This week we return to the topic of Headache Surgery. Specifically, the diagnosis of Occipital Neuralgia (ON).
As we reviewed before, there are three anatomical regions we evaluate for chronic headaches, the frontal, temporal and occipital areas.
Often providers generalize the topic of Occipital Neuralgia (ON). However, it is important to understand that there are three different occipital nerves on each side that can become neuralgic. There is the Greater Occiptal Nerve (GON), the Lesser occipital nerve (LON) and the Third Occiptal Nerve (TON). All three must be evaluated. One or all three may be involved.
We call the constellation of the these three nerve neuralgias, Occipital Nerve Syndrome (ONS). You must assess whether each of these nerves has an Occipital Neuralgia (ON). The assement of the three occipital nerves fall under the diagnosis of Occipital Nerve Syndrome (ONS).
Globally providers are getting better at making the diagnosis of ON. That said, it is still many times either missed or under treated. We are still fighting to have our surgical techniques recognized by many frontline providers (mainly neurologists unfortunately). It should be important for these surgical techniques to be integrated in to the comprehensive stratified care model for those with a diagnosis of ONS/ON. In reality, evaluation for ONS/ON should be considered in any post-traumatic and post-surgical chronic headache that doesn’t respond to medical management, medications, and time.
Stand by, there is much more ground to cover regarding the topic of ON/ONS, but these concepts are extremely important points.
If you or someone you know is suffering with Occipital Neuralgia, know there is hope beyond your duffel bag of medications….
May you live without the burden of a chronic, daily headache!
Pax = Peace (Latin)