigate ON in many cases (6)[C]. 

MEDICATION

First Line

NSAIDs and muscle relaxants 

Second Line

Antiepileptic drugs (AED...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

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

PROGNOSIS

REFERENCES

1
Shimizu S, Oka H, Osawa S, et al. Can the proximity of the occipital artery to the greater occipital nerve act as a cause of idiopathic greater occipital neuralgia? An anatomical and histo...

CODES

ICD10

  • M54.81 Occipital neuralgia

  • R20.8 Other disturbances of skin sensation

SNOMED

  • 71760005 Cervico-occipital neuralgia (finding)

  • 279079003 dysesthesia (finding)

  • 247404004 Allodynia (finding)

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.

  • The diagnosis of ON requires a resp...

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