Occipital Neuralgia

Occipital neuralgia is a headache disorder characterized by paroxysmal, stabbing pain along the distribution of the greater, lesser, or third occipital nerves. Etiologies include trauma, compression, or idiopathic inflammation. Pathophysiology involves irritation or entrapment of occipital nerves, triggering nociceptive signaling to the trigeminocervical complex. Diagnosis is clinical, supported by nerve blocks and imaging to exclude structural lesions. Management includes pharmacologic therapy (NSAIDs, anticonvulsants), nerve blocks, physical therapy, and surgical decompression in refractory cases; prognosis is generally favorable with targeted treatment.