Refractory occipital scalp pruritus treated with computed tomography-guided greater occipital nerve ablation

Abstract

Greater occipital nerve blocks and thermal ablations have been widely discussed as an efficacious treatment strategy for multiple difficult to treat conditions, including occipital neuralgia, migraines, and cervicogenic headaches. Nerve blocks have also recently been presented as a method of treating neuropathic itch in the upper extremities, where pruritus occurs without visible dermatologic manifestations. We report a case of refractory occipital scalp pruritus in a patient who had excellent although time-limited response to greater occipital nerve blocks but achieved durable symptom control with CT-guided greater occipital nerve ablation.

Bedside greater occipital nerve block with bupivacaine for the treatment of recalcitrant scalp pruritus

“…There have been rare reports of NP treated with CT-guided nerve block and nerve ablation, but outpatient bedside PNBs have not been reported to our knowledge. 4 , 5 …”