Headache Pain: Occipital Neuralgia or Migraine

Head pain or headaches are a common medical problem in the United States. It is estimated that about 40 million Americans suffer from some type of headache problem. Migraine headaches are a leading cause of temporary total disability in the U.S. Occipital neuralgia is a type of headache that is frequently misdiagnosed as migraine.

Occipital neuralgia is a painful condition that can affect one side of the head or the other. At other times, patients experience global head pain. It is when occipital neuralgia affects only one side, that it is all too commonly mistaken as a migraine attack. Part of the problem is that the pain, in some cases ,  of occipital neuralgia is as severe as a migraine headache. Migraines typically shift from one side to the other. Occipital neuralgia, when one sided, stays on the same side.

Migraines are classified as a vascular headache disorder. It is thought that the blood vessels around the brain first constrict then dilate – causing the typical migraine headache pain. Migraines are associated commonly with  light and sound sensitivity, nausea and less frequently vomiting. The pain is moderate to severe with a pulsating quality to it. Movement tends to make the pain worse. This is why migraine suffers prefer to lay down in a quiet, dark room.

In contrast, patients with occipital neuralgia are usually not incapacitated, even though their pain may be moderately severe. There are no associated symptoms such as light and sound sensitivity or stomach upset. The pain of occipital neuralgia is a constant pain but can be sharp with pain going along the side of the head to the eyes.

Occipital neuralgia is due to irritation of the occipital nerve which is at the base of the skull. The nerve exits the upper spine and comes through the several layers of muscle at the top of the spine, at the skull base. If these muscles and tendons that attach the skull to the spine become inflamed or in spasm, this causes one or both occipital nerves to become inflamed. It is this irritation of the occipital nerve that causes the headache.

Occipital neuralgia is a common headache disorder that is all too frequently missed. This is important in the treatment of headache patients, as migraine treatment does not improve the occipital nerve irritation. The most effective treatment for occipital neuralgia is an occipital nerve block. This is an outpatient procedure, which takes only a couple of minutes. If done correctly, occipital nerve blocks can relieve approximately 90% of the patents treated. Eliminating occipital neuralgia will stop one of the common triggers for migraine. If you have headaches that are not responding from standard therapy, you may have occipital neuralgia. At Sarasota Neurology, Dr. Kassicieh specializes in treating migraines and all other types of headache disorders. Call for you appointment today.

 

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