scholarly journals Hemifacial Pain and Hemisensory Disturbance Referred from Occipital Neuralgia Caused by Pathological Vascular Contact of the Greater Occipital Nerve

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Byung-chul Son ◽  
Jin-gyu Choi
Keyword(s):  
Facial Pain ◽  
Afferent Input ◽  
Occipital Artery ◽  
Occipital Neuralgia ◽  
Unique Case ◽  
Occipital Nerve ◽  
Sensory Change ◽  
Greater Occipital Nerve ◽  
Upper Cervical ◽  
Stimulation Of

Here we report a unique case of chronic occipital neuralgia caused by pathological vascular contact of the left greater occipital nerve. After 12 months of left-sided, unremitting occipital neuralgia, a hypesthesia and facial pain developed in the left hemiface. The decompression of the left greater occipital nerve from pathological contacts with the occipital artery resulted in immediate relief for hemifacial sensory change and facial pain, as well as chronic occipital neuralgia. Although referral of pain from the stimulation of occipital and cervical structures innervated by upper cervical nerves to the frontal head of V1 trigeminal distribution has been reported, the development of hemifacial sensory change associated with referred trigeminal pain from chronic occipital neuralgia is extremely rare. Chronic continuous and strong afferent input of occipital neuralgia caused by pathological vascular contact with the greater occipital nerve seemed to be associated with sensitization and hypersensitivity of the second-order neurons in the trigeminocervical complex, a population of neurons in the C2 dorsal horn characterized by receiving convergent input from dural and cervical structures.

Treatment of occipital neuralgia by partial posterior rhizotomy at C1–3

1995 ◽  
Vol 82 (4) ◽  
pp. 581-586 ◽  
Author(s):  
David Dubuisson
Keyword(s):  
Sensory Loss ◽  
Minimal Risk ◽  
Occipital Neuralgia ◽  
Content Type ◽  
Occipital Nerve ◽  
Root Entry Zone ◽  
Relieve Pain ◽  
Greater Occipital Nerve ◽  
Upper Cervical ◽  
Postoperative Vertigo

✓ To minimize the sensory loss associated with intradural posterior rhizotomy for medically refractory occipital neuralgia, partial sectioning of the upper cervical posterior rootlets was performed in 11 patients. The ventrolateral aspect of each posterior rootlet from C-1 to the upper portion of C-3 was divided at the root entry zone. In three patients with bilateral neuralgia, the procedure was performed on both sides, for a total of 14 partial rhizotomy procedures in the 11 patients. This resulted in satisfactory preservation of scalp sensation in all cases. Pain within the territory of the greater occipital nerve was consistently reduced or abolished by this procedure. The overall degree of pain relief was rated good or excellent after 10 of the 14 procedures. The other four procedures alleviated pain in the territory of the greater occipital nerve, but the results were marred by persistent periorbital or temporal pain. Two patients subsequently underwent complete C1–3 posterior rhizotomy without further improvement. Although partial posterior rhizotomy at C1–3 did not always relieve pain in the periorbital and temporal regions, this procedure did provide consistent long-term relief of severe occipital pain with minimal risk of postoperative vertigo, scalp anesthesia, or deafferentation syndrome.

scholarly journals V2 Trigeminal Referred Pain from Chronic Occipital Neuralgia Caused by Entrapment of the Greater Occipital Nerve

2019 ◽  
Vol 08 (01) ◽  
pp. 076-080 ◽  
Author(s):  
Chang-ik Lee ◽  
Byung-chul Son
Keyword(s):  
Female Patient ◽  
Afferent Input ◽  
Referred Pain ◽  
Occipital Neuralgia ◽  
Upper Lip ◽  
Occipital Nerve ◽  
Burning Pain ◽  
Trigeminal Pain ◽  
Greater Occipital Nerve ◽  
New Onset

AbstractAlthough entrapment of the greater occipital nerve (GON) is a well-known cause of occipital neuralgia, occurrence of referred hemifacial trigeminal pain involving V2 distribution from chronic occipital neuralgia is rare. A 67-year-old female patient with intermittent left-sided occipital neuralgia of 10-year duration presented with a new onset of left-sided hemifacial pain of 5-month duration. With aggravation of left-sided occipital neuralgia, continuous burning pain and paresthesia gradually developed in her left malar and periorbital area. They also spread to her left upper lip. Severe compression of the left GON by tendinous aponeurotic attachment of the trapezius was found intraoperatively. Decompression of the left GON from chronic entrapment resulted in immediate relief for her hemifacial pain and chronic occipital neuralgia. These findings provide clinical affirmation of the existence of trigeminal/cervical convergence and hypersensitivity. Chronic irritating afferent input of occipital neuralgia caused by entrapment of the GON seems to be associated with sensitization and hypersensitivity of the second-order neurons in the trigeminocervical complex receiving convergent input from dural and cervical structures. Referred trigeminal pain from chronic occipital neuralgia may extend to V2 in addition to V1 trigeminal distribution.

Occipital Neuralgia

2019 ◽  
pp. 51-64
Author(s):  
Richard L. Weiner
Keyword(s):  
Occipital Neuralgia ◽  
Occipital Nerve ◽  
Greater Occipital Nerve ◽  
Cervical Roots ◽  
Stimulation Of

Patients with occipital neuralgia typically complain of intractable, posterior headaches. Prior attempts to treat this condition have traditionally consisted of various strategies to decompress or cut the greater occipital nerve. Some have even advocated the ablation of ganglia or cervical roots that give rise to the occipital nerve. However, such treatments are highly invasive, irreversible, and fraught with failure and complications. Modern strategies employing subcutaneous stimulation of the occipital nerve using linear stimulation arrays are quite effective and lower in invasiveness and risk. This chapter discusses the clinical hallmarks of occipital neuralgia and the technique by which these subcutaneous electrodes are implanted and utilized.

scholarly journals Ultrasound Scan of the Occipital and Upper Cervical Region

2019 ◽  
Author(s):  
Sergi Boada Pie
Keyword(s):  
Vertebral Artery ◽  
Cervical Region ◽  
Posterior Arch ◽  
Occipital Artery ◽  
Cranial Ultrasound ◽  
Ultrasound Scan ◽  
Great Occipital Nerve ◽  
Occipital Nerve ◽  
Greater Occipital Nerve ◽  
Upper Cervical

The sonoanatomical knowledge of the upper cervical and occipital region is critical for the identification of structures involved in the pathophysiology of cervicogenic headache and neck pain. We propose a systematic caudo-cranial ultrasound scan using a paramedial transverse view. The first relevant structure to identify is the Obliquus Capitis Inferior Muscle (OCIM) that in turn will allow us to locate the Great Occipital Nerve (GON), the C1-C2 joint, the C2 dorsal root ganglion, medial to the joint, and the Vertebral Artery, lateral to the joint. Sonogram 1 demonstrates the great occipital nerve (GON) between the seminspinalis capitus muscle (SMCEM) and obliquus Capitis Inferior Muscle (OCIM) and the C1-C2 joint. Aligning the transducer obliquely along the long axis of the OCIM, may allow for better visualization of the muscle. With a cranial displacement of the probe, one can identify the posterior arch of C1 and the vertebral artery as it transverses from lateral to medial crossing the medial posterior aspect of the atlanto-occipital joint (sonograms 2 and 3). Finally, with more cranial scan, one can identify the occipital bone and the occipital artery near the distal branches of the greater occipital nerve and third occipital nerve more medially (Sonogram 4). With continued cranial scanning the GON will be more superficial as it pierces the trapezius aponeurosis.

Hemifacial Trigeminal Pain Referred from Occipital Neuralgia Due to Compression of the Greater Occipital Nerve by the Occipital Artery

2018 ◽  
Vol 79 (05) ◽  
pp. 442-446 ◽  
Author(s):  
Hak-cheol Ko ◽  
Jin-gyu Choi ◽  
Byung-chul Son
Keyword(s):  
Spatial Relationship ◽  
Occipital Artery ◽  
Occipital Neuralgia ◽  
Occipital Nerve ◽  
Trigeminal Pain ◽  
Nociceptive Pathways ◽  
Greater Occipital Nerve ◽  
Subcutaneous Layer ◽  
High Cervical ◽  
Crossing Point

Although pathologic vascular contact between the occipital artery and the greater occipital nerve (GON) at the crossing point in the nuchal subcutaneous layer can cause occipital neuralgia, referred hemifacial trigeminal pain from chronic occipital neuralgia owing to this cause is extremely rare.A 61-year-old female patient with left-sided occipital neuralgia for 4 years presented with a new onset of left-sided hemifacial pain. Decompression of the left GON from pathologic contacts with the occipital artery resulted in immediate relief for hemifacial pain and chronic occipital neuralgia. The present case implies that sensitization and hyperactivity of the trigeminocervical complex that receives the convergent input from trigeminal and high cervical occipital nociceptive pathways can be a pathogenic mechanism in referred hemifacial pain from occipital neuralgia. In the present case, a branching tributary of the occipital artery at the crossing point forming a constricting loop above the course of the GON was found to be the cause of entrapment. Because the occipital artery is reported to be consistently located superficial to the GON at the crossing point, a spatial relationship between the occipital artery and the GON rather than a mere adhesion or contact might have pathologic significance in the development of occipital neuralgia.

Greater Occipital Nerve Decompression for Occipital Neuralgia

2018 ◽  
Vol 29 (5) ◽  
pp. e518-e521 ◽  
Author(s):  
Anson Jose ◽  
Shakil Ahmed Nagori ◽  
Probodh K. Chattopadhyay ◽  
Ajoy Roychoudhury
Keyword(s):  
Occipital Neuralgia ◽  
Occipital Nerve ◽  
Nerve Decompression ◽  
Greater Occipital Nerve

scholarly journals CT-guided infiltration of greater occipital nerve for refractory craniofacial pain syndromes other than occipital neuralgia

2020 ◽  
Vol 101 (10) ◽  
pp. 643-648
Author(s):  
A. Ricquart Wandaele ◽  
A. Kastler ◽  
A. Comte ◽  
G. Hadjidekov ◽  
R. Kechidi ◽  
...  
Keyword(s):  
Occipital Neuralgia ◽  
Ct Guided ◽  
Occipital Nerve ◽  
Pain Syndromes ◽  
Greater Occipital Nerve ◽  
Craniofacial Pain
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