Occipital Neuralgia

  One and a half years ago, i had an acute attack.  there was no accident, nothing that could be used to explain this attack.  For about 4-5 seconds, i felt a tingle in my right temple, i didn't pay much attention too it, then the next thing i knew there was this explosion of pain, my entire head was on fire.  I would say a migraine or a head ache, but that wouldn't explain it.  the first thought was a stroke or anyureism.  I had a cat scan, a mri, and nothing showed up except a pineal cyst.  After the initial attack, any activity would trigger another.  especially if i used my left arm.  I went thru months of pysical therapy, muscle relaxers (the knots on my neck an upper shoulder were enourmous).  At the end of physical therapy, the pain was localized to an area on the back of my head, directly above the neck.  the final diagosis was occipital neuralgia.  However, when i tried to find information on this, I found arguments that occipital neuralgia doesn't even exist.  One of the Neurologist's I visited even in indicated that there was no such thing.  I was eventually sent to a psychiatrist, because they believed it was psychosomatic.  This past year i have lived on muscle relaxers, valium, and amitryptilene, just to make my pain bearable.  I have not went a single day since the original attack that i have not had moderate to severe pain.  The only complete relief i recieved was in a marcaine nerve block, however, i have had several and after the last one the doc said he felt i shouldn't take anymore.  At this point, I am wanting to know what I can do about this occipital neuralgia.  I have heard of BoTox, and I am going to discuss this with my neurologist this month.  But are there other avenues.  My pain is real, and it has come to the point that i cannot function in daily life and suicide seems to be the only answer.  I would appreciate any comments, resources where i might find more information on the non-existant occipital neuralgia, what causes it, and how to fix it, or at least more permanent methods of relieveing the pain.  I need information so that i can work with my docs and insurance.  It has been uphill battle all the way.  Any informatin would be helpful.
____________
____________
Dear Drew,
Occipital neuralgia is characterized by episodes of severe, lancinating pain in the back of the head and neck due to irritiation of the occipital nerve for various reasons.  It is usually diagnosed by history and response to treatments.
The first line of treatment for occipital neuralgia is with medication.  Tegretol, an anti-seizure medication, is often useful in this situation.  If a patient fails medical therapy, a physician may consider injection therapy.  Steroids, local anesthetics and botox have all been used with success, though every patient is different.
Speak to your physician about the situation and see if you don't qualify for medical therapy such as Tegretol.  This could potentially save you some time and a lot of strife.
Good luck.