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Occipital nerve block for headaches: a narrative review.
J Oral Facial Pain Headache
June 2024
Departments of Anesthesiology and Pharmacology, Toxicology, and Neurosciences, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA 71103, USA.
The occipital nerve block involves the injection of a local anesthetic and possibly a corticosteroid near the occipital nerves at the base of the skull and aims at providing relief from chronic headaches by temporarily numbing or reducing inflammation around the occipital nerves. It has proven to be efficacious in treating chronic headaches, especially those that are refractory to medication; it is both diagnostic and therapeutic with symptom abatement from weeks to months. Occipital nerve blocks can be utilized alone or with standard-of-care therapy for various other headache conditions, such as cluster headaches, episodic headaches or chronic migraines.
View Article and Find Full Text PDFThe literature in botulinum toxin treatment for painful diabetic neuropathy (PDN), post traumatic neuralgia (PTN), postherpetic neuralgia (PHN) and occipital neuralgia (ON) was reviewed up to Oct 1st, 2024. Using the efficacy criteria set forth by the Assessment and Guideline subcommittee of the American Academy of Neurology, the current levels of efficacy for these conditions could be designated as followings: PDN: B (probably effective, two class II study), PTN: A (effective, two class I studies); PHN: A (effective, two class I studies), ON: (undetermined due to lack of blinded investigations). Due to the small number of patients in these studies, proof of efficacy requires conduction of controlled and blinded studies in large cohorts of patients with longer follow ups.
View Article and Find Full Text PDFSignatures of chronic pain in multiple sclerosis: a machine learning approach to investigate trigeminal neuralgia.
Pain
December 2024
Division of Brain, Imaging and Behaviour, Krembil Research Institute University Health Network, Toronto, ON, Canada.
Chronic pain is a pervasive, disabling, and understudied feature of multiple sclerosis (MS), a progressive demyelinating and neurodegenerative disease. Current focus on motor components of MS disability combined with difficulties assessing pain symptoms present a challenge for the evaluation and management of pain in MS, highlighting the need for novel methods of assessment of neural signatures of chronic pain in MS. We investigate chronic pain in MS using MS-related trigeminal neuralgia (MS-TN) as a model condition focusing on gray matter structures as predictors of chronic pain.
View Article and Find Full Text PDFEffective Acupuncture in Treating Decade-Long Occipital Neuralgia in an Elderly Patient.
Am J Case Rep
December 2024
Department of Acupuncture and Moxibustion, Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Foshan, Guangdong, China.
BACKGROUND Occipital neuralgia is a headache caused by irritation or damage to the occipital nerves situated at the rear of the head and neck. It is characterized by sharp, stinging, or electric shock-like pain in the distribution area of the occipital nerve, which often causes patients acute pain and discomfort. To report on the feasibility of non-drug therapy in addressing this condition, we present a case report showcasing the remarkable improvement in occipital neuralgia symptoms achieved with a single acupuncture session, followed by a brief period of care.
View Article and Find Full Text PDFA Novel Ultrasonographic Method to Quickly and Accurately Access the C2 Dorsal Root Ganglion.
Pain Physician
November 2024
Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA.
Background: Occipital neuralgia manifests as pain in the cutaneous distribution of occipital nerves, with the greater occipital nerve stemming from the C2 spinal nerve and the lesser occipital nerve originating from the C2 and C3 spinal nerves. While pulsed radiofrequency ablation of the C2 dorsal root ganglion (DRG) is an effective treatment for refractory occipital neuralgia, accessing the C2 DRG remains a clinical challenge even under fluoroscopic guidance.
Objective: We aimed to develop an ultrasonographic method for quickly and accurately accessing the C2 DRG.
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