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Sudden onset occipital-cervico-brachial neuralgia
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Sudden onset occipital-cervico-brachial neuralgia

Hi, Two days after the 2008 season flu shot (shot on 11/19, first episode on 11/20), I had a sudden crescendo-like headached lancinating pain (9 on 10 high scale) about 1 inch above the ear and incidental but uncomfortable heat and tingling radiating towards temple area, upper external ear, right side neck, in front of the scapula, skipping the shoulder, running down the top of my arm and ending in the thumb, forefinger and third finger.  I had no head trauma, just a regular day. The first two episodes were 3 days apart, pain at 9 on a 10 high scale (visited emergency room both times due to extreme pain) and lasted 1 hr 40 minutes and occurred just after I layed down to sleep.  All the usual suspects were ruled out by neurologist.  Currently taking 200 mg of carbomazepine at 8 pm trying to manage pain with subsequent attacks, seven more to date of varying intensity but shorter in duration, approximately 1 hour now.  MD and neurologist DO suspect idiopathic Trigeminal Neuralgia, but rolled their eyes over the burning, tingling sensation in arm.  I see though that occipital neuralgia makes more sense for the area of lancinating pain, but that does not explain the concurrent presence of the arm and right side neck heat and tingling.   I am completely befuddled how this occurs at exactly the same time (totally synchronized).
By the way, I am 56, 20 lbs overweight, am getting a consultation soon over elevated TSH and cholesterol, take Bisoprol 6.5 mg daily for borderline hypertension, but otherwise am quite healthy, exercise regularly and have not had even a slight cold in 2 years.
I was in a car accident 8 years ago and did a head plant and rotation while skiing at age 29 (heard my C1 - C7 go crunch). In the car accident, I landed (literally) with my head turned to the right over my right shoulder likely at about 40 mph after hitting black ice and departing the road perpendicular to the highway and dropping 20 feet (with seat belt on -- thank God I was in my Tahoe or I probably wouldn't be writing this).  Nothing broken, but for about 1 year I had pulsating pain radiating up two lines on the left and right side of the back of my head and terminating at the top, but only intermittently and a frequency about 2 per month and then again repeated about 2 years after the accident and then nothing.  
My question is: Is there some relationship between occipital-cervico-brachial-trigeminal nerves such that these symptoms would present at the same identical time in cadence rising in this crescendo manner, sustaining a level of intensity and diminishing all at the exact same time? Thank you for your time, puzzled and hoping to steer my doctors to a diagnosis as I am in rural America with no access to a major neurology clinic.  Cheers, Outsidetheboxgirl.


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