This is Emergency Medicine Cases EM Quick Hits podcast, and I'm your host, Dr. Anton Hellman. EMCases is brought to you by Shremi, the Schwartz-Rizman Emergency Medicine Institute. That's a non-profit organization dedicated to improving EM care through high-quality research and education. The opinions expressed on this podcast are intended for general information and educational purposes only and should not be used to diagnose treat or prevent any medical condition, nor should they be used as a substitute for medical advice from qualified practicing physician. Unless stated otherwise, the opinions expressed by the hosts or guests are made in their individual capacity, not on behalf of the Institute nor medicine cases. First, a word from our sponsor Metricade, the experts in complex physician scheduling since 2012. I've been using Metricade's incredible scheduling system for a decade, and it's been a game changer for me and my colleagues.

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That's easyresc.com slash EMC-A-S-E-S. First up we have Dr. Matthew MacArthur,

who's going to tell us a little bit about occipital nerve blocks. Who to do them on, how to do them,

why to do them. Here he goes.

Recently, I had a patient come into the ED with occipital neuralgia.

The patient was a female in her 40s, not on any regular medications,

who presented with three days of frequent, sharp stabbing pains,

originating from her left occipate and shooting up the scalp and behind the

ear with associated allodynia and pain with brushing her hair on that side of the head.

She also had concurrent viral RTI symptoms with fever, aches and pains, cough, and sore throat

in the middle of a winter influenza season. The patient endorsed a

previous history of occipital neuralgia and her last bad flare-up was a few years ago when she had

COVID, which felt very similar to her current presentation. And at that time, the headaches did

eventually settle on their own after about a week. She had tried numerous pain medications, including some Tylenol No. 3s and Cotorilac

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