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On the concept of third occipital headache
Journal of Neurology, Neurosurgery, and Psychiatry
|July 1, 1986
Summary
Osteoarthritis in the C2-3 joint may cause headaches. Blocking the third occipital nerve (TON) helped identify this cause in 70% of patients with suspected cervical headaches, revealing a largely unrecognized diagnosis.
Area of Science:
- Neurology
- Orthopedics
- Pain Medicine
Background:
- Cervicogenic headaches are often linked to the C2-3 zygapophysial joint.
- Osteoarthritis of this joint is a potential cause of such headaches.
- The third occipital nerve (TON) innervates the C2-3 zygapophysial joint.
Purpose of the Study:
- To introduce a novel technique for blocking the third occipital nerve (TON).
- To utilize this nerve block as a screening tool for diagnosing headaches originating from the C2-3 zygapophysial joint.
- To establish the clinical significance of TON-mediated headaches.
Main Methods:
- A technique for selectively blocking the third occipital nerve (TON) was developed.
- This nerve block was employed as a diagnostic screening procedure.
- The study included consecutive patients presenting with suspected cervical headache.
Main Results:
- Seven out of ten patients (70%) with suspected cervical headache showed pain mediated by the third occipital nerve (TON).
- The identified pain source was consistently linked to the C2-3 zygapophysial joint.
- This suggests a significant prevalence of TON-mediated headaches in this patient group.
Conclusions:
- Third occipital nerve (TON) blocks are effective in identifying headaches originating from the C2-3 zygapophysial joint.
- TON-mediated headache is a significant, yet often unrecognized, cause of cervicogenic headache.
- This diagnostic approach is crucial for distinguishing TON headaches from other headache types like tension headaches.