Severe Base of skull tension

I have had migraines since I was 13. It took them almost a year of severe chronic migraines to diagnose be because I was so young, because I don't usually have Aura and this was 1997.

I have a variety of presentations. Most often, I have a vague prodrome consisting of general uneasiness, mild nausea, and fatigue. Sometimes followed by a non-visual Aura of intense dizziness and a weird thing on the right side of my head that is best described as similar to a very localized chill. Then the pain that more often than not doesn't exceed a 4, which is a huge blessing since I get so many, though sometimes it spikes to 8 or 9 and three times in my life to 10, but it comes with worse fatigue and nausea. Then the hangover general unwellness.

Sometimes I get silent migraines and it takes me all day to figure out why I feel so bad, though I'm getting better at recognizing them.

Sometimes the prodrome feels more like someone inserted a key right in my spine at the bar of my neck and is twisting it, pulling all those muscles in and I don't even notice, I just feel sick and sore, until I realize my neck and shoulders have been tensed up for over an hour and intentionally relaxing them causes a visual alteration in my posture they were so tight. Or that exact same thing happens around my ears. But then, from there, it's migraine as usual.

Rarely, maybe a handful of times since '97, I'll have a left side migraine that follows a more classic migraine profile.

Once I had optical Aura so bad I couldn't see for two seconds, but have had optical Aura fewer than ten times in my history.

My biggest trigger is weather, but stress can do it, as can eye strain, or any other type of headache can escalate.

And unrelated to migraine I get hypostatic low blood pressure. I think that's what it's called... When you get so dizzy when you stand up too fast that your vision fuzzes out like static snow on a TV for a few seconds? I can't take beta blockers for my migraines because my blood pressure dropped to 80/50 when they tried it.

MY QUESTION, though, is about this: on rare occasions, like tonight, I'll be awakened in the middle of the night with a burning tension at the base of my skull that has me writhing in pain. I can feel the unilateral pain of the migraine on the right side of my head, behind my right eye, but the pain at the base of my skull is what makes me want to scream in agony. It isn't tender to the touch, but it's so tight massage is almost unbearable even though it does provide some relief. Heat is unthinkable. Ice almost helps but not really. Trying to stretch almost does make me scream.

I found almost by accident that sitting cross-legged facing the back of my couch with extra pillows stacked against the back I could lean forward and the pressure of resting my forehead against them in a gentle stretch actually did provide significant relief until the worst passed.

Now I'm just incredibly sore pretty much all the way down my spine and across my shoulders from the incredible tension.

I've only had this happen maybe three times but have experienced similar tension, though very short lived, as a side effect of migranol in '98 and imitrex when I don't take a muscle relaxant with it (when it was first prescribed to me in 02 I had two meds I took with it to balance side effects. I have a scrip for just imitrex currently, but while I once considered it a miracle drug it hardly does anything now).

Anyway, I have an appt with my neurologist in Sept to follow up on ajovy at 6 months. I intend to ask about this frankly terrifying tension then, but I was wondering if anyone else experiences anything similar or thinks I should make an earlier appt.