A one-sided headache that isn’t migraine
Migraine is thought to originate deep inside the brain. This isn’t the case for all headache disorders. Sometimes, peripheral nerves closer to the skin’s surface can mimic some of the symptoms of migraine. It often takes a trained headache specialist to unravel the mystery and recommend the right treatment. One of those headache disorders is occipital neuralgia.
Occipital neuralgia is rare, affecting 3.2 out of every 100,000 people each year. The ICHD-3 beta places it in a separate category, distinguishing it from migraine or tension-type headaches. the category is called “cranial neuralgia”, simply meaning “pain in the head.” Officially, occipital neuralgia has no known cause. However, there are some who believe nerve entrapment may contribute to its development. Whiplash, inflammation, or compression of nerves by arteries or tumors may explain this types of pain. More studies are needed to confirm this theory.
Patients with occipital neuralgia experience scalp tenderness and aching all the time. Simply touching the affected area can set off a series of painful stabbing attacks. Some patients describe the pain as “shock-like.” This condition can significantly impair a patient’s daily life because simply turning the head, brushing the hair, putting on a hat, or lying on a pillow can trigger attacks. Pain can occur on one or both sides of the back of the head. Between attacks, patients may experience reduced sensation across the back of the head. The affected nerves exit the spinal column at C2 and spread upward across the back of the head. Sometimes the pain can spread to the trigeminal nerve complex, producing pain in the forehead, eyes, cheeks, and jaw.