Occipital neuralgia

Occipital neuralgia
Classification and external resources
ICD-10	G52.8,R51, G44.847
ICD-9-CM	723.8
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Occipital neuralgia, also known as C2 neuralgia or, rarely, Arnold's neuralgia, is a medical condition characterized by chronic pain in the upper neck, back of the head and behind the eyes. These areas correspond to the locations of the lesser and greater occipital nerves. Wrapped around the greater occipital nerve is the occipital artery, which can contribute to the neuralgia. The condition is also sometimes characterized by diminished sensation in the affected area.

The main symptom of occipital neuralgia is chronic headache. The pain is commonly localized in the back and around or over the top of the head, sometimes up to the eyebrow or behind the eye. Because chronic headaches are a common symptom of numerous conditions, occipital neuralgia is often misdiagnosed at first, most commonly as tension headaches or migraines, leading to unsuccessful treatment attempts. Another symptom is sensitivity to light, especially when headaches occur.

Occipital neuralgia is characterized by severe pain that begins in the upper neck and back of the head. This pain is typically one-sided, although it can be on both sides if both occipital nerves have been affected. Additionally, the pain may radiate forward toward the eye as it follows the path of the occipital nerve(s). Individuals may notice blurred vision as the pain radiates near or behind the eye. The pain is commonly described as sharp, shooting, zapping, an electric shock, or stabbing. The bouts of pain are rarely consistent, but can occur frequently depending on the damage to the nerves. The amount of time the pain lasts typically varies each time the symptom appears; it may last a few seconds or be almost continuous. Occipital neuralgia can last for hours or for several days.

Other symptoms of occipital neuralgia may include:

Occipital neuralgia is caused by damage to the occipital nerves, which can arise from trauma (usually concussive), physical stress on the nerve, repetitive neck contraction, flexion or extension, or as a result of medical complications (such as osteochondroma, a benign bone tumour). A rare cause is a cerebrospinal fluid leak. Another is radio frequency nerve ablation. Rarely, occipital neuralgia may be a symptom of metastasis of certain cancers to the spine. Among other cranial neuropathies, Occipital Neuralgia is also known to occur in patients with Multiple Sclerosis.

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