O ccipital neuralgia is a pain located in the occipital region that radiates superiorly and anteriorly in the distribution of the greater occipital nerve. Less frequently, the lesser or third occipital nerves are involved. It frequently occurs unilaterally, but can occur bilaterally.
Most cases are due to nerve entrapment or injury.
Treatment includes medications, local anesthetic blocks, and in refractory cases, surgical decompression or ablation of the nerve. The greater occipital nerve , the one commonly involved, arises from the C2 root and travels superiorly through the posterior cervical muscles. It penetrates the muscles just below the superior nuchal line to reach the scalp. The nerve lies halfway between the inion and the mastoid and is accompanied by the occipital artery and vein. The lesser occipital nerve is lateral to the greater occipital nerve and courses superiorly on the surface of the sternocleidomastoid muscle to innervate the posterior lateral scalp.