In the Journals

Imaging detected cervical spine disease in patients with scalp dysesthesia

Patients with scalp dysesthesia also displayed abnormal cervical spine images, according to study data.

Using a retrospective review of medical records, researchers evaluated 15 women (aged 38 to 83 years) with scalp dysesthesia. CT, MRI and X-rays confirmed that 14 patients had cervical spine disease, with degenerative disk disease (DDD) occurring most commonly. Of the 11 patients with DDD, it was observed at C5-C6 in 10 patients, while six patients displayed DDD at multiple levels (two at C4-C7, two at C5-C7, one at C4-C6, and one at C6-C7).

Anterolisthesis, osteophytic spurring, lordosis, kyphosis and nerve root impingement also were detected via imaging.

Topical or oral gabapentin was recommended as therapy for 14 patients, and seven patients returned for follow-up. Two patients reported improved symptoms from topical gabapentin, and two improved using oral gabapentin. Absence of follow-up data from the other seven patients limited treatment outcome, the researchers said.

“Scalp dysesthesia is a syndrome characterized primarily by scalp burning or pruritus in the absence of any other unusual physical examination and may be associated with cervical spine disease,” the researchers concluded. “The pathogenesis may be related to chronic muscle tension placed on the pericranial muscles and scalp aponeurosis secondary to the underlying cervical spine disease and is likely unrelated to psychiatric disorders.

“Larger, prospective studies are needed to further characterize the pathogenesis of scalp dysesthesia and to determine the most efficacious treatments.”

Patients with scalp dysesthesia also displayed abnormal cervical spine images, according to study data.

Using a retrospective review of medical records, researchers evaluated 15 women (aged 38 to 83 years) with scalp dysesthesia. CT, MRI and X-rays confirmed that 14 patients had cervical spine disease, with degenerative disk disease (DDD) occurring most commonly. Of the 11 patients with DDD, it was observed at C5-C6 in 10 patients, while six patients displayed DDD at multiple levels (two at C4-C7, two at C5-C7, one at C4-C6, and one at C6-C7).

Anterolisthesis, osteophytic spurring, lordosis, kyphosis and nerve root impingement also were detected via imaging.

Topical or oral gabapentin was recommended as therapy for 14 patients, and seven patients returned for follow-up. Two patients reported improved symptoms from topical gabapentin, and two improved using oral gabapentin. Absence of follow-up data from the other seven patients limited treatment outcome, the researchers said.

“Scalp dysesthesia is a syndrome characterized primarily by scalp burning or pruritus in the absence of any other unusual physical examination and may be associated with cervical spine disease,” the researchers concluded. “The pathogenesis may be related to chronic muscle tension placed on the pericranial muscles and scalp aponeurosis secondary to the underlying cervical spine disease and is likely unrelated to psychiatric disorders.

“Larger, prospective studies are needed to further characterize the pathogenesis of scalp dysesthesia and to determine the most efficacious treatments.”