Lesser Occipital Nerve Injection

Lesser Occipital Nerve Injection
Indication	Occipital Neuralgia and headache disorders
Syringe	3mL
Needle	27-30G
Steroid	optional 4mg dexamethasone
Local	1-3mL of anaesthetic
Volume	1-3mL

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The lesser occipital nerve (LON) is commonly injected alongside the greater occipital nerve for headache disorders.

Anatomy

The lesser occipital nerve (LON) arises from the primary ventral rami of the second and third cervical nerves. It passes superiorly along the posterior border of sternocleidomastoid. It divides into cutaneous branches that supply the lateral portion of the posterior scalp.

Cranio-cervical Dermatomes.^[1]

Procedure

Landmark guided

The procedure is similar to the the greater occipital nerve injection
Locate the LON by going two-thirds of the way between the occipital protuberance and the mastoid process.
Enter perpendicular to the skip, stop at the periosteum.
Aspirate gently and then inject.

References

↑ Blumenfeld et al.. Expert consensus recommendations for the performance of peripheral nerve blocks for headaches--a narrative review. Headache 2013. 53:437-46. PMID: 23406160. DOI.

Literature Review

Reviews from the last 7 years: review articles, free review articles, systematic reviews, meta-analyses, NCBI Bookshelf

Articles from all years: PubMed search, Google Scholar search.

TRIP Database: clinical publications about evidence-based medicine.

Other Wikis: Radiopaedia, Wikipedia Search, Wikipedia I Feel Lucky, Orthobullets,

[1] Blumenfeld et al.. Expert consensus recommendations for the performance of peripheral nerve blocks for headaches--a narrative review. Headache 2013. 53:437-46. PMID: 23406160. DOI.

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