title: Clinical-radiologic heterogeneity of occipital neuralgiform pain as multiple sclerosis relapse.
abstract: Occipital neuralgia may be related to traumatic, compressive, or inflammatory injury to the occipital nerve or C2 radicular level and cervical spinal cord lesions. We report a series of 3 patients with definite relapsing-remitting multiple sclerosis (MS) who experienced sudden occipital neuralgiform pain with or without diminished sensation in the cervical region and associated with magnetic resonance imaging (MRI) evidence of a new active or new T2-weighted demyelinating C2 cervical lesion. We suggest that sudden paroxysmal occipital pain may signal relapse of MS and cervical MRI with gadolinium should be considered; these patients show good clinical response to high-dose intravenous corticosteroids.
authors.affiliation: Neurological and Behavioral Sciences, University of Siena, Siena, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: De Santi
authors.forename: Lucia
authors.initials: L
authors.lastname: Monti
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Menci
authors.forename: Matteo
authors.initials: M
authors.lastname: Bellini
authors.forename: Pasquale
authors.initials: P
authors.lastname: Annunziata
mesh_terms: D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000150:complications* / Q000188:drug therapy / Q000473:pathology*; D009437:Neuralgia / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D018696:Neuroprotective Agents / Q000627:therapeutic use; D009777:Occipital Bone / Q000294:innervation*; D013116:Spinal Cord / Q000473:pathology*
chemical_list: D018696:Neuroprotective Agents; D008775:Methylprednisolone