Severe Ocular Pain Secondary to Occipital Neuralgia Following Vitrectomy Surgery

Jo, Mason; Katz, Benjamin A.; Hh, Greene

doi:10.1097/00006982-200406000-00021

Cited by 13 publications

(5 citation statements)

References 1 publication

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“…Patients with ON suffer from a shooting or stabbing pain in the neck that radiates over the cranium. The pain is characterized as persistent, paroxysmally aggravating, and of variable distribution; can be perceived in the retro-orbital area due to the convergence of the C2 dorsal root and the nucleus trigeminus pars caudalis ( 6 ). Due to connections with the VIII, IX, and X cranial nerves and the cervical sympathicus, vision impairment/ocular pain (67%), tinnitus (33%), dizziness (50%), nausea (50%), and congested nose (17%) can also be present ( 7 ).…”

Section: Clinical Presentationmentioning

confidence: 99%

Neuralgias of the Head: Occipital Neuralgia

2016

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Occipital neuralgia is defined by the International Headache Society as paroxysmal shooting or stabbing pain in the dermatomes of the greater or lesser occipital nerve. Various treatment methods exist, from medical treatment to open surgical procedures. Local injection with corticosteroid can improve symptoms, though generally only temporarily. More invasive procedures can be considered for cases that do not respond adequately to medical therapies or repeated injections. Radiofrequency lesioning of the greater occipital nerve can relieve symptoms, but there is a tendency for the pain to recur during follow-up. There also remains a substantial group of intractable patients that do not benefit from local injections and conventional procedures. Moreover, treatment of occipital neuralgia is sometimes challenging. More invasive procedures, such as C2 gangliotomy, C2 ganglionectomy, C2 to C3 rhizotomy, C2 to C3 root decompression, neurectomy, and neurolysis with or without sectioning of the inferior oblique muscle, are now rarely performed for medically refractory patients. Recently, a few reports have described positive results following peripheral nerve stimulation of the greater or lesser occipital nerve. Although this procedure is less invasive, the significance of the results is hampered by the small sample size and the lack of long-term data. Clinicians should always remember that destructive procedures carry grave risks: once an anatomic structure is destroyed, it cannot be easily recovered, if at all, and with any destructive procedure there is always the risk of the development of painful neuroma or causalgia, conditions that may be even harder to control than the original complaint.

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Section: Clinical Presentationmentioning

confidence: 99%

Neuralgias of the Head: Occipital Neuralgia

2016

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“…Constant pain can persist between the paroxysms. The pain can be perceived in the retro‐orbital area caused by overlap of the C2 dorsal root and the nucleus trigeminus pars caudalis 25 . Vision impairment/ocular pain (67%), tinnitus (33%), dizziness (50%), nausea (50%), and congested nose (17%) can be present because of connections with cranial nerves VIII, IX, and X, and the cervical sympathicus 26…”

Section: Diagnosismentioning

confidence: 99%

8. Occipital Neuralgia

et al. 2010

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Occipital neuralgia is defined as a paroxysmal shooting or stabbing pain in the dermatomes of the nervus occipitalis major and/or nervus occipitalis minor. The pain originates in the suboccipital region and radiates over the vertex. A suggestive history and clinical examination with short-term pain relief after infiltration with local anesthetic confirm the diagnosis. No data are available about the prevalence or incidence of this condition. Most often, trauma or irritation of the nervi occipitales causes the neuralgia. Imaging studies are necessary to exclude underlying pathological conditions. Initial therapy consists of a single infiltration of the culprit nervi occipitales with local anesthetic and corticosteroids (2 C+). The reported effects of botulinum toxin A injections are contradictory (2 C+/-). Should injection of local anesthetic and corticosteroids fail to provide lasting relief, pulsed radio-frequency treatment of the nervi occipitales can be considered (2 C+). There is no evidence to support pulsed radio-frequency treatment of the ganglion spinale C2 (dorsal root ganglion). As such, this should only be done in a clinical trial setting. Subcutaneous occipital nerve stimulation can be considered if prior therapy with corticosteroid infiltration or pulsed radio-frequency treatment failed or provided only short-term relief (2 C+).

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“…10,13 Furthermore, occipital neuralgia may involve the fronto-orbital region through trigeminocervical interneuronal connections in the trigeminal spinal nuclei. 1,14 As a final limitation, no surgery was demonstrated to verify the compression of aforementioned nerves.…”

Section: Discussionmentioning

confidence: 99%

Can exostoses of the external occipital protuberance and superior nuchal lines cause headache? A report of two cases

Bahadır¹

2023

NeuroAsia

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Compression of the occipital nerves can cause occipital headache. Several potential compression points have been identified along their course. One of these points is the hitherto undescribed instance of exostoses of anatomic structures of the occipital bone. A 34-year-old man with a prominent external occipital tuberance and superior nuchal lines complained of headache in the area of distribution of the greater occipital nerve with tenderness near the bony protrusion on palpation. A 44-year old woman experienced stabbing pain in the lateral orbital region with pressure on the ossified insertion of the ipsilateral trapezius muscle near the external occipital protuberance. Local nerve block achieved temporary relief of pain. Exostosis of the external occipital protuberance and superior nuchal lines may impinge on the greater and third occipital nerves. The characteristics of the pain in our cases differ in some aspects from those of occipital neuralgia.

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Severe Ocular Pain Secondary to Occipital Neuralgia Following Vitrectomy Surgery

Cited by 13 publications

References 1 publication

Neuralgias of the Head: Occipital Neuralgia

Neuralgias of the Head: Occipital Neuralgia

8. Occipital Neuralgia

Can exostoses of the external occipital protuberance and superior nuchal lines cause headache? A report of two cases

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