Acute‐Onset Severe Occipital Neuralgia Associated With High Cervical Lesion in Patients With Neuromyelitis Optica Spectrum Disorder. Issue 7 (14th June 2017)

• Record Type: Journal Article
• Authors: Hayashi, Yuichi; Koumura, Akihiro; Yamada, Megumi; Kimura, Akio; Shibata, Toshirou; Inuzuka, Takashi
• Is Part Of: Headache. Volume 57:Issue 7(2017)
• Page Start: 1145
• Page End: 1151
• Publication Date: 2017-06-14
• Subjects: neuromyelitis optica -- occipital neuralgia -- cervical MRI -- C2 myelitis -- corticosteroid; Headache -- Periodicals; Headache -- Periodicals; 616.8491
• DOI: 10.1111/head.13126
• Languages: English
• ISSNs: 0017-8748

Abstract

Abstract : Objective: To address occipital neuralgia in patients with neuromyelitis optica spectrum disorder (NMOSD). Background: NMOSD is an inflammatory demyelinating disease that commonly presents with pain; however, headache symptoms have received little attention. Methods: We presented three cases of NMOSD in which the patients experienced acute‐onset, severe, and steroid‐responsive occipital neuralgia. All patients provided consent to use their demographic and imaging data retrospectively. Results: In all three cases, MRI revealed a new high‐intensity area in the cervical cord at the C1‐C3 level of the spine, which was diminished in two of the three cases after corticosteroid pulse therapy. Conclusion: Our cases support the recognition of NMOSD as a cause of secondary headache. As patients with NMOSD experience severe occipital neuralgia, a relapse should be considered and a cervical MRI should be performed.