occipital neuralgia (quick pearls)

18 Jul

can be caused by cervical spondylosis and stenosis – a very common thing we usually call osteoarthritis of the cervical spine and degenerative disk disease.

Spurs, facet narrowing, disk space narrowing, ostephytes, etc, most commonly at C5-C7 are blamed.

Others have blamed inflammation around the C2-3 nerve roots.


Limited cervical range of motion or neck muscle spasms may occur.

Occipital neuralgia occurs as pain in the distribution of the greater or lesser occipital nerves.


Treatment with lidocaine can work to stop syptoms, but carbamazepine and gabapentin may also be helpful.

Injection of local steroids, local heat, and anti-inflammatory medication may also be useful.


Submitted by J. Stone.


References: (Tintinalli’s Emergency Medicine Chapter 276 – Cervial Spondylosis and stenosis), (Adam’s and Victor’s Principles of Neurology – Ch.10 Occipital Neuralgia), (UpToDate – Ivan Garza- Occipital neuralgia); picture

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