Presented at the 2013 AAPM Annual Meeting « Back

Occipital Nerve Radiofrequency Ablation for Occipital Neuralgia and Headaches: Use in Special Patient Populations

Robert Kent, DO MHA, rkent@health.usf.edu¹, Sandip Patel, MD¹, Rafael Miguel, MD¹, Mauna M. Radahd, MD¹, (1) University of South Florida, Tampa, Florida

Two patients who presented to the pain clinic complaining of recurrent and incapacitating pain consistent with occipital neuralgia and associated headaches and their treatment with occipital nerve radiofrequency ablation (RFA) are presented. Patient 1 is a 43-year-old female with a 2-year history of occipital pain and associated headaches which developed after craniotomy. The patient responded positively to left greater and lesser occipital local anesthetic diagnostic/therapeutic injections. The patient did not wish to take neuromodulators and controlled substances due to lack of pain relief and persistent side effects. She was offered the option of RFA versus occipital nerve stimulation with an implantable system. The patient selected and underwent left greater and lesser occipital nerve RFA with positive results. Patient 2 is a 35 year old in her 10th week of pregnancy with severe cervicalgia, cervical radiculopathy and associated occipital headaches secondary to cervical disc disease and abnormal antalgic neck positioning. She was taking large amounts of oxycodone without any significant relief and considered termination of pregnancy. The patient responded to RFA with complete relief on the left side and complete elimination of headaches and head pain but persistence of right-sided neck pain. She was able to wean off all analgesic medication and deliver at term without issue.

Funding: None