J Korean Pain Soc.  1996 Nov;9(2):390-394.

The effect of Nerve Blocks in the Management of Occipital Neuralgia

• Jeong ET
• Choi HC
• Lim SY
• Shin KM
• Hong SY
• Choi YR
• Jeong YJ

Abstract

BACKGROUND: Occipital neuralgia is characterized by pain, usually deep and aching, in the diitribution of the second and/or third cervical dorsal root. Two broad groups of patients iaclude primary occipital neuralgia with no apparent etiology and secondary neuralgia with structural pathology. Patients with occipital neuralgia can develop autonomic changes and hyperesthesia. In patients who have not improved with conservative treatment, we have carried out various nerve blocks and evaluated the effectiveness.
METHODS
In a series of 20 occipital neuralgia patients with no apparent etiolgy, we have carried out great occipital nerve blocks with needle TEAS. In patients who have not improved more than 75% on VAS with great occipital block, we have carried out C2 ganglion blocks and in patients who have not improved more than 75% with C2 ganglion block, C3 root blocks, C2/C3 facet joint blocks have been carried out in due order.
RESULTS
In 3 patients out of l0 patients who have not improved with great occipital nerve block, C2 ganglion block led to pain relief. A good response of C3 root block was achived in 2 of 7 patients without response to C2 ganglion block and C2/C3 facet joint block led to improvement in 1 of 5 patients without response to C3 root block.
CONCLUSIONS
Nerve blocks like great occipital nerve block, C2 ganglion block, C3 root block, or C2/C3 facet joint block were effective in the patients who have not improved with conservative treatment

Keyword

Nerve block: great occipital nerve block; C2 ganglion block; C3 root block; C2/C3 facet joint block; Pain: occipital neuralgia

MeSH Terms

Ganglion Cysts
Humans
Hyperesthesia
Needles
Nerve Block*
Neuralgia*
Pathology
Spinal Nerve Roots
Tea
Zygapophyseal Joint
Tea