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Acute‐Onset Severe Occipital Neuralgia Associated With High Cervical Lesion in Patients With Neuromyelitis Optica Spectrum Disorder
Author(s) -
Hayashi Yuichi,
Koumura Akihiro,
Yamada Megumi,
Kimura Akio,
Shibata Toshirou,
Inuzuka Takashi
Publication year - 2017
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1111/head.13126
Subject(s) - medicine , neuromyelitis optica , occipital neuralgia , spectrum disorder , lesion , multiple sclerosis , pediatrics , neuralgia , radiology , surgery , anesthesia , neuropathic pain , psychiatry
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.