Efficacy of Cervical Medial Branch Block in Two Patients with Refractory Occipital Neuralgia.

ABSTRACT

Occipital neuralgia is often characterized by severe, paroxysmal and debilitating pain in the distribution of greater and lesser occipital nerve. It can cause severe refractory headache. Occipital nerve blocks have been used for long in diagnosis and treatment. We describe the efficacy of cervical medial branch block in patients with refractory occipital neuralgia. Two patients with refractory occipital neuralgia who were earlier treated with medications and occipital nerve block without much benefit were given cervical medial branch block. Visual analogue scale (VAS) score was checked for evaluation of effect of cervical medial branch block. The VAS score at 3 month after cervical medial branch block was significantly decreased compared to baseline scores in both patients. There were no major complications. Our case report suggests that cervical medial branch block can be used as a treatment modality in patients with refractory occipital neuralgia. This also suggests that cervical medial branches are important pain generators located in cervical region, could be an important source of pain in occipital neuralgia.