What relieves a headache? Discover the symptoms, causes, diagnosis, and effective treatments for various types of headaches, including occipital neuralgia and hemiplegic migraines.

Occipital Neuralgia: Symptoms, Causes, and Diagnosis

Occipital neuralgia is a condition in which the nerves that run from the top of the spinal cord up through the scalp, called the occipital nerves, are inflamed or injured. This can cause intense pain that feels like a sharp, jabbing, electric shock in the back of the head and neck. Other symptoms include aching, burning, and throbbing pain that typically starts at the base of the head and goes to the scalp, pain on one or both sides of the head, pain behind the eye, sensitivity to light, and tender scalp.

Occipital neuralgia can happen when there’s pressure or irritation to the occipital nerves, maybe because of an injury, tight muscles that entrap the nerves, or inflammation. Many times, doctors can’t find a cause for it. Some medical conditions linked to occipital neuralgia include trauma to the back of the head, neck tension or tight neck muscles, osteoarthritis, tumors in the neck, cervical disc disease, infection, gout, diabetes, and blood vessel inflammation.

To diagnose occipital neuralgia, your doctor will ask about your medical history, any injuries you’ve had, and do a physical exam. They may also give you a shot to numb the nerve, called a nerve block, to see if it provides relief. Blood tests or an MRI scan may be ordered if the case is not typical.

Treating Occipital Neuralgia

The first step in treating occipital neuralgia is to relieve the pain. Over-the-counter anti-inflammatory drugs like naproxen or ibuprofen, applying heat to the neck, resting in a quiet room, and massaging tight and painful neck muscles can help. If those don’t work, your doctor may prescribe medications like muscle relaxants, antiseizure drugs, or antidepressants.

Nerve blocks and steroid shots may also be used as a short-term treatment, with a series of two to three shots over several weeks to get the pain under control. Surgery is rare but may be an option if the pain doesn’t improve with other treatments or keeps coming back. Procedures like microvascular decompression or occipital nerve stimulation may be considered.

Hemiplegic Migraines: Symptoms and Causes

Hemiplegic migraine is a rare and serious type of migraine headache. Many of its symptoms mimic those common to stroke, such as muscle weakness that can cause temporary paralysis on one side of the body (hemiplegia). Early symptoms called auras may include trouble with muscle control and sensation, severe throbbing pain often on one side of the head, a pins-and-needles feeling moving up the arm, numbness on one side of the body, weakness or paralysis on one side, loss of balance and coordination, dizziness or vertigo, nausea and vomiting, and other vision and language difficulties.

The causes of hemiplegic migraines are not fully understood, but they are believed to involve genetic factors and abnormalities in brain function that lead to the temporary paralysis and other neurological symptoms.

Diagnosing Hemiplegic Migraines

Diagnosing hemiplegic migraines can be challenging, as the symptoms often mimic those of a stroke. Your doctor will likely ask about your medical history, conduct a physical exam, and may order tests like an MRI or CT scan to rule out other conditions. A neurologist specializing in headaches may be consulted to confirm the diagnosis.

Treating Hemiplegic Migraines

Treatment for hemiplegic migraines aims to manage the acute symptoms and prevent future attacks. Medications like triptans, anti-seizure drugs, and calcitonin gene-related peptide (CGRP) inhibitors may be prescribed. Lifestyle changes like avoiding migraine triggers, getting enough sleep, and managing stress can also help. In some cases, hospitalization may be necessary during severe attacks.

Preventing and Managing Headaches

Regardless of the type of headache, there are several strategies that can help prevent and manage the pain. These include:

• Identifying and avoiding potential triggers like stress, lack of sleep, certain foods, hormonal changes, and weather changes
• Practicing stress management techniques like meditation, yoga, and deep breathing
• Staying hydrated and getting regular exercise
• Taking over-the-counter pain relievers as needed
• Seeking professional treatment if headaches persist or worsen

The key is working closely with your healthcare provider to determine the underlying cause of your headaches and develop a personalized treatment plan. With the right approach, you can find relief and better manage your headaches.

When to Seek Medical Attention

If you experience sudden, severe headaches, headaches that interfere with your daily life, or headaches accompanied by concerning symptoms like vision changes, weakness, or confusion, it’s important to seek medical attention right away. These could be signs of a more serious condition that requires prompt diagnosis and treatment.