Pulsed radiofrequency of occipital nerve to manage intractable occipital neuralgia due to occipital mass

Abstract

Occipital neuralgia, a chronic pain syndrome, is characterized by paroxysmal shooting or stabbing pain in the posterior part of the scalp in the distribution of the greater, lesser, and/or third occipital nerves. It is associated with extremely debilitating symptoms that drastically affect a patient’s quality of life. The symptoms are refractory to traditional treatments, including pharmacologic and non-pharmacological treatments. Pharmacologic treatments include non-steroidal anti-inflammatory drugs, tricyclic antidepressants, antiepileptics, and possibly opioids. If occipital neuralgia is refractory to pharmacologic treatments, non-pharmacological treatments can be performed, such as local anesthetic and corticosteroid infiltration, botulinum toxin A injection, neurostimulation, and pulsed radiofrequency of the occipital nerve. Pulsed radiofrequency is a safe, non-invasive treatment with long-term benefits. There are few cases where occipital neuralgia was caused by an occipital mass. In this case report, we describe the use of ultrasound-guided pulsed radiofrequency in managing intractable occipital neuralgia due to an occipital mass.

Keywords

• Occipital neuralgia
• Ultrasound
• Pulsed radiofrequency
• Occipital nerve
• Occipital mass