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Infiltrative cervical lesions causing symptomatic occipital neuralgia.
[pyomyositis]
Occipital
neuralgia
is
a
well-recognized
cause
of
posterior
head
and
neck
pain
that
may
associate
mild
sensory
changes
in
the
cutaneous
distribution
of
the
occipital
nerves
,
lacking
a
recognizable
local
structural
aetiology
in
most
cases
.
Atypical
clinical
features
or
an
abnormal
neurological
examination
are
alerts
for
a
potential
underlying
cause
of
pain
,
although
cases
of
clinically
typical
occipital
neuralgia
as
isolated
manifestation
of
lesions
of
the
cervical
spinal
cord
,
cervical
roots
,
or
occipital
nerves
have
been
increasingly
reported
.
We
describe
two
cases
(
one
with
typical
and
another
one
with
atypical
clinical
features
)
of
occipital
neuralgia
secondary
to
paravertebral
pyomyositis
and
vertebral
relapse
of
multiple
myeloma
in
patients
with
relevant
medical
history
that
aroused
the
possibility
of
an
underlying
structural
lesion
.
We
discuss
the
need
for
cranio-
cervical
magnetic
resonance
imaging
in
all
patients
with
occipital
neuralgia
,
even
when
typical
clinical
features
are
present
and
neurological
examination
is
completely
normal
.
Diseases
Validation
Diseases presenting
"vertebral relapse"
symptom
pyomyositis
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