Therapeutic approaches to Occipital Neuralgia – a case report

Occipital neuralgia (ON), is a painful condition affecting the posterior head in the distributions of the greater occipital nerve (GON), lesser occipital nerve (LON), third occipital nerve (TON), or a combination of the three. In 90% of cases, ON is a result of GON pathology. This condition results almost always from the compression of one of these nerves at one of several anatomic points. Irritation of the GON and/or LON by chronically contracted muscles and spondylosis of the upper cervical spine is often implicated. Clinically, these patients refer a shooting or stabbing pain in the neck, usually unilateral, that radiates over the cranium, characterized as persistent, paroxysmally aggravating, and of variable distribution. The primary conservative treatment approach for patients with ON aims at reducing muscle tension and improving posture. If non-pharmacological and pharmacological treatments are unsuccessful, minimally invasive interventional procedures should be considered. Anesthetic blocks of the GON and LON can be utilized both for diagnostic purposes and as a therapeutic option.