Occipital neuralgia is an uncommon primary headache disorder characterized by intermittent, sharp stabbing occipital pain. Diagnosis is made on the basis of history, clinical examination, and positive response to anesthetic block of the greater occipital nerve. Conservative treatment with physical therapy and low dose antiepileptic drugs or tricyclic antidepressants is often effective. Ultrasound-guided occipital nerve block via the classic approach at the posterior nuchal line or the paramedian approach at the suboccipital triangle can be also an option for managing occipital neuralgia. However, in refractory cases, pulsed radiofrequency or occipital nerve stimulation to the occipital nerve can also be considered. In the present report, we describe the case of a patient whose pain from occipital neuralgia was managed with ultrasound-guided pulsed radiofrequency treatment to the greater occipital nerve at the suboccipital triangle, with a brief review of occipital neuralgia.

Keywordsgreater occipital nerve block, occipital neuralgia, pulsed radiofrequency thermocoagulation, ultrasound, ultrasound-guided procedure.