Epidemiology and clinical features of occipital neuralgia: A systematic review and meta-analysis
Abstract
BACKGROUND: Occipital neuralgia (ON) describes severe, paroxysmal occipital nerve pain. This review synthesizes data on the epidemiology and clinical features of ON.
METHODS: A systematic search of PubMed and Embase databases was conducted from 1988 to 2024. Two investigators independently screened titles, abstracts and full-text articles, and conducted a risk of bias assessment. Meta-analyses were performed using a random-effects model, and between-study heterogeneity was assessed using the I² statistic.
RESULTS: Fifteen clinic-based studies, comprising 579 patients with ON, were eligible. No population-based studies were identified. Of these, three clinic-based studies examined the relative frequency of ON among adults evaluated for headache or facial pain, with reported rates ranging from 0.6 to 24.4%. Pooled estimates revealed that ON presents in the fifth decade of life and afflicts females (73%). Common clinical features were unilateral pain (81%), a stabbing quality (59%) and severe intensity (54%). Pain affected the greater occipital nerve (98%) with accompanying hypoesthesia (73%). A history of co-existing migraine was common (46%) and a proportion had a history of neck trauma (30%). The between-study heterogeneity was considerable for most clinical features assessed.
CONCLUSIONS: ON shows female predominance and links with migraine and neck trauma. Identified features can aid diagnosis and management, but high heterogeneity calls for population-based research to…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 579 participants or records.
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