I saw a new neurologist yesterday who actually gave quite a bit of thought to my condition. As I was told in the past, she said I had occipital neuritis/neuralgia. My last occipital block and injection in my upper neck three months ago wore off, and that awful burning, pressure, tingling had come back.
The doctor had a really interesting perspective on it. She felt my neck and head and mentioned several times how she could feel a giant knot on the lower, back of my head/upper neck on the symptomatic side. She believes I stretched my occipital nerve doing aggressive sit-ups two years ago (which I had already suspected), and the muscle the nerve runs through (I think she said the supra occipital muscle) responded by going into spasm, continuing to “clamp” down on the occipital nerve, which continues the cycle. She said the treatment was another occipital block to stop the pain while also using a muscle relaxer to “relax” the muscle helping to ease it away from the nerve.
She injected me with a lidocaine-type med in the office and started me on the muscle relaxer. Unfortunately, the new muscle relaxer med gave me the heaves, and I felt really, really ill. So, another one-hit-wonder for me 
She also feels I am a good candidate for Botox and submitted a request to my insurance company. I am wondering if anyone here as had success with using Botox to relieve dizziness?
When I asked her about my dizziness (actually chronic dysequilibrium) and tinnitus, she said it sounded as if I had dissected a vertebral artery doing the sit-ups as the symptoms are consistent. I question this, however, since I have had episodes of symptom relief for extended periods of time, and a dissected vertebral artery would have healed (or I would have died or become disabled from a clot two years ago…) I had several (more) MRIs this afternoon so she can take another look at my brain stem and the arteries in my neck and brain.
Anyway, she did mention in passing that occipital neuritis can be a migraine trigger. In March, I had four occular migraine-like events, and the pupil on my affected side is bigger than the other, which is associated with migraine (and also with neck injury). When I go back for a follow-up appointment, I will ask her specifically about her opinion on VM. The question in my mind is whether my dizziness is caused directly by irritation of the occipital nerve or indirectly by the occipital neuritis being a migraine trigger thus causing VM.
It really makes sense to me about the muscle spasms in my neck/lower head continuing my dizziness (indirectly by continuing irritation of the occipital nerve?) since the dizziness always gets worse if anyone manipulates or rubs my neck or if I cry (tensing my neck) or hold my head in a down and forward position. It also possibly explains how if I’ve had an exceptional night sleep (or under light anesthesia for a surgical procedure) my tinnitus improves because the muscles in my neck/head would be more likely to be relaxed, releasing pressure off the nerves in my head. (The occipital nerve actually runs outside the skull, under the skin running behind/between muscles.)
Any feedback on treating dizziness with Botox??
