OCCIPITAL NEURALGIA TREATED BY INTRADURAL DORSAL NERVE ROOT SECTIONING

The term occipital neuralgia was first used in 1821 to describe a char acteristic pain in the region innervated by the greater occipital nerv e. Since that time numerous authors have failed to reach a consensus c oncerning the presentation, cause, and treatment of this entity. Revie w of these previous works reveals that the term occipital neuralgia en compasses a collection of signs and symptoms which develop secondary t o a variety of different disease processes. We have treated nine patie nts suffering from severe occipital pain with associated C2 hypesthesi a, unilateral retro-orbital pain, and occipital or C2 tubercle trigger points by intradurally sectioning the C1-C4 dorsal rootlets (C4 if sh oulder pain existed). All patients had been treated previously with va rious modalities without success. This paper discusses the results obt ained in these patients.