How is occipital neuralgia diagnosed?
Occipital neuralgia can be diagnosed—and temporarily treated—by an occipital nerve block. For patients who do well with this temporary “deadening” of the nerve, a more permanent procedure may be a good option. These treatments include cutting the nerve surgically, “burning” the nerve with a radio-wave probe, or eliminating the nerve with a small dose of an injected toxin. Obviously any procedure that deadens the nerve permanently is likely to leave some degree of permanent numbness in the scalp. A few patients may do well with procedures that “spare” the affected occipital nerve—a surgeon could decompress the nerve by removing any impinging muscles or scar tissue, or a pain specialist could implant an occipital nerve stimulator, a pacemaker-like device that stimulates the nerve with electricity resulting in tingling rather than pain. Because all of these procedures are invasive, carrying some degree of risk of permanent complication, we generally first try to use medications to “calm d
