In addition to having chronic, intractable migraines, I have occipital neuralgia now.
This was, as the kids like to say, “sussed out” by the location in which my migraines almost always start. Apparently it’s not a common diagnosis or even a common thing, although I am not surprised to have been diagnosed with… wait for it, something that isn’t common. This would explain why triptans do not really work on me, or they only work a little bit. The pain from occipital neuralgia can not be ameliorated by triptans because that pain is not actually migraine pain, even though I have both diagnoses at present. However, it can be lessened with targeted Botox shots as well as steroid shots along the location in which the nerve travels. I am open to both of these things if they can in any way meaningfully help. My pain management clinic is actually trying to get Botox injections approved for me, so I will see how that goes. It has taken awhile, but apparently these things predictably do. I will just bide my time here and wait, heh.