Driver Develops Occipital Neuralgia From a Rear Impact Car Accident

This case involves a thirty-five-year-old woman who was rear-ended by another car, which jolted her head forward and backward. Shortly after the occurrence, she started complaining of headache and neck pain. She was subsequently treated for headache, back pain, and foot pain. She was also seen by a neurologist who prescribed her physical therapy. After treatment, her back improved but she continued to experience occipital and eye pain. A nerve block was performed, which provided temporary relief, but did not resolve the patient’s complaints. A pain management physician diagnosed her with occipital neuralgia.

Question(s) For Expert Witness

1. How would you determine if a patient had occipital neuralgia?

Expert Witness Response E-006821

Occipital neuralgia is irritation of the occipital nerve. It usually presents as headaches that begin in the neck and radiate into the back of the head into the suboccipital and sometimes the temporal area. The best way to diagnose and treat the problem is to do occipital nerve blocks. If the pain gets better after a block (which involves injection of a local anesthetic and steroid) that implies that the headaches are due to occipital neuralgia. It's certainly possible that this woman had occipital neuralgia. By reviewing the medical records, in addition to asking specific questions of the patient, I can determine any breaches in the standard of care.