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Severe headache and sensitive scalp. Tests normal for CT scan and MRI. What can be the treatment and solution?

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ENT Specialist
Practicing since : 1991
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I am suffering from severe headache everyday past 8yrs. headache ache increases to peak level whenever i take head bath nor apply hair oil or if i stand in hot sun for more than 5min. i had undergone many health test and got reports as NORMAL for both CT as well as MRI scanning . i had consulted nearly 70-90 doctors. tooked variety of pills , tried ayurvedic medicines but none helped me.. I am afraid to go out during day time . ting is my scalp is very sensitive , once i tooked head massage for 10min in saloon later i got admitted for 2days in hospital. this is my present situation.. So pls do help me.. ..
Posted Wed, 23 May 2012 in Headache and Migraines
Answered by Dr. Sumit Bhatti 10 hours later

Thank you for your query.

1. The Scalp is innervated by the Trigeminal Nerve (Fifth Cranial Nerve) and the Occipital Nerves (Spinal C2).

2. You seem to be suffering from Neuralgia.

3. Neuralgias may be due to nerve entrapment, nerve damage at a molecular level, damage to nerve fibre insulation and centrally in the brain. It will be helpful if you can describe your headaches and type of pain in detail. Is there any asymmetry which can help identify the nerve/s involved?

4. You should see a Neurologist specializing in pain management. Special tests such as EMG (ElectroMyoGraphy) and NCS (Nerve Conduction Tests) may be required. Once the offending nerve/s or trigger zones are identified, they can be blocked by anesthesia to confirm the diagnosis.

5. Neuralgias are treated with different painkillers, anti-depressants and anti-epileptic medications such as Amitriptyline, Carbamazepine and Gabapentin. Have you had a trial of these medications?

6. Treatment includes relieving any nerve entrapment in the muscle compartments or pressur from abnormal blood vessels along the course. There are a variety of treatments available. Radio-frequency ablation and Gamma Knife therapy are newer treatments available if medical therapy fails to control symptoms.

7. I would definitely rule out diabetes, hypertension, thyroid problems, sinus problems and migraine.

8. You will have to elaborate on your history, investigations and past treatment for me to understand your exact problem. Further treatment options can then be discussed in detail.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

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