Hayashi Yuichi, Koumura Akihiro, Yamada Megumi, Kimura Akio, Shibata Toshirou, Inuzuka Takashi
Department of Neurology and Geriatrics, Gifu University Graduate School of Medicine, Japan.
Department of Internal Medicine, Takayama Red Cross Hospital, Takayama, Japan.
Headache. 2017 Jul;57(7):1145-1151. doi: 10.1111/head.13126. Epub 2017 Jun 14.
To address occipital neuralgia in patients with neuromyelitis optica spectrum disorder (NMOSD).
NMOSD is an inflammatory demyelinating disease that commonly presents with pain; however, headache symptoms have received little attention.
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.
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.
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.
