Occipital Neuralgia

Patients with occipital neuralgia typically complain of intractable, posterior headaches. Prior attempts to treat this condition have traditionally consisted of various strategies to decompress or cut the greater occipital nerve. Some have even advocated the ablation of ganglia or cervical roots that give rise to the occipital nerve. However, such treatments are highly invasive, irreversible, and fraught with failure and complications. Modern strategies employing subcutaneous stimulation of the occipital nerve using linear stimulation arrays are quite effective and lower in invasiveness and risk. This chapter discusses the clinical hallmarks of occipital neuralgia and the technique by which these subcutaneous electrodes are implanted and utilized.