The AAPS 103rd Annual Meeting 2025

Introduction

•Occipital neuralgia (ON) is a paroxysmal headache disorder

•Sharp, stabbing pain in the distributions of the greater, lesser, and/or 3rd occipital nerves

•ON is often underdiagnosed, leading to delay in treatment

•The timing of symptom onset following trauma and the specific mechanisms of injuries resulting in ON remain unknown

Study Aims:

1.Assess timing of ON following trauma

2.Identify injury mechanisms that predispose to ON

3.Evaluate outcomes following surgical decompression

Methods

•441 patients were screened for nerve decompression surgery à 212 (48.1%) met criteria for a diagnosis of ON

•Surveys were administered at screening:

•Age of ON onset & baseline pain characteristics

•History of head/neck trauma

•25 patients (38.5%) underwent surgical decompression

•Assessed for postoperative pain characteristics

•Statistical analysis: univariable logistic regressions

Results

•65 patients (30.6%) reported pain following trauma to the head/neck

•Most patients reported that their pain started on the same day or within 1 week of injury

•Whiplash was the most common mechanism, followed by direct strike to the head

Postoperative Outcomes

Patients experienced significant reductions in frequency, duration, and intensity after surgery (p<0.05)

88% improvement in occipital nerve pain at the surgical site

Conclusion

•The majority of patients experienced ON symptom onset within 1 week of trauma

•Surgical decompression is an effective treatment strategy for patients with trauma-associated ON

Early screening for ON is recommended in patients with head or neck trauma

Onset Of Occipital Neuralgia Following Head And Neck Trauma