Occipital Neuralgia and Cervicogenic Headache: Diagnosis and Management

被引:71
作者
Barmherzig, Rebecca [1 ,2 ]
Kingston, William [1 ]
机构
[1] Univ Toronto, Div Neurol, Womens Coll Hosp, Ctr Headache, Toronto, ON, Canada
[2] Hosp Sick Children, Div Neurol, Dept Pediat, Toronto, ON M5G 1X8, Canada
关键词
Occipital neuralgia; Cranial neuralgia; Cervical neuralgia; Cervicogenic headache; Primary headache; Secondary headache; ELECTRICAL NERVE-STIMULATION; PULSED RADIOFREQUENCY; PERIPHERAL NEUROSTIMULATION; NECK PAIN; BLOCKS; NEUROTOMY; JOINT; POPULATION; PREVALENCE; RELIEF;
D O I
10.1007/s11910-019-0937-8
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Purpose of ReviewOccipital neuralgia (ON) and cervicogenic headache (CGH) are secondary headache disorders with occipital pain as a key feature. Due to significant phenotypic overlap, differentiating ON and CGH from primary headache disorders such as migraine or tension-type headache, or other secondary headache disorders, can be clinically challenging. This article reviews the anatomy, clinical features, unique diagnostic considerations, and management approaches relating to ON and CGH.Recent FindingsConservative therapeutic approaches are considered first-line. Anesthetic nerve blocks may have a dual role in both supporting diagnosis and providing pain relief. Newer minimally invasive procedures, such as pulsed radiofrequency (PRF) and occipital nerve stimulation (ONS), represent an exciting therapeutic avenue for severe/refractory cases. Surgical interventions should be reserved for select patient populations who have failed all other conservative and minimally invasive options, to be weighed against potential risk.SummaryON and CGH represent an ongoing diagnostic challenge. Further studies are required to consolidate efficacy regarding the comprehensive management of ON and CGH.
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页数:8
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