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Cervicogenic Headache

Cervicogenic headache refers to head pain originating from the neck. The term cervicogenic headache was first introduced by Sjaastad and colleagues in 1983. However, the concept of cervicogenic headache is controversial and not well accepted by the majority of neurologists. The International Headache Society published its first diagnostic criteria in 1998 and revised it 2004. Patients with cervicogenic headache often have histories of head and neck trauma. Pain may be unilateral or bilateral. Pain is frequently localized in the occipital area. However, pain may also be found in the frontal, temporal or orbital regions. Headaches may be triggered by neck movement or sustained neck postures. This headache is constant with episodic throbbing attacks, like a migraine.

Patients may have other symptoms mimicking a migraine, such as nausea, vomiting, photophobia, phonophobia, and blurred vision. Cervicogenic headache is often misdiagnosed as migraine(10). History of head injury and detail physical examination on the occipital and upper cervical area often can help differential diagnosis. Patient with cervicogenic headache may have tenderness over the suboccipital, C2, C3, or C4 regions, or over the third occipital nerve.

Cervicogenic headache does not respond well to migraine medications. Treatment should be focused on the removal of pain source from the occipital-cervical junction. Initial therapy is directed to physical therapy modalities and NSAIDs. Interventional treatment, such as greater occipital nerve block, cervical facet joint block, and botulinum toxin injections, often provides effective pain relief.

Meet the FLPNR Team

  • YiLi Zhou, M.D., Ph.D
  • Hoang (Wayne) T. Vu, D.O.
  • Lourdes Varela–Batista, M.D.
  • Vinh-Loc Nguyen, P.A.
  • Kirstie Nicol, P.A.
  • Irene Aponte Moreno, N.P.
  • Sunny Park, N.P.
Neurologist in Ocala, FL Doctor of Osteopathic Medicine in Ocala, FL Physician in Ocala, FL Physician in Ocala, FL Physician in Ocala, FL Nurse Practitioner in Ocala, FL Nurse Practitioner in Ocala, FL
Neurologist in Ocala, FL

YiLi Zhou, M.D., Ph.D.

Harvard-Trained, Board-Certified Pain Specialist and Neurologist.

Dr. Zhou graduated from Wenzhou Medical College, China in 1982 with training in both modern western medicine and traditional Chinese medicine. He had neurology fellowship training at Shanghai Medical School, specializing in EMG/NCV and evoked potential studies. He served as an attending neurologist in China.

Doctor of Osteopathic Medicine in Ocala, FL

Hoang (Wayne) T. Vu, D.O.

Dr. Zhou graduated from Wenzhou Medical College, China in 1982 with training in both modern western medicine and traditional Chinese medicine. He had neurology fellowship training at Shanghai Medical School, specializing in EMG/NCV and evoked potential studies. He served as an attending neurologist in China.

Physician in Ocala, FL

Lourdes Varela–Batista, M.D.

Dr. Varela is a fellowship trained pain specialist and board certified PMR expert. Her specialities include physical medicine and rehabilitation and interventional pain medicine. She received her undergraduate degree from University of Puerto Rico and completed her medical degree from New York Medica College. Dr. Varela completed her physical medicine and rehabilitation residency at University of Texas Health Science Center San Antonio.

Physician in Ocala, FL

Vinh-Loc Nguyen, P.A.

Vinh-Loc Nguyen is a NCCPA certified physician assistant and is licensed by the State of Florida Department of Health. He received his Bachelor of Science degree in microbiology and Bachelor of Arts Degree in economics from University of Florida in 1994. He had a successful career in the financial industry before returning to his true passion for medicine.

Physician in Ocala, FL

Kirstie Nicol, P.A.

Kirstie has been serving as a physician assistant at Florida Pain and Rehabilitation Center, Lake City since September 2016. She is board certified by the National Commission on Certification of Physician Assistants (NCCPA). She received her master of science in physician assistant studies, at Clarkson University in Potsdam, NY.

Nurse Practitioner in Ocala, FL

Irene Aponte Moreno, N.P.

Ms. Irene Aponte Moreno is an Adult-Gerontology certified Nurse Practitioner and licensed by the State of Florida Department of Health. In 2014, she received her Master of Science degree in Nursing from the University of South Alabama. She completed her Bachelor of Science degree in Nursing from Jacksonville State University in December of 2006. In 2003, she received an Associates of Arts degree from Southwestern Michigan College. She also completed an Associate degree in Informatics from the University Institute Antonio Jose de Sucre located in Lara State, Venezuela.

Nurse Practitioner in Ocala, FL

Sunny Park, N.P.

Ms. Sunny Park is an AANP and ANCC certified Advanced Registered Nurse Practitioner, licensed by the State of Florida Department of Health. She graduated with Summa Cum Laude with Bachelor of Arts in Drawing from Southern Illinois University in 1999. She pursued nursing career and graduated with Associate of Science in Nursing in 2007 and started working as a registered nurse in Cardiovascular ICU in St.Luke’s Medical Center. She continued with her education and graduated with Magna Cum Laude obtaining Bachelor of Science in Nursing in 2010 from Cardinal Stritch University. During her nursing education, she was awarded multiple scholarships including the Lamplight scholarship by Milwaukee Nurses Association.

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