Occipital neuralgia (ON)--or Arnold's neuralgia--is an acute, electrical, paroxysmal, and occasionally throbbing disorder originating from the occiput and extending along the posterior scalp at the distribution of the occipital nerves
As previously discussed, occipital neuralgia may involve the greater occipital nerve
, lesser occipital nerve
, third occipital nerve
or a combination of these neural structures (Figure 1).
Methods: Ultrasound-guided bilateral occipital nerve
block was administrated in 21 patients who developed PDPH after spinal anesthesia but did not respond to conservative medical treatment within 48 hours between January 2012 and February 2014.
The diagnosis of occipital neuralgia was made with recommendations for bilateral occipital nerve
blocks and the addition of gabapentin to his regimen.
We performed a greater occipital nerve
block with bupivacaine 0.
The device delivers electrical impulses near the occipital nerves
via insulated lead wires tunneled under the skin.
They're using a procedure known as occipital nerve
stimulation (ONS) to treat cervicogenic headache, a form of chronic headache triggered by problems with the bones, muscles and other structures in the neck and characterized by pain that shoots from the back of the head to the top.
I described a device called the Occipital Nerve
Stimulator which is placed just under the skin and sends out electrical impulses that turn off the painful symptoms of a migraine attack.
Called Occipital Nerve
Stimulation for the Treatment of Intractable Migraine (ONSTIM), the study involves a Medtronic Synergy neurostimulation device, which was implanted in a 47-year-old female who has suffered from chronic headache for 8 years.
Each sonic muscle is innervated by a single nerve formed by branches of the ventral occipital nerve
roots that exit the hindbrain just caudal to the vagus nerve.
In the literature, greater occipital nerve
(GON) blocks with local anesthetics and steroids were used in migraine patients, and some benefits in acute migraine and prophylaxis were obtained (3,4,5,6).
In clinical practice, PRF to the suprascapular nerve, [sup], occipital nerve
, [sup], and other peripheral nerves [sup],,, has also shown clinical efficacy, but no animal models had been established to examine the mechanisms suppressing hyperalgesia.
In headache and migraine treatment, some of the most common codes include 64405, for unilateral occipital nerve
block; 64450, for unilateral block of another peripheral nerve; 64612, for unilateral facial nerve chemodenervation; and 64615, for bilateral chemodenervation of the facial nerve, trigeminal nerve, cervical spinal nerve, and accessory nerves, she added.
12) Occipital neuralgia is a condition associated with paroxysmal jabbing pain in the distribution of the greater occipital nerves
or the third occipital nerve
, typically as a result of entrapment of a nerve along it course.
A more detailed chapter on occipital nerve
stimulation completes this section.