AAPS 104th Annual Meeting

Learning To Speak The Same Language: Deep Dive Into Occipital Neuralgia In A High-Volume Pediatric Neurology Center

Occipital neuralgia (ON): an uncommon cranialneuralgia characterized by neuropathic pain in theoccipital nerve distribution
Pediatric ON is poorly understood: its truefrequency, presentation, and optimal treatmentalgorithms are unknown
Limited evidence and reliance on adult literaturecontribute to under-recognition and variability inmanagement, particularly in refractory cases

This study aims to:

Characterize the clinical features, managementpatterns, and treatment outcomes of pediatric patientswith symptoms consistent with ON
Highlight the need for interdisciplinary frameworksto improve identification, treatment, and referralpatterns for pediatric ON

Study design: Retrospective cohort using the CHOPHeadache Registry (July 2016-August 2024)

Inclusion criteria: Identified patients with symptomsconsistent with ON (meeting criteria 1-4):

Data collected: demographics, headache characteristics,diagnostic workup, and treatments

Outcome measures: overall symptom improvement atmost recent follow-up, response to treatment attempts

N=89 (0.6%) met symptomatic ON criteria

Median age: 13 years, 54% male

67% (N=60) met criteria for additional headachedisorders. 33% (N=29) met ON criteria alone.

ON is rare, but present in the pediatric population
High degree of diagnostic and symptomatic overlap
A subset with symptoms of ON remains refractory to medical management
There is a need for clearer criteria for treatment escalation
Interdisciplinary discussion may improve diagnostic accuracy,standardization of care, and identification of candidates for surgicalevaluation

Future Directions

Learning To Speak The Same Language: Deep Dive Into Occipital Neuralgia In A High-Volume Pediatric Neurology Center