Re: Parasthesia

Posted By Laurie on May 02, 1999 at 09:51:15
Is it possible to have a parasthesia that just affects the head, neck and shoulders?  I have had a burning, pins and needles and occasionally itching sensation in these areas for four months.  Just awoke one morning and it was there -- hasn't gone away since.  Two neuros have diagnosed headache, but I know this is not a headache.  Antidepressants make the burning spread from head to toe (have tried two SSRIs and one tricyclic -- will not do that again!!).  Have had 2 MRIS, evoked potentials, EEG, blood work -- all are normal (I'm a 35yo female).  One neuro suggested a viral infection.  Currently on Neurontin, Lorcet (max of one per day) as needed for pain.  My internist calls it neuritis and also doesn't believe it's a headache (she's been my dr for several years and knows my history best vs. the neuros who only saw me one time).  I just want to find out what this is and how long it might last.  Thanks for any insight.

[CCF MD mdf]

Posted By CCF MD mdf on May 03, 1999 at 23:10:32
Numbness, burning, pins/needles, paresthesias ...
These are all very difficult to figure out sometimes. If the anatomic distribution is such that it suggests a particular location in the nervous system from which symptoms might be coming, then it's usually not so hard. But MANY people have generalized paresthesias or migratory sensory abnormalities which don't conform to anatomic or physiologic structures.
Yours is such a case, and it is not surprising that the MRI has been negative. EEG and evoked potentials were long shots, but not surprising that they were negative.
In order to suggest viral infection, one must know what was infected. I don't have enough information to be able to agree with that suggestion.
Neuritis implies that one knows the problem is in a nerve or set of nerves somewhere (specific nerves, not just "nerves"). Further, it implies that one knows it is an inflammatory process. I don't know that from the data here.
Headache is interesting. Usually, people with headaches know they have headaches - no one else can tell you that. Now it IS possible to have migraine withOUT headache (so-called acephalgic migraine), and I have seen that in a few people. But usually it is more clear-cut anatomically - for example, sparkling lights in one half of the visual field for a few moments. Your pattern doesn't match, at least from the data presented here.
Hard to tell you how long yours will last.
Bummer about the response to SSRI and tricyclics. They are very handy meds for these sorts of symptoms (for migraines, too) for reasons that are not quite clear yet. I wonder if you tried too large a dose too quickly. My personal style is to start tricylics at very tiny doses and work up very slowly - it takes a long time to effect, but it is better tolerated. Also, one tricyclic may be awful and the next one well tolerated.
I don't quite know what to tell you. If you would like yet a third opinion, you are welcome to call 800 223-2273 and ask for neurology appointments at 4-5559. I hope this helps.
CCF MD mdf.











Follow Ups:


Parasthesia Laurie 5/04/1999
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Re: Parasthesia CCF Neuro[P] MD, RPS 5/29/1999
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