Occipital neuralgia is pain in the head and neck that begins at base of the head and moves to the scalp. The nerves send feeling from the brain to the top and back of your head. Occipital neuralgia has many causes that include neck tension, whiplash, a pinched nerve, osteoarthritis, cervical disc disease, blood vessel inflammation, gout, diabetes or an infection. A cause is not found in some cases.