Q: Dr. Eppley, I had occipital neuralgia decompression surgery 5 weeks ago, My doctor also talked about decompressing the auriculotemporal nerve. I was nervous to have them done at the same time, so we were conservative and are waiting to see if it will be necessary after the 3 month mark from surgery. I have never suffered from migraines. I had a whiplash in my neck that had caused my neuralgia. I had mild temple pain on the right side, but my doctor said that could come from the greater occipital as well, so I wanted to wait see if that went away like the nerve pain has. What are your thoughts? I have been reading your website and wanted to get your input. I also wanted to know what the recovery time was for the auriculotemporal nerve. Is it the same as the occipital nerve decompression surgery. Also what are the percentages of success after auriculotemporal decompression.
A: Given that the origin of your head pain was from a whiplash injury and not a ‘traditional’ migraine trigger, I don’t think anyone can answer your question as to the success of auriculotemporal nerve decompression in your case. For refractory temporal pain it is also important to identify where the potential nerve source involved is the auriculotemporal or the zygomaticotemporal nerves. They are in different locations on the temple with one being in the hairline and the other between the hairline and the brow. If the pain location is between the hairline and the brow (the zygomaticotemporal nerve), this should first be tested by Botox injections which can predict the success of surgical nerve decompression/avulsion. There is no test for the auroiculotemporal nerve and whether its decompression will be successful.
Dr. Barry Eppley