Treatment is identical to the treatment outlined for trigeminal neuralgia. Infrequently, rhizotomy may be necessary. 5 Occipital Neuralgia Occipital neuralgia is a chronic pain syndrome originating from irritation of the greater occipital nerve. The pain associated with this syndrome is localized to the distribution of the greater occipital nerve. This pain syndrome is frequently a cause of chronic daily headaches.
Occipital neuralgia is commonly a result of spasm of the cervical paraspinal muscles.
The diagnosis of occipital neuralgia is fairly simple. Palpation of the greater occipital nerve reproduces the pain syndrome. Paraspinal muscle spasm may also be appreciated. Cervical spine X-rays or MRI may disclose structural problems associated with spasm of the paraspinal muscles such as disc herniations, degenerative arthritis or spinal stenosis. 6 Treatment is with the drugs noted in Table 2.