SEP 23, 2016
Intracranial Pressure/Headache , Neuro-Ophthalmology/Orbit
Highlights of the International Headache Society diagnostic criteria for greater occipital neuralgia include pain that is recurrent, severe, and shooting or stabbing in quality. Other criteria include dysesthesia or tenderness of the scalp. The eye exam should not reveal other causes for pain, and other primary (such as migraine) and secondary (giant cell arteritis, cervical spine disease) headache syndromes should be excluded by history, physical exam, and ancillary testing. Relief of pain along the course of the greater occipital nerve with an injection of local anesthetic helps suggest the diagnosis, but is not pathognomonic because other headache syndromes such as migraine might be relieved by these injections.