If you have headaches, let your MD know if you have any of the below symptoms.

Occipital neuralgia, also known as C2 neuralgia, or (rarely) Arnold’s neuralgia, is a medical condition characterized by chronic pain in the upperneck, back of the head and behind the eyes. These areas correspond to the locations of the lesser and greater occipital nerves. The greater occipital nerve also has an artery that supplies blood that is wrapped around it – the occipital artery – that can contribute to the neuralgia. This condition is also sometimes characterized with diminished sensation in the affected area as well.

Occipital neuralgia is caused by damage to these nerves. Ways in which they can be damaged include trauma (usually concussive), physical stress on the nerve, repetitious neck contraction, flexion or extension, and as a result of medical complications (such as osteochondroma, a benign tumour of the bone). Another cause is from Radio Frequency nerve ablation. There are several different areas that have potential to cause injury from compression: 1. The space between the vertebral bones of C1 and C2 2. The atlantoaxial ligament as the dorsal ramus emerges 3. The deep to superficial turn around the inferiolateral border of the obliquus capitis inferior muscle and its tight investing fascia 4. The deep side of semispinalis capitis, where initial piercing can involve entrapment in either the muscle itself or surrounding fascia 5. The superficial side of semispinalis capitis, where completion of nerve piercing muscle and its fascia again poses risk 6. The deep side of the trapezius as the nerve enters the muscle 7. The tendinous insertion of the trapezius at the superior nuchal line 8. The neurovascular intertwining of the GON and the occipital artery

The symptom 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 is characterized by severe pain that begins in the upper neck and back of the head. This pain is typically one sided, although can be on both sides if the both occipital nerves have been affected. Additionally, the pain may radiate forward toward the eye, as it follows the path of the occipital nerve(s). Individuals may notice blurred vision as the pain radiates near or behind the eye. The neuralgia pain is commonly described as sharp, shooting, zapping, an electric shock, or stabbing. The bouts of pain are rarely consistent, even within an individual. The amount of time the pain lasts typically varies each time the symptom appears, it may last a few seconds or be almost continuous.

Other symptoms of occipital neuralgia may include:

In recent research, occipital neuralgia has also been linked to the metastasis of certain cancers.

Once diagnosed, occipital neuralgia can be treated in several ways. Some less invasive treatments are as follows: chiropractic manipulation, massage, yoga, physical therapy, rest, heat, anti- inflammatory medication, antidepressant medication, anti- convulsant medication, opioid and nonopioid analgesia, and migraine prophylaxis medication. Alternatives to these may include local nerve block, peripheral nerve stimulation, steroids, rhizotomy, phenol injections,antidepressants, and Occipital Cryoneurolysis.

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

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Williamson et al. The Journal of Headache and Pain 2013, 1(Suppl 1):P65http://www.thejournalofheadacheandpain.com/content/1/S1/P65

http://www.hopkinsmedicine.org/neurology_neurosurgery/specialty_areas/headache/conditions/occipital_neuralgia.html