We would like to report a simple technique used in treating six cases of herpes zoster trigeminal neuralgia seen at our office within the past 18 months. This procedure is based on the technique suggested by Dr. P. G. Skillern Sr.1
An anatomical diagram to illustrate the probable rationale for such therapy is presented in Figure 1.
The technique for injection of the great occipital nerve on the affected side is as follows:
The patient is placed sitting in a chair with the posterior scalp facing an adequate light source. Figure 2 shows a small curette searching for pinpoint tenderness. Pressure on this point produces pain which betrays the site of the great occipital nerve. The main trunk of this nerve traverses a vertical course ranging from one-fourth to one inch lateral to a midpoint on the occipital protuberance. This site can then be marked with a suitable staining
SKILLERN SD, RODIN H. Herpes Zoster Trigeminal Neuralgia: Pain Relief by Alcoholic Block of the Great Occipital Nerve. Arch Dermatol. 1960;82(2):247–249. doi:10.1001/archderm.1960.01580020089015
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