Occipital neuralgia is defined as a paroxysmal jabbing pain in the distribution of the greater or lesser occipital nerves accompanied by diminished sensation over half of the scalp at the back of the head.

This syndrome is best managed with physical therapy, however, when this fails it can be well treated by cutting the origins of the nerves that supply the scalp as they exit the spinal cord thus leaving the patient with a numb region that is pain free.

All patients undergo CT guided nerve blocks with lidocaine prior to performing the surgical procedure to help predict which individuals will benefit.