Differential Diagnosis for Occipital Headache with Motor Weakness
Single Most Likely Diagnosis
- Cervicogenic Headache: This condition is characterized by referred pain to the occipital region due to cervical spine dysfunction, which can also cause motor weakness due to nerve root compression or irritation.
Other Likely Diagnoses
- Tension-Type Headache with Coexisting Musculoskeletal Issue: Tension-type headaches can present with occipital pain and may be accompanied by motor weakness if there is an underlying musculoskeletal issue affecting the neck or shoulder region.
- Migraine with Aura: Some migraines can present with occipital headache and transient motor weakness as part of the aura phase, although this is less common.
- Cervical Spondylosis: This condition involves wear and tear on the discs in the neck, which can lead to nerve compression, causing both occipital headache and motor weakness.
Do Not Miss Diagnoses
- Subarachnoid Hemorrhage: Although less common, a sudden onset of severe occipital headache (often described as "the worst headache of my life") with motor weakness could indicate a subarachnoid hemorrhage, which is a medical emergency.
- Stroke or Transient Ischemic Attack (TIA): Sudden onset of motor weakness along with headache could be indicative of a stroke or TIA, especially if the headache is severe and accompanied by other neurological deficits.
- Meningitis: Inflammation of the protective membranes covering the brain and spinal cord can cause severe headache, fever, and sometimes motor weakness, requiring immediate medical attention.
Rare Diagnoses
- Occipital Neuralgia: This condition involves irritation of the occipital nerves, leading to severe pain in the occipital region, and could potentially cause motor weakness if the nerves affected also have motor branches.
- Chiari Malformation: A structural defect in the cerebellum that controls balance can cause occipital headache and, in some cases, motor weakness due to compression of the spinal cord or nerve roots.
- Multiple Sclerosis: An autoimmune disease that affects the brain and spinal cord, leading to a wide range of neurological symptoms, including headache and motor weakness, although the presentation would typically be more complex and multifocal.