Occipital headache treated succesfully with palmitoylethanolamide

Under the titel  

‘Occipital Neuralgia Responding to Palmitoylethanolamide’ 

Rocco Salvatore Calabrò and Placido Bramanti reported a case in ‘Headache’, a female patient affected by occiptal-treatment-refractory-neuralgia that greatly improved after oral intake of palmitoylethanolamide (PEA). 

Occipital neuralgia (ON) is defined as paroxysmal shooting or stabbing pain in the dermatomes of the nervus occipitalis major or nervus occipitalis minor. This is severe headache which often originates in the suboccipital region and radiates over the vertex, and may be elicited by pressure/percussion over the nervus occipitalis.

A 36-year-old woman was seen by the authors with acute episodes of burning pain in the right occipital region, often extending to the top of her head, for the previous 8 months. Initially, the patient initially suffered from headache only when lying in the bed, but the pain gradually became continuous, with periodic exacerbations, and was associated with the presence of sensibility changes, such as dysesthesia and hypersensitivity in the distribution of the greater occipital nerve. 

Thus, the patient was treated with gabapentin, up to 600 mg/ day, but significant neurological side effects appeared and treatment was stopped. As the patient refused any other comparable analgesic drugs, PEA, up to 1200 mg/day, was introduced and after around 2 weeks of treatment pain gradually improved.

The authors reported more positive experiences with PEA in neuralgias, such as in pudendal neuralgia.


Calabrò RS, Bramanti P. Occipital Neuralgia Responding to Palmitoylethanolamide. Headache. 2013 May 23. doi: 10.1111/head.12136.

Calabrò RS, Gervasi G, Marino S, Mondo PN, Bramanti P. Misdiagnosed chronic pelvic pain: Pudendal neuralgia responding to a novel use of palmitoyletha- nolamide. Pain Med. 2010;11:781-784.

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