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Diagnosed with amyopathic dermatomyositis. Having burning skin, numbness and tingling. MRI showed hronic degenerative white matter findings. Help?

Nov 2013
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Practicing since : 1994
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I was diagnosed with the inflammatory myopathy called amyopathic dermatomyositis in 2005. I have been having symptoms that do not fall under that umbrella. They come and go. They include sensation of burning skin, numbness and tingling, transient visual changes, mild nausea and recently, dizziness. I had an MRI of the brain that showed only scattered T2 intensities indicative of "chronic degenerative white matter findings". I am 58 years old, not diabetic or overweight with a long time heriditary history of controlled high blood pressure. At this point, I do not no where to turn. I want to be checked out for vasculitis of some sort, but family doctor seems unconcerned after MRI result and do not see rheumatologist until October. Did not see vasculitis in specialty drop-down. Maybe rheumatologist?

meant to say "deep white matter" and "chronic microvascular
Posted Wed, 17 Jul 2013 in Brain and Spine
Answered by Dr. Sudhir Kumar 7 hours later

Thank you for posting your query.

I have gone through your case details. MRI brain report suggests lack of blood flow to brain (ischemic changes). The most likely underlying cause for these findings is high blood pressure (as in your case). The treatment required is control of BP with good medications, and using aspirin to prevent further ischemia.

However, in view of past history of inflammatory myopathy, I agree with you that we need to exclude vasculitis. This would include investigations such as MR angiogram or 4 vessel angiogram, and blood tests such as XXXXXXX XXXXXXX etc. I would also like to add here that the chance of vasculitis is very less in your case.

I hope it helps. Please get back if you have any more queries.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Above answer was peer-reviewed by
Follow-up: Diagnosed with amyopathic dermatomyositis. Having burning skin, numbness and tingling. MRI showed hronic degenerative white matter findings. Help? 9 hours later
Thank you!

If not vasculitis, what are other avenues to address the symptoms I describe? They ARE concerning and sometimes debilitating. I know not much is known about myositis, but so far, those other are not part of the picture. Thanks so much.
Answered by Dr. Sudhir Kumar 1 hour later
Thank you for getting back.

As of now, as I mentioned, good control of blood pressure and use of aspirin tablets would suffice.
For relief of symptoms, symptomatic treatment may be helpful, such as gabapentin or pregabalin capsules (for skin burning, tingling, etc) and betahistine tablets (for dizziness).

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
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