Occipital Neuralgia and Cervicogenic Headache: Diagnosis and Management

Barmherzig, Rebecca; Kingston, William

doi:10.1007/s11910-019-0937-8

Cited by 65 publications

(81 citation statements)

References 70 publications

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“…6). 9 The cervical neck strain from donning the equipment could have led to the development of cervicogenic headache or tension-type headache (TTH) [22][23][24] The peripheral sensitisation may activate the trigeminocervical complex through nociceptive information transmitted via different branches of the trigeminal nerve through the trigeminal ganglia and brainstem to the higher cortical areas thereby triggering the headache attacks coronavirus disease 2019 25,26 Alternatively, a neuralgia with transient effects on the underlying superficial sensory nerves could have occurred, although other reasons were more likely as most respondents did not report characteristics suggestive of a neuropathic process. 27 These etiological reasons could perhaps explain why a large proportion of those with pre-existing primary headache disorders and concomitant de novo PPE-associated headaches reported an increase in the average number of headache days over a 30 day period, with the perception that this change was probably attributable to the PPE.…”

Section: Discussionmentioning

confidence: 99%

Headaches Associated With Personal Protective Equipment – A Cross‐Sectional Study Among Frontline Healthcare Workers During COVID‐19

et al. 2020

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Background.-Coronavirus disease 2019 (COVID-19) is an emerging infectious disease of pandemic proportions. Healthcare workers in Singapore working in high-risk areas were mandated to wear personal protective equipment (PPE) such as N95 face mask and protective eyewear while attending to patients.Objectives.-We sought to determine the risk factors associated with the development of de novo PPE-associated headaches as well as the perceived impact of these headaches on their personal health and work performance. The impact of COVID-19 on pre-existing headache disorders was also investigated.Methods.-This is a cross-sectional study among healthcare workers at our tertiary institution who were working in highrisk hospital areas during COVID-19. All respondents completed a self-administered questionnaire.Results.-A total of 158 healthcare workers participated in the study. Majority [126/158 (77.8%)] were aged 21-35 years. Participants included nurses [102/158 (64.6%)], doctors [51/158 (32.3%)], and paramedical staff [5/158 (3.2%)]. Pre-existing primary headache diagnosis was present in about a third [46/158 (29.1%)] of respondents. Those based at the emergency department had higher average daily duration of combined PPE exposure compared to those working in isolation wards [7.0 (SD 2.2) vs 5.2 (SD 2.4) hours, P < .0001] or medical ICU [7.0 (SD 2.2) vs 2.2 (SD 0.41) hours, P < .0001]. Out of 158 respondents, 128 (81.0%) respondents developed de novo PPE-associated headaches. A pre-existing primary headache diagnosis (OR = 4.20, 95% CI 1.48-15.40; P = .030) and combined PPE usage for >4 hours per day (OR 3.91, 95% CI 1.35-11.31; P = .012) were independently associated with de novo PPE-associated headaches. Since COVID-19 outbreak, 42/46 (91.3%) of respondents with pre-existing headache diagnosis either "agreed" or "strongly agreed" that the increased PPE usage had affected the control of their background headaches, which affected their level of work performance. Conclusion.-Most healthcare workers develop de novo PPE-associated headaches or exacerbation of their pre-existing headache disorders.

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Section: Discussionmentioning

confidence: 99%

Headaches Associated With Personal Protective Equipment – A Cross‐Sectional Study Among Frontline Healthcare Workers During COVID‐19

et al. 2020

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“…Despite this relatively strict criterion, it can be difficult to clinically diagnose CGHA. For instance sharp pain in the occipital region may reflect occipital neuralgia, which can mimic a CGHA (Barmherzig & Kingston, 2019), whereas overlapping signs and symptoms with other forms of headaches can imitate CGHA, including neck pain, nausea, vomiting, photophobia and phonophobia associated with migraine headaches (Fredriksen, Antonaci, & Sjaastad, 2015;Sjaastad, 2008).…”

Section: Introductionmentioning

confidence: 99%

Spinal manipulation for the management of cervicogenic headache: A systematic review and meta‐analysis

Fernandez

Moore

Tan

et al. 2020

European Journal of Pain

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Background Spinal manipulative therapy (SMT) is frequently used to manage cervicogenic headache (CGHA). No meta‐analysis has investigated the effectiveness of SMT exclusively for CGHA. Objective To evaluate the effectiveness of SMT for CGHA. Databases and Data Treatment Five databases identified randomized controlled trials comparing SMT with other manual therapies. The PEDro scale assessed the risk‐of‐bias. Pain and disability data were extracted and converted to a common scale. A random effects model was used for several follow‐up periods. GRADE described the quality of evidence. Results Seven trials were eligible. At short‐term follow‐up, there was a significant, small effect favouring SMT for pain intensity (mean difference [MD] −10.88 [95% CI, −17.94, −3.82]) and small effects for pain frequency (standardized mean difference [SMD] −0.35 [95% CI, −0.66, −0.04]). There was no effect for pain duration (SMD − 0.08 [95% CI, −0.47, 0.32]). There was a significant, small effect favouring SMT for disability (MD − 13.31 [95% CI, −18.07, −8.56]). At intermediate follow‐up, there was no significant effects for pain intensity (MD − 9.77 [−24.21 to 4.68]) and a significant, small effect favouring SMT for pain frequency (SMD − 0.32 [−0.63 to − 0.00]). At long‐term follow‐up, there was no significant effects for pain intensity (MD − 0.76 [−5.89 to 4.37]) and for pain frequency (SMD − 0.37 [−0.84 to 0.10]). Conclusion For CGHA, SMT provides small, superior short‐term benefits for pain intensity, frequency and disability, but not pain duration, however, high‐quality evidence in this field is lacking. The long‐term impact is not significant. Significance CGHA are a common headache disorder. SMT can be considered an effective treatment modality, with this review suggesting it providing superior, small, short‐term effects for pain intensity, frequency and disability when compared with other manual therapies. These findings may help clinicians in practice better understand the treatment effects of SMT alone for CGHA.

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“…Moreover, Janis et al (2010), reported six major compression points along its course in 25 fresh cadaveric heads which were: between the SSC and OCI, at the entrance and the exit from the SSC, at the entrance and exit from the TP and at the crossing point with the occipital artery [11]. Treatment options of ON include posture correction, pharmacological treatment, local anesthetic injection, botulinum toxin infiltrations, pulse radiofrequency therapy and surgery [1,5]. Occipital nerve block using a local anesthetic with corticosteroids was injected at 2 cm lateral and 2 cm inferior to the external occipital protuberance (EOP) for blocking the GON [13].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the greater occipital nerve location regarding its relation to intermastoid and external occipital protuberance to mastoid process lines

et al. 2021

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Occipital Neuralgia and Cervicogenic Headache: Diagnosis and Management

Cited by 65 publications

References 70 publications

Headaches Associated With Personal Protective Equipment – A Cross‐Sectional Study Among Frontline Healthcare Workers During COVID‐19

Headaches Associated With Personal Protective Equipment – A Cross‐Sectional Study Among Frontline Healthcare Workers During COVID‐19

Spinal manipulation for the management of cervicogenic headache: A systematic review and meta‐analysis

Evaluation of the greater occipital nerve location regarding its relation to intermastoid and external occipital protuberance to mastoid process lines

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