1. Radiculopathies usually involve C6-7 (see cervical radiculopathies); rarely the C3-4 nerve root foramen is affected with compression of the C4 root. Symptoms are pain and paresthesias in the ear region with sensory loss.
2. The cervical plexus is vulnerable in traction injuries such as motorcycle injuries that also affect the upper trunk of the brachial plexus, and during surgery of carotids (endarterectomy) or radical dissection of the neck. Motor dysfunction other than phrenic injury is hard to detect. Sensory loss in the upper cervical regions is common.
3. Herpes zoster is common in C2 and C3 dorsal root ganglia. Both zosteriform eruptions and postherpetic neuralgia may occur.
4.C2 ganglionopathy/radiculopathy and greater occipital neuropathy (avoid term occipital neuralgia, and cervicogenic headache, and whiplash injury) presents with deep stabbing unilateral pain in the neck and back of the head, with hyper/hypesthesia of scalp and tenderness of the nerve. It is caused by trauma (whiplash), spondylosis, ligamentous entrapment, zoster, neurofibroma (dorsal ramus), and trauma/compression of the GON. "the cardinal symptom is intermittent or continuous numbness or paresthesias (with or without pain) in C2 dermatome. The C2 nerve may be tender to palpate, or patients may have vertigo. Some cases may require surgical exploration.
C2 nerve root is rarely involved in major fracture/dislocation, congenital abnormalities of the cervical spine, , subluxation of the atlas on the axis joint to to rheumatoid arthritis, or bone softening disorders such as Paget's disease, osteogenita imperfecta, and osteomalacia. Whiplash may be a cause but is probably vastly overstated.
Treatment including analgesics and acolar may or may not help, as may injections of anesthetics or corticosteroids. Surgery may reveal severe facet disease, ligamentous entrapment of a ganglion. Procedures may include C2 ganglionectomy or partial sectioning of the C1-3 rootlets.
5. The diversity of causes of "cervicogenic headache" make reports of definitive treatment difficult to evaluate.
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