Exeresis in occipital neuralgia

31 patients, suffering from an occipital neuralgia, were treated surgically by section of the n. occipitalis major or minor. The retrospective study of these cases extends over a period of one to nine years. In 26 patients (84%) a good result was achieved initially, and 16 patients (52%) are completely free of any complaint up to the present. In five patients (16%) no improvement has occurred. In two of these five patients an epipharyngeal cancer was discovered later; in one of the patients trigeminal neuralgia was established later on. Contrary to earlier published intradural rhizotomy this operation is simple and without risk (it is performed under local anaesthesia), and in long-standing, obstinate and tormenting cases very good results can thus be achieved. The unclear aetiology of the neuralgia was observed anatomically by the atypical course of the nerves. Other methods for the treatment of occipital neuralgia were not considered here.