Third occipital nerve

Last revised by Rohit Sharma on 27 Mar 2023

The third occipital nerve (TON) is a branch of the posterior root of C3, which provides cutaneous sensation to a small portion of the occipital scalp and innervates the C2/3 facet joints

Occipital region of the scalp close to the midline.

The posterior root of C3 (the third cervical nerve) gives off a medial branch which traces a path between the semispinalis capitis and cervicis muscles, before passing through the splenius capitis and trapezius muscles. Subjacent to the trapezius the medial branch gives off the third occipital nerve.

The third occipital nerve runs as thin fibers vertically, medial to the greater occipital nerve 2, for a short distance, before passing laterally, crossing the greater occipital nerve and running as far as the retroauricular line, where there may be overlap with small twigs from the lesser occipital nerve. Vertically the fibers do not extend beyond the superior nuchal line.

There are no named branches of the third occipital nerve, however, multiple small twigs intercommunicate with branches of the greater occipital nerve. Far laterally, the branches may overlap with small twigs from the lesser occipital nerve.

Some of the branches transverse medially, across the midline, and intercommunicate with the contralateral third occipital nerve 1.

The third occipital nerve supplies an area of the medial occipital scalp, overlapping with areas supplied by the greater and lesser occipital nerves. It also supplies the C2/3 facet joints 4.

  • third occipital nerve block

  • third occipital neurolysis or neurectomy

  • occipital nerve stimulation

  • occipital neuralgia, implicated with the greater and lesser occipital nerves

  • migraine, implicated with the greater and lesser occipital nerves

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