Occipital neuralgia

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Classification according to ICD-10
G52.8 Diseases of other specified cranial nerves
G44.8 Other specified headache syndromes
ICD-10 online (WHO version 2019)

The occipital neuralgia and occipital neuralgia , C2 neuralgia is one neuralgia (nerve pain) of the three occipital nerve , so the greater occipital nerve , the lesser occipital nerve or the third occipital nerve .

Symptoms

Occipital neuralgia manifests itself as stabbing, attack-like pain that occurs at the back of the head up to the top of the head. The pain can also follow the course of the nerves and spread towards the forehead, side of the skull and temple area. Typically they occur on one side, less often both sides can be affected. The affected areas may also have tenderness or paresthesia (non-painful sensation without physical stimulus). The mobility of the head is often limited due to pain.

causes

Occipital neuralgia can have many causes. On the one hand, muscle tension in the neck or degenerative changes such as osteoarthritis can cause one or more of the nerves to be irritated, causing pain. On the other hand, trauma , gout , diabetes , inflammation of the blood vessels, infections or, more rarely, masses in the area of ​​the upper cervical spine, which can arise, for example, as a result of a tumor, can be responsible for the pain. In most cases, however, no exact cause can be determined.

therapy

In order to reduce the pain, anti-inflammatory painkillers that are as gentle on the stomach as possible, long-acting and peripheral pain relievers are used. If the pain is still too severe in severe cases, “ central painkillers ” that work directly in the brain and spinal cord must be used. The painkillers are not used in the long term to avoid habituation effects or even dependence . Combined with pain distancing antidepressants , the dosage, the painkillers also be reduced. Alternatively, local anesthetics can be used to combat the pain , which may then have to be injected several times a day or continuously with a catheter .

Physical therapy (heat and cold applications, massages) and muscle relaxants can also be used to relieve tension in the muscles .

If conservative measures fail, microsurgical neurolysis or nerve decompression can be performed, which attempts to surgically relieve pressure on the nerves. However, the potential benefits of such a measure must be carefully weighed against the potential risks.

Individual evidence

  1. ↑ a b Hartmut Göbel (Ed.): Conversation table between the codes of the headache classifications of the IHS and the WHO ICD-10 . In: ICD-10 guidelines for the classification and diagnosis of headaches. Springer, Berlin / Heidelberg / New York, ISBN 3-540-65242-6 .
  2. ↑ a b c What is Occipitalis Neuralgia , Baden-Württemberg State Medical Association, June 14, 2008, accessed on July 29, 2015.
  3. ↑ N. Manolitsis, F. Elahi: Pulsed radiofrequency for occipital neuralgia . In: Pain physican . tape 17 , no. 6 (November / December), 2014, pp. E709-E717 , PMID 25415786 .
  4. ↑ a b c Halid Bas: trigeminal neuralgia, occipital neuralgia, post-therapeutic neuralgia . ARS Medici Dossier, 2005. (Original publication: Avi Ashkenazi, Morris Levin: Three common neuralgias. In: Postgraduate Medicine. 166, No. 3, 2004, pp. 16–32.)
  5. ↑ a b c Patient Information: Occipital Neuralgia , American Association of Neurolagical Surgeons (AANS), February 2013, accessed July 29, 2015.