Greater Occipital Neuralgia Syndrome

Chances are you've had countless headaches in your lifetime. Unfortunately, headaches abound in our culture. Roughly 90 percent of adults have experienced, or will experience, a tension headache, which is classified as a primary headache, along with migraines, cluster headaches and greater occipital neuralgia syndrome. Secondary headaches occur from other diseases, such as brain tumors and stroke. The third category encompasses facial pain and other kinds of headache pain. This three-tier system of talking about headaches was devised in 2007 by the International Headache Society, reports MedicineNet.com.

Significance

• Although it's not a term that people are accustomed to, neuralgia syndrome is a rather frequent cause of headache pain. It should be noted that occipital neuralgia syndrome, a primary headache cause, can also fall under the secondary headache category, particularly when tumor, hemorrhage or osteoarthritis occur.

Features

• The syndrome gets its name from the affected spinal nerves. The greater occipital nerves--two nerve pairings--are located in the region of the second and third vertebrae in the neck. The pain people experience is felt behind the eyes, and especially at the nape of the neck, moving to the front, back and sides of the head. Many instances of greater occipital neuralgia syndrome can be blamed on neck muscles that are chronically contracted, but other sources have been pinpointed.

Causes and Symptoms

• Among the numerous causes of neuralgia syndrome are viral infection, inflammation of the blood vessels, diabetes, gout, tumors that affect the second and third vertebrae, cervical disk disease and compression of the greater or lesser occipital nerves or second and third vertebral nerve roots from degeneration.

  The pain of greater occipital neuralgia syndrome is not unlike that of a migraine or cluster headaches People experience a pain that both burns and throbs and comes and goes. The base of the skull and side of the scalp are affected in large part. There's sometimes scalp tenderness upon palpation.

Diagnosis

• Targeted neuralgia syndrome can be tricky at best, given all the kinds of headache pain a person might experience, says NeurosurgeryToday.org. Your doctor will order diagnostic tests, but not before conducting a physical exam and getting a medical history. Unusual findings might prompt your doctor to test further. Magnetic resonance imaging (MRI) and computed tomography scan (CT) are valuable tools in diagnosing neuralgia syndrome, as they provide a clear picture of the greater occipital nerves and the interface with the spinal cord and canal.

Treatment

• Nonsurgical therapies of choice serve to deaden or kill pain. Among these are the application of heat as well as physical therapy and massage. Muscle relaxants and anti-inflammatory drugs are often helpful. Blocking the nerves with steroids is a more invasive approach that's not recommended for long-term relief.

  When all else fails, surgery is an option. Microvascular decompression surgically exposes the affected nerves so they can be moved away from the region of compression. Occipital nerve stimulation feeds electrical impulses into the occipital nerves, blocking pain messages.