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Neurology (Expert Forum)
Scalp and facial numbness in relation to fungal infections?
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Scalp and facial numbness in relation to fungal infections?
by Sheri-Miler, Aug 31, 1998 12:00AM
Dear Physicians:
I would like to know if cases of severe seborrheic dermatitis and/or scalp infections can produce symptoms of pain alternating with numbness in the scalp and forehead. Basically, can fungal infections spread from scalp down into the scalp nerves?
I am a 35 year old woman who is basically healthy, but for the last three years I have suffered pain (yes pain, not "itching") in my scalp which alternates with numbness. Have been to g.p., dermatologist, gynecologist, endocrinologist to little avail. Have also lost ALOT of hair! Dermatologist in VA allowed me to be on Nizoral 30 days which seemed to help but we moved recently to TX and the doctor here insists it's merely seborrheic dermatitis and will not prescribe it because of "possible liver problems". Any suggestions as to where to turn next? Have you ever heard of such a condition? Any information greatly appreciated! Thank you!
Sherri M.
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I suppose a riproaring infection could cause inflammation to irritate the nerve endings around the face. Facial sensation is carried by the trigeminal nerve (cranial nerve V). There are three branches: V1 to the forehead, V2 below the eye and above the mouth, and V3 below the mouth (roughly). One would expect that if there were nerve involvement of some inflammatory process that the pain or discomfort would respect anatomic boundaries. By the way, the scalp way behind the hairline and behind the ears is served by a high cervical nerve root rather than a cranial nerve.
It is not uncommon (in the absence of skin problems) to have pain or numbness in the posterior scalp because of some mechanical irritation of the cervical nerve roots. Your doctor should be able to determine that.
I personally am no good at any dermatologic problems: distinguishing between seborrheic dermatitis and fungal infection is not for the neurologist to do. I can't even say whether the treatment is reasonable.
Be sure you get a dermatologist you trust. If you are in or near a large city (Dallas, Houston, San Antonio, etc), you should be able to find one at the local medical school.
I hope this helps. CCF MD mdf.
