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Dr. Bob
Dr. Bob, Neurologist (MD)
Category: Neurology
Satisfied Customers: 5423
Experience:  Neurology & Int Medicine (US Trained): 20 yrs experience
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I have twinges like electric shocks in the back of my head 2

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I have twinges like electric shocks in the back of my head 2 or 3 times a day
Doctor-Bob :

How long has this been going on?

Customer:

four months

Doctor-Bob :

how many times per day, on average

Doctor-Bob :

is it 2 or 3 every day?

Customer:

2 or 3 times a day

Doctor-Bob :

how long does the sensation last?

Customer:

less than a second

Doctor-Bob :

are you in generally good health otherwise?

Customer:

yes

Doctor-Bob :

This is what we call occipital neuralgia. Most of the feeling in the back and top of the head is transmitted to the brain by the two greater occipital nerves. There is one nerve on each side of the head. Emerging from between bones of the spine in the upper neck, the two occipital nerves make their way through muscles at the back of the head and into the scalp. They sometimes reach nearly as far forward as the forehead,

Doctor-Bob :

Irritation of one these nerves anywhere along their course can cause a shooting, zapping, electric, or tingling pain.

Doctor-Bob :

In some patients the scalp becomes extremely sensitive to even the lightest touch, making washing the hair or lying on a pillow nearly impossible. In other patients there may be numbness in the affected area. The region where the nerves enter the scalp may be extremely tender. Do you have any of these features?

Customer:

no

Doctor-Bob :

In difficult cases, we sometimes do what is called an occipital nerve block. An occipital nerve block is an injection of a steroid or other medication around the greater and lesser occipital nerves that are located on the back of the head just above the neck area. This usually calms the nerves. If this doesn't sound like something you would be interested in, there are medications that can be tried.

Customer:

Could this escalate to a situation that could cause incapacitation if left un-treated?

Doctor-Bob :

Not at all. It is a local nerve problem. Something is irritating it. When that irritant goes away the problem should slowly resolve.

Doctor-Bob :

It's possible you have arthritis in the cervical (neck) spine and this is causing crowding of the nerves as they exit the spinal cord and emerge under the skull. This does not tend to get better but can improve some with physical therapy. You would need to see your doc for an exam, an x-ray of the spine and a referral to PT.

Doctor-Bob :

An MRI would probably not be necessary but would provide even more information.

Customer:

There is no pain at all, but a slight crunchy noise ( sensation ) if I roll my head from side to side

Doctor-Bob :

That's usually from arthritis in the joints and possible scar tissue in some of the ligaments holding the bones together. This is a very common finding over 40 and usually is more of an annoyance than anything else.


Customer:

Thanks. That all makes sense. I will book in for an Xray.

Doctor-Bob :

You're welcome. If I've been helpful to you, and you have no further questions, please remember to accept my answer so I get credit for my time. I appreciate the acknowledgment. Best wishes.

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