Occipital neuralgia commonly presents as pain at the base of the skull with occasional shock-like sensations in the back of the head wrapping around to the top of the head and sometimes behind the eyes. The pain usually occurs on one side; although, it can occur on both and can last for a few seconds or be constant. Sometimes, a person with occipital neuralgia may experience blurry vision. Trauma to the greater and lesser occipital nerves usually causes occipital neuralgia. Extended periods of neck extension, as in painting ceilings or looking at a computer screen that is too elevated, can lead to injury of the nerves. It is diagnosed by ruling out other causes of headache and with diagnostic injections in which the occipital nerves are made numb using a local anesthetic such as lidocaine. If relief is attained, the diagnosis is occipital neuralgia.
Occipital neuralgia is typically caused by trauma to the greater and lesser occipital nerves and long periods of neck extension.