Cervicogenic headache in patients with presumed migraine: Missed diagnosis or misdiagnosis?

Xiaobin Yi, Andrew J. Cook, Robin J. Hamill-Ruth, John C. Rowlingson

Research output: Contribution to journalArticlepeer-review

30 Scopus citations


The differential diagnosis of headache is often challenging, with significant clinical and socioeconomic consequences of incomplete or inaccurate diagnosis. Overlapping symptoms contribute to the diagnostic challenge. Four female patients, ages 26 to 69 with standing diagnoses of migraine, were evaluated and treated for complaints of chronic, severe headaches. All had obtained limited relief from migraine therapies. On physical examination, all had occipital nerve tenderness or positive Tinel sign over the occipital nerve. All responded well to occipital nerve blocks with local anesthetic, achieving complete or substantial pain relief lasting up to 2 months. We conclude that accurate diagnosis of occipital neuralgia or cervicogenic headache as contributing factors can lead to substantial headache relief through occipital nerve blocks in patients with coexisting or misdiagnosed migraine.

Original languageEnglish
Pages (from-to)700-703
Number of pages4
JournalJournal of Pain
Issue number10
StatePublished - Oct 1 2005


  • Cervicogenic
  • Diagnosis
  • Headache
  • Migraine
  • Occipital nerve block
  • Occipital neuralgia


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