Questions posted in the Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.

Subject: Re: Occipital Neuralgia Treatment
Forum: The Neurology and Neurosurgery Forum

Hi, I am very new to the forum, and this is in fact my first post. I will appreciate if I can receive some advice here.

I am 20, and was diagnosed with ON 3 months ago. Actually, I was diagnosed with migraine first,since June 1998, but after my
headaches got worse, and the medicines did not work, and was hospitalised for 3 times, I was diagonsed with
neuralgia.

I went for 10 sessions of acupuncture, but it did not seem to work. When the neurologist increased my dose of
medications, I exprienced side effects which really affected my daily life and studies, such as giddiness, blurred
vision, confusion, unsteadiness. In the hospital, I was not allowed out of bed myself. And I am only 20!!! I can't let
this affect my life. Finally, I had a greater and lesser occipital nerve block on 16 March. This really kind of relieved
my headaches.

However, now I have headaches from the right side of the back part of my head, where the pain orignates from the
neck, and spreads to the top.( My pain used to be on the left side.)The pain on the left side is also coming back,
I get headaches everyday. The doctor increased the
doses (neurontin, baclofen), but I experienced side effects again, so I went back to the old dose. The doctor
did recommend another nerve block as an alternative to taking painkillers.

Do neuralgia patients have to take painkillers in the long term, without stopping? Will the pain stop by itself? I really
do not want to be controlled by this pain, and depend on painkillers in the long term. Does that mean that I should have
another nerve block? Are there any other alternatives?


Dear Nichole:

Sorry to hear about your head pain. What we usually will try initially is indomethacin. This has been found to be an effect medication to treat this type of headache. Most patients will have to take medication over the long term. I would try the indomethacin then if that doesn't work then other medications and then if needed, another nerve block. If your unsatisfied with the approach of your neurologist, then if it is possible, just get a second opinion.

Good luck. I hope your head pain comes under control.

Sincerely,

CCF Neuro[P] MD


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