I am suffering from localized tenderness in scalp. I also have left thigh numbness. My doctor diagnosed it as mild meralgia paresthetica. He prescribed Pregabalin, but I did not take due to concern of dizziness and drowsiness. I always have a fear that antidepressant medicine can cause cancer in later stages of life. I have attached my medical history for your reference. Please help.
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Thanks for giving such an elaborate information and history (attachment removed to protect patient identity).
Poorly treated migraine or irregular treatment.Investigations to be done:
1. Nerve conduction study of bilateral lower limbs, including bilateral lateral cutaneous nerve of thigh.
2. MRI brain and MR angiogram intracranial vessels with contrast.
3. ANA (antinuclear antibody), ESR (erythrocyte sedimentation rate), HBsAg (hepatitis B surface antigen), Anti HCV (hepatitis C virus), CRP (C-reactive protein) and fundus examination to look for papilledema.
1. Migraine headache leading to chronic daily headache.
2. Giant-cell arteritis (temporal arteritis).
3. Insomnia due to chronic daily headache.
Migraine headache.Treatment plan:
Get nerve conduction study as advised above. If it suggests meralgia paresthetica, then try Gabapentin in place of Pregabalin.
Rule out other causes of scalp tenderness by MRI and blood tests. If the tests come out be normal, then start appropriate prophylactic medications for migraine.
1. Avoid trigger factors of migraine headache.
2. Do not wear tight belt at waist.
Revert back with the test reports to a neurologist online.---> https://www.icliniq.com/ask-a-doctor-online/neurologist
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Thank you doctor,
The MRI was done for scalp and brain before two years, which was quite normal. I do not have a headache. I have pain under the skin of the scalp. My glucose level in fasting and random are 75 and 105 respectively. My CRP, homocysteine and all other body function test like liver function, kidney, heart, TMT and echo are normal. My cholesterol is 200 and vitamin B12 is 180. I had only one episode of migraine before six years, which was a throbbing headache. Then, two years ago, I had left-sided dull continuous pain on the scalp that eases after rest or sleep, but comes again.
Welcome back to icliniq.com.
Revert back with the reports to a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist
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