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Hi Kisha. Occipital neuralgia is a fairly common type of headache characterized by throbbing, piercing, or electric-shock-like chronic pain in the upper neck, back of the head, and behind the ears, usually on one side of the head, but sometimes both.
The location of pain is related to the areas supplied by the greater and lesser occipital nerves, which run from the area where the spinal column meets the neck, up to the scalp at the back of the head. The pain is caused by irritation or injury to these nerves, which can be the result of trauma to the back of the head, pinching of the nerves by overly tight neck muscles, compression of the nerve as it leaves the spine due to osteoarthritis, or lesions in the neck.
Treatment is generally symptomatic and includes massage and rest. In some cases, antidepressants or nerve stabilizers such as topamax may be used when the pain is particularly severe. Other treatments may include local nerve blocks and injections of steroids directly into the affected area.
While the topamax is an anti-seizure medication, it is used more commonly for disorders of the nerves, including neuropathic pain.
This makes sense because the firing of the nerves, in this case the occipital nerves, is really a form of mild seizures in the affected nerves...they fire inappropriately, sometimes spreading to nearby nerves as well. The medication helps to stabilize these rogue nerves, and raise the threshold required to cause them to depolarize (fire).
This medication does not cause seizures. The only risk of this would be if you were on a high dose and then suddenly stopped it. High doses are usually not required to calm down aberrant nerves.