Occipital neuralgia (ON) is a rare cause of headache characterized by severe episodes of lancinating pain within the distribution of the greater and lesser occipital nerves [17]. This paroxysmal jabbing pain may be associated with aching in the greater or lesser occipital nerve distributions between paroxysms. Often there is tenderness over the nerve and sometimes there can be diminished sensation or dys-esthesia in the distribution of the nerve [12]. Although specific causes such as whiplash injury, prior skull base surgery, rheumatoid arthritis, nerve entrapment by hypertrophied atlantoaxial ligaments, compression of the greater occipital nerve by an anomalous ectatic vertebral artery, and degenerative C1-C2 arthrosis are reported, the majority of cases are idiopathic [8,11].
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