Acute-Onset Severe Occipital Neuralgia Associated With High Cervical Lesion in Patients With Neuromyelitis Optica Spectrum Disorder.

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.