Occipital neuralgia is a common cause of headache. In this disease suffer from two pairs of nerves that originate in the second and third cervical vertebrae - occipital nerves. Usually the pain begins in the occipital region and can be given to the side and front of the head and eyes.
Causes of occipital neuralgia
Occipital neuralgia syndrome can be either primary or secondary. Secondary occipital neuralgia may occur on a background of diseases such as brain tumors, trauma, infectious process (meningitis, encephalitis), and also against the backdrop of systemic disease (eg lupus erythematosus).
The cause of occipital neuralgia may be any of the above diseases, and the pain often associated with chronic neck muscle contraction. Sometimes the cause of occipital neuralgia can not be identified. In this case, talking about idiopathic neuralgia.
The main causes of occipital neuralgia secondary:
Osteoarthritis of the joints of the upper cervical vertebrae;
Injury to large and small occipital nerves;
Compression (compression) of large and small occipital nerves or the second - the third cervical nerve roots by degenerative changes (low back pain, etc.);
Diseases of the intervertebral discs of the cervical spine;
The tumor that affects the second or third cervical nerve root;
Gout;
Diabetes mellitus;
Inflammation of blood vessels;
An infection.
The symptoms of occipital neuralgia
Occipital neuralgia symptoms include a burning, throbbing pain, prolonged nature, sometimes passing into shooting. The pain is often described by patients as migraine, some patients may experience other symptoms characteristic of migraine and cluster headaches. Usually the pain begins at the base of the skull, and may be given in different parts of the head. Some patients may experience pain in the eye (on the side where there is a pathology). The pain is most often the one hand, but sometimes it occurs on both sides. In some patients, certain movements may trigger neck pain (as in trigeminal neuralgia). In this case the scalp is very sensitive to touch, for example, even a simple combing can cause pain.
Diagnosis of occipital neuralgia
Diagnosis of occipital neuralgia can be very difficult and the doctor has to distinguish it from many other causes of headaches. Correct diagnosis involves a thorough medical examination, collection of complaints, their evaluation, as well as additional diagnostic measures. These include magnetic resonance imaging and computed tomography.
Magnetic resonance - a kind of study, allowing a cross-sectional images of internal organs with very high accuracy. It is based on human exposure by electromagnetic waves in a strong magnetic field, after which the electromagnetic radiation is recorded. Further, it is processed by a computer.
Computed tomography - a type of x-ray studies, allowing a cross-sectional images of organs and tissues. The principle of obtaining these images lies in the fact that a certain area, which is subjected to the study, exposed X-ray radiation from different angles and at different depths. Further, the information goes to the computer, where it is processed and the whole X-ray image obtained by a certain layer of tissue. Non-surgical treatment of occipital neuralgia
The purpose of this treatment is pain relief. Often such pain can facilitate heat applications, rest, physiotherapy, including massage, anti-inflammatory drugs and muscle relaxants. The stern of a certain effect can give anticonvulsants such as carbamazepine (finlepsin) and gabapentin.
Very successfully for the treatment of occipital neuralgia, the method of occipital nerves blockade using steroidal anti-inflammatory drugs (kenalog, gidrokotrizon, dekstametazon, metipred and others). However, the frequent use of this method is fraught with side effects of steroids.
Surgical treatment of occipital neuralgia
Surgical treatment is indicated in severe chronic pain and lack of effect of conservative treatment. You should always assess the positive effects and the risk of surgery.
Microvascular decompression. This method is to eliminate compression of the occipital nerves. It uses a microsurgical technique. Decompression (removal of compression) can significantly reduce the sensitivity of the nerve roots that lead to the elimination of pain.
Stimulation of the occipital nerves (neurostimulation). This method consists in the fact that the occipital nerves are fed thin wire through which electrical impulses are given a certain current and voltage. This leads to a blockade of pain impulses to the occipital nerves in the brain. The essence of neurostimulation is this: if you put the electrodes on any level above the source of pain, then an electrical impulse, which arises when the system is to stimulate, blocking the way for passage of the pain impulse. Pain impulse does not reach the place of perception in the brain, he interrupted, blocked by an electric pulse which is felt by us as a pleasant feeling of warmth or vibration at the same place, where before we had the most severe pain. At a certain mode of stimulation of the patient in general can not feel nothing but pleasure from the absence of pain.
The advantage of this method lies in the fact that he, in comparison with the operational methods, the least invasive (ie requires minimal intervention - in the case of an excited just summing up the nerve to the thin wire) and is accompanied by virtually no side effects.
