Occipital neuralgia, also known as C2 neuralgia

Neuralgia

Neuralgia is pain in one or more nerves that occurs without stimulation of pain receptor cells. Neuralgia pain is produced by a change in neurological structure or function rather than by the excitation of pain receptors that causes nociceptive pain. Neuralgia falls into two categories: central...

, Arnold's neuralgia, is a medical condition characterized by chronic pain

Chronic pain

Chronic pain has several different meanings in medicine. Traditionally, the distinction between acute and chronic pain has relied upon an arbitrary interval of time from onset; the two most commonly used markers being 3 months and 6 months since the initiation of pain, though some theorists and...

 in the upper neck

Neck

The neck is the part of the body, on many terrestrial or secondarily aquatic vertebrates, that distinguishes the head from the torso or trunk. The adjective signifying "of the neck" is cervical .-Boner anatomy: The cervical spine:The cervical portion of the human spine comprises seven boney...

, back of the head

Head

In anatomy, the head of an animal is the rostral part that usually comprises the brain, eyes, ears, nose and mouth . Some very simple animals may not have a head, but many bilaterally symmetric forms do....

 and behind the eye

Human eye

The human eye is an organ which reacts to light for several purposes. As a conscious sense organ, the eye allows vision. Rod and cone cells in the retina allow conscious light perception and vision including color differentiation and the perception of depth...

s. These areas correspond to the locations of the lesser

Lesser occipital nerve

The lesser occipital nerve or small occipital nerve is a cutaneous spinal nerve arising between the second and third cervical vertebrae, along with the greater occipital nerve...

 and greater occipital nerve

Greater occipital nerve

The greater occipital nerve is a spinal nerve, specifically the medial branch of the dorsal primary ramus of cervical spinal nerve 2. This nerve arises from between the first and second cervical vertebrae, along with the lesser occipital nerve. It ascends after emerging from the suboccipital...

s.

Causes

Occipital neuralgia is caused by damage to these nerves. Ways in which they can be damaged include trauma

Physical trauma

Trauma refers to "a body wound or shock produced by sudden physical injury, as from violence or accident." It can also be described as "a physical wound or injury, such as a fracture or blow." Major trauma can result in secondary complications such as circulatory shock, respiratory failure and death...

 (usually concussive), physical stress on the nerve, repetitious neck contraction, flexion or extension, and as a result of medical complications (such as osteochondroma

Osteochondroma

Osteochondroma is a type of benign tumor that consists of cartilage and bone. It is a benign capped-cartilage outgrowth, connected to bone by a stalk.It is the most frequently observed neoplasm of the skeleton....

, a benign tumour of the bone).

One cause is vascular compression.

Symptoms

The symptom

Symptom

A symptom is a departure from normal function or feeling which is noticed by a patient, indicating the presence of disease or abnormality...

 of this condition is chronic headache. The pain is commonly localized in the back of head 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 for numerous conditions, occipital neuralgia is often misdiagnosed at first, most commonly as tension headache or a migraine leading to treatment failure or addiction. Another symptom is the eyes being sensitive to light, especially when headaches occur.

Occipital neuralgia can cause very intense pain that feels like a sharp, jabbing, electric shock in the back of the head and neck. Other symptoms of occipital neuralgia may include:

•Aching, burning, and throbbing pain that typically starts at the base of the head and radiates to the scalp

•Pain on one or both sides of the head

•Pain behind the eye

•Sensitivity to light

•Tender scalp

•Pain when moving the neck

Treatment

Once diagnosed, occipital neuralgia can be treated in several ways. These include local nerve block

Nerve block

Regional nerve blockade, or more commonly nerve block, is a general term used to refer to the injection of local anesthetic onto or near nerves for temporary control of pain. It can also be used as a diagnostic tool to identify specific nerves as pain generators...

, peripheral nerve stimulation, steroids, rhizotomy

Rhizotomy

A rhizotomy is a term chiefly referring to a neurosurgical procedure that selectively severs problematic nerve roots in the spinal cord, most often to relieve the symptoms of neuromuscular conditions such as spastic diplegia and other forms of spastic cerebral palsy...

, phenol

Phenol

Phenol, also known as carbolic acid, phenic acid, is an organic compound with the chemical formula C6H5OH. It is a white crystalline solid. The molecule consists of a phenyl , bonded to a hydroxyl group. It is produced on a large scale as a precursor to many materials and useful compounds...

 injections, antidepressants, and Occipital Cryoneurolysis

Occipital Cryoneurolysis

Occipital cryoneurolysis is a procedure used to treat nerve pain generated by peripheral nerves commonly due to the condition occipital neuralgia. A probe is carefully placed adjacent to the specific nerve...

.

Other less common forms of surgical neurolysis or microdecompression are also used to treat the condition when conservative measures fail.