The Korean Journal of Pain

  • 제23권1호
  • /
  • Pages.82-87
  • /
  • 2010
  • /
  • 2005-9159(pISSN)
  • /
  • 2093-0569(eISSN)
대한통증학회 (The Korean Pain Society)
권호 표지
DOI QR코드

DOI QR Code

Fluoroscopy and Sonographic Guided Injection of Obliquus Capitis Inferior Muscle in an Intractable Occipital Neuralgia

  • Kim, Ok-Sun (Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine) ;
  • Jeong, Seung-Min (Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine) ;
  • Ro, Ji-Young (Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine) ;
  • Kim, Duck-Kyoung (Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine) ;
  • Koh, Young-Cho (Department of Neurosurgery, Konkuk University School of Medicine) ;
  • Ko, Young-Sin (Department of Pathology, Konkuk University School of Medicine) ;
  • Lim, So-Dug (Department of Pathology, Konkuk University School of Medicine) ;
  • Shin, Hwa-Yong (Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine) ;
  • Kim, Hae-Kyoung (Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine)
  • 투고 : 2009.11.05
  • 심사 : 2010.01.11
  • 발행 : 2010.03.01
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Occipital neuralgia is a form of headache that involves the posterior occiput in the greater or lesser occipital nerve distribution. Pain can be severe and persistent with conservative treatment. We present a case of intractable occipital neuralgia that conventional therapeutic modalities failed to ameliorate. We speculate that, in this case, the cause of headache could be the greater occipital nerve entrapment by the obliquus capitis inferior muscle. After steroid and local anesthetic injection into obliquus capitis inferior muscles under fluoroscopic and sonographic guidance, the visual analogue scale was decreased from 9-10/10 to 1-2/10 for 2-3 weeks. The patient eventually got both greater occipital neurectomy and partial resection of obliquus capitis inferior muscles due to the short term effect of the injection. The successful steroid and local anesthetic injection for this occipital neuralgia shows that the refractory headache was caused by entrapment of greater occipital nerves by obliquus capitis inferior muscles.

키워드

참고문헌

  1. Andrychowski J, Czernicki Z, Netczuk T, Taraszewska A, Dabrowski P, Rakasz L, et al. Occipital neuralgia: possible failure of surgical treatment-case report. Folia Neuropathol 2009; 47: 69-74.
  2. Hashiguchi A, Mimata C, Ichimura H, Kuratsu J. Occipital neuralgia as a presenting symptom of cervicomedullary dural arteriovenous fistula. Headache 2007; 47: 1095-7. https://doi.org/10.1111/j.1526-4610.2007.00865.x
  3. Bruti G, Mostardini C, Pierallini A, Villani V, Modini C, Cerbo R. Neurovascular headache and occipital neuralgia secondary to bleeding of bulbocervical cavernoma. Cephalalgia 2007; 27: 1074-9. https://doi.org/10.1111/j.1468-2982.2007.01363.x
  4. Bloom KK, Ellen J, Kaye D. Occipital neuralgia and twelfth nerve palsy from a chondromyxoid fibroma. J Ky Med Assoc 2004; 102: 255-8.
  5. Garza I. Craniocervical junction schwannoma mimicking occipital neuralgia. Headache 2007; 47: 1204-5. https://doi.org/10.1111/j.1526-4610.2007.00887.x
  6. Hardy D. Relief of pain in acute herpes zoster by nerve blocks and possible prevention of post-herpetic neuralgia. Can J Anaesth 2005; 52: 186-90. https://doi.org/10.1007/BF03027727
  7. Kihara T, Shimohama S. Occipital neuralgia evoked by facial herpes zoster infection. Headache 2006; 46: 1590-1. https://doi.org/10.1111/j.1526-4610.2006.00616_2.x
  8. Mourouzis C, Saranteas T, Rallis G, Anagnostopoulou S, Tesseromatis C. Occipital neuralgia secondary to respiratory tract infection. J Orofac Pain 2005; 19: 261-4.
  9. Nikakis P, Koutsis G, Potagas C, Mandellos D, Sfagos C. Occipital neuralgia as an isolated symptom of C2 myelitis. Headache 2006; 46: 1304-6. https://doi.org/10.1111/j.1526-4610.2006.00543_2.x
  10. Stechison MT, Mullin BB. Surgical treatment of greater occipital neuralgia: an appraisal of strategies. Acta Neurochir (Wien) 1994; 131: 236-40. https://doi.org/10.1007/BF01808620
  11. Vital JM, Grenier F, Dautheribes M, Baspeyre H, Lavignolle B, Senegas J. An anatomic and dynamic study of the greater occipital nerve (n. of Arnold). Applications to the treatment of Arnold's neuralgia. Surg Radiol Anat 1989; 11: 205-10. https://doi.org/10.1007/BF02337823
  12. Kastler B, Boulahdour Z, Aubry S, Fergane B, Patay Z. Arnold's neuralgia. In: Interventional radiology in pain treatment. Edited by Kastler B. Berlin Heidelberg, Springer. 2007, pp 71-80.
  13. Hunter CR, Mayfield FH. Role of the upper cervical roots in the production of pain in the head. Am J Surg 1949; 78: 743-51. https://doi.org/10.1016/0002-9610(49)90316-5
  14. Lynn B. Cutaneous hyperalgesia. Br Med Bull 1977; 33: 103-8. https://doi.org/10.1093/oxfordjournals.bmb.a071408
  15. Jankiewicz JJ, Hennrikus WL, Houkom JA. The appearance of the piriformis muscle syndrome in computed tomography and magnetic resonance imaging. A case report and review of the literature. Clin Orthop Relat Res 1991; 262: 205-9.
  16. Bogduk N. The anatomy of occipital neuralgia. Clin Exp Neurol 1981; 17: 167-84.
  17. Caputi CA, Firetto V. Therapeutic blockade of greater occipital and supraorbital nerves in migraine patients. Headache 1997; 37: 174-9. https://doi.org/10.1046/j.1526-4610.1997.3703174.x
  18. Sung DH, Choi JY, Kim DH, Kim ES, Son YI, Cho YS, et al. Localization of dystonic muscles with 18F-FDG PET/CT in idiopathic cervical dystonia. J Nucl Med 2007; 48: 1790-5. https://doi.org/10.2967/jnumed.107.044024

피인용 문헌

  1. Termocoagulación por radiofrecuencia en la neuralgia occipital de Arnold vol.17, pp.8, 2010, https://doi.org/10.1016/j.resed.2010.09.006