Purpose: The purpose of this study was to verifying the responses to the occipital nerve block for occipital neuralgia patients who has tender point around suboccipital area.

Methods: In a prospective way, 45 pediatric patients with occipital neuralgia were enrolled since July, 2005. All patients have normal vital sign and physical examination except for exquisite tenderness at suboccipital region in the great occipitial nerve or less occipital nerve. If pressing on these areas induces radiating pain over or through the scalp to the eye, the diagnosis is made. Pain was measured before and after the procedure using the visual analog pain indexes.

Results: Forty five pediatric patients with occipital neuralgia were enrolled from July 2005 to July 2013. Forty five patients, male: female = 15: 30, mean age: 15 +/- 8years. Twenty three out of 45 patients (51%) performed brain MRI. All patients except for two epilepsy patients showed normal neuroimaging study. Thirty nine (87%) patients were treated with 2% lidocaine (8%), 2% mepivacaine(85%), 0.2% ropivacaine(8%) and steroid. Six (13%) patients were treated with acupuncture. Pain indexes were declined in 31 patients, but 6 were not response. Mean visual analog pain index scores declined by 4.3 units. Twenty four (53%) patients experienced recurrence of the disorder, but 24 patients, 15(63%) patients were relived without the need for any further treatment. No complications or side effects were reported.

Conclusion: Our data suggests that occipital nerve block were safe and effective treatment for the children with occipital neuralgia.