Management of Uncommon Secondary Arnold Neuralgia: Case Report and Review of the Literature

Occipital neuralgia, also called Arnold neuralgia, is a sharp, stabbing pain in the back of the scalp that affects the occipital nerve. The epidemiology and pathophysiology are uncertain, but it is considered to be different from other headache types. Postoperative Arnold neuralgia is rare and its treatment options also remain elusive. We report the case of a 42-year-old man with a history of C1-C2 arthrodesis with wires, plates, and screws after a C1-C2 avulsion fracture, who was followed up as an outpatient for unilateral, left stabbing, and sharp pain in the neck, that radiates over the cranium. The patient reported relief from stabbing and paroxysmal pain, which completely subsided with drug treatment within four months of treatment. This case suggests that thoroughly administered four months of medical treatment may be a beneficial treatment for patients with occipital neuralgia and should be sought before surgery is suggested to a patient who has undergone surgery for a cervical condition.