It is now 2 1/2 weeks after my second block at c2 and of the occipital nerve. I
woke up on day 15 and my head pain was completely gone. Since my problems came
back mid-June after a 3 month hiatus following my first injection, I had been
having progressively intense unilateral pressure and tingling sensations and
then intense burning on the left side of my head (back, behind the ear, on the
scalp above the ear and at the top, left side of my head). The papers given to
me by the surgery center said the steroids in the injection should kick-in 3-5
days post-injection. However, I’ve read elsewhere that the injection can take
2-3 weeks to have an impact. My neck pain is still present and does not seem to
be much better.
I’m still dizzy (although I had 2 days of some reprieve 5 days post-injection),
but it is different. It’s not the violent and exhausting bobbing and rocking I
had been having. Fingers crossed it will continue to improve. Last time, it
took 5-6 weeks for the dizziness to improve by 75-80%.
I may have mentioned this before, but I’ve recently had 3 physicians mention the
connection between cervical issues and dizziness. One of the physical rehab
physicians told me that even lower cervical stenosis can cause dizziness due to
changes in the CSF flow. She also said she has had many patients with issues at
c1 and c2/3 (upper cervical) with dizziness that resolved with injections. (Of
course, I am not advocating that everyone run out and request an injection; I’m
simply passing along the information in case it’s of interest to anyone.)
I’ve had other strange, intermittent symptoms in my face(twitching left eye,
strong pain in my top, left gums/teeth, left cheek tingling, weird feelings on
the left side under my mouth), and the mechanism of these sensations was
explained to me as well. Apparently, the occipital nerve ganglion interconnects
with the trigeminal nerve ganglion (I think she said in the brain stem or maybe
just at c2?) so it’s not unusual for someone with occipital neuralgia to have
pain referred to any of the trigeminal nerve branches, especially the area
around the eye, which is innervated by one of the TN branches. (Other TN
branches go to other areas of the face…) These sensations have all
disappeared since my c2 injection.
I asked her what the connection is between the upper cervical area and ear/dizzy
problems. She told me there are sensory nerves for the ear that are in
proximity to the occipital nerve origins at c2 (I’m paraphrasing) as well as
neck proprioceptors, which are nerve receptors in the neck muscles that feed
information to the central nervous system (brain) regarding where one is in
space. My feeling was that this subject is not well understood. Here’s an
excerpt from and a link to an interesting case study from Taiwan that mentions
the relationship of the upper cervical spine to dizziness and tinnitus:
“The possible causes of occipital neuralgia has been discussed elsewhere.,4 but
it is important to consider other causes of occipital neuralgia as migraine and
cluster headaches as well as diseases that involve the C!, C2 and C3 nerve roots
may be easily confused.5 These roots receive branches from the spinal accessory
nerve and the superior sympathetic ganglion. There is also communication between
the roots and the trigeminal ganglion and probably the acoustic and vestibular
nerves which may explain some of the confusing symptoms such as blurred vision,
nasal stuffiness, tinnitus and dizziness.”
pain-manage.org.tw/ex/ex10.htm
One neurologist I saw mentioned there was “cross-talk” between the various
nerves that run through the upper cervical spine. (I guess that’s the same
thing as “communication” between the nerve roots as referenced above.)
I’m certainly not advocating that everyone on this board has cervical issues
and/or occipital neuritis as the root of their rocking/bobbing/dizziness. (I’m
well aware of the controversy that exists in the MdDS and MAV communities
regarding this… ) However, a couple of people asked me to pass along the
information my physicians shared so that is why I am providing this follow-up.
I’m just telling my story as it unfolds. I’ll check in again and let you know
if there is any further improvement with my rocking/bobbing. Oh, and my left
ear is still clear; it has not felt “full” nor plugged since I had the
injection! (With the exception of that 3 month period after my first injection,
2 1/2 weeks is the longest I’ve gone without that annoying full sensation and
clicking/popping in my left ear.) I also haven’t had that awful stabbing left ear pain since I had the injection. (Unfortunately, I still have intermittent tinnitus, a symptom that never went away even when the dizziness was improved this past spring.)