What Is Occipital Neuralgia?


Occipital neuralgia is a distinct type of headache characterized by piercing, throbbing, or electric-shock-like chronic pain in the upper neck, back of the head, and behind the ears, usually on one side of the head. It is often misdiagnosed. Dr. McLaughlin is expert in the diagnosis and treatment of occipital neuralgia

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Occipital neuralgia is an irritation of the greater occipital nerve, characterized by pain in the back of the head, behind the ear, radiating up to the top of the head/ sometimes behind the eye.

Most of your feeling in the back and top of your head is sent to the brain by the two greater occipital nerves. There is one of these nerves on each side of the head. The nerves emaerge from between the bones of the spine in the upper neck, and then the occipital nerves make their way through the muscles at the back of the head and into the scalp. Occasionally, the occipital nerve reaches almost to the forehead, but the nerves do not cover the face or the area near the ears; other nerves supply these regions.

Often times it is the result of a trauma such as a whiplash or a bad head injury, but it can also occur spontaneously.

What causes Occipital Neuralgia?

Some common causes include:

  • Compression of the space between the vertebral bones of C1 and C2
  • Compression of the atlantoaxial ligament as the dorsal ramus emerges
  • Compression of the deep to superficial turn around the inferiolateral border of the obliquus capitis inferior muscle and its tight investing fascia
  • Compression of the deep side of semispinalis capitis, where initial piercing can involve entrapment in either the muscle itself or surrounding fascia
  • Compression of the superficial side of semispinalis capitis, where completion of nerve piercing muscle and its fascia again poses risk

Surgery for Occipital Neuralgia

Occipital Neuralgia Overview

We also recommend this article from the American Association of Neurological Surgeons.


Neuralgia Expert Articles by Princeton Brain & Spine Founder Dr. Mark McLaughin
Surgical treatment for occipital neuralgia is sometimes required. In this video, Dr. McLaughlin explains the key points that will be considered before surgery is recommended.
Occipital neuralgia is a distinct type of headache characterized by piercing, throbbing, or electric-shock-like chronic pain in the upper neck, back of the head, and behind the ears, usually on one side of the head.
Trigeminal neuralgia (also called Tic Douloureux) is a chronic pain condition characterized by recurring episodes of extreme, sporadic, sudden burning or electric shock-like face pain.
Glossopharyngeal neuralgia is a condition characterized by recurring episodes of severe pain in the tongue, throat, ear, and area near the tonsils. An overview from Dr. McLaughlin.
Occipital Neuralgia (ON) is a common disease that is often often misunderstood or not diagnosed by many physicians. Princeton New Jersey neurosurgeon Mark R. McLaughlin, MD explains.
Video: Stress may result in increased perception of facial pain from Trigeminal Neuralgia. Dr. McLaughlin offers some thoughts on dealing with TN during the coronavirus crisis. April 2020
September 2021: Video update with Mark R. McLaughlin, MD. What you need to know about COVID19 and Trigeminal Neuralgia.
Video January 2022 : Dr. McLaughlin highlights the current literature as it relates to Trigeminal Neuralgia and the Covid Virus. What have we learned?
A January 2022 review of medical literature related to COVID-19 vaccination, Trigeminal Neuralgia, and Neurological Complications. What does the medical literature tell us?
The wife of WGN Sports Anchor Pat Tomasulo suffers from Trigeminal Neuralgia. An informative video.
Dr. McLaughlin was interviewed about Trigeminal Neuralgia and his experience as a top Neuralgia specialist in New Jersey.
One of my great passions is the treatment of Trigeminal Neuralgia. It is a traumatizing and painful condition. This video was prepared for Saint Peters Healthcare. In it, I answer some common questions about TN.






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