title: Occipital Neuralgia Diagnosis and Treatment: The Role of Ultrasound.
abstract: BACKGROUND
  Occipital neuralgia is a form of neuropathic type of pain in the distribution of the greater, lesser, or third occipital nerves. Patients with intractable occipital neuralgia do not respond well to conservative treatment modalities. This group of patients represents a significant therapeutic challenge and may require interventional or invasive therapeutic approaches.
  
  
  OBJECTIVE
  Occipital neuralgia frequently occurs as a result of nerve entrapment or irritation by a tight muscle or vascular structure, or nerve trauma during whiplash injury. Although the entrapment theory is most commonly accepted, it lacks strong clinical evidence to support it. Accordingly, the available interventional approaches have been targeting the accessible part of the occipital nerve rather than the entrapped part.
  
  
  CONCLUSIONS
  Bedside sonography is an excellent imaging modality for soft tissue structures. Ultrasound not only allows distinguishing normal from abnormal entrapped occipital nerves, it can identify the level and the cause of entrapment as well. Ultrasound guidance allows precise occipital nerve blocks and interventions at the level of the "specific" entrapment location rather than into the site of "presumed" entrapment.
authors.forename: Samer
authors.initials: S
authors.lastname: Narouze
mesh_terms: D006801:Humans; D009408:Nerve Compression Syndromes / Q000150:complications; D009437:Neuralgia / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy*; D009778:Occipital Lobe; D010525:Peripheral Nerves
keywords: diagnostic ultrasound; entrapment neuropathy; occipital neuralgia