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DrOAB, Doctor (MD)
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Experience:  In practice since 2000.
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I have a burning sensation on top of my head. Went to neurologist,

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I have a burning sensation on top of my head. Went to neurologist, eye doctor, but everything seems OK...but my problem is continuing almost for 1 year
Submitted: 7 years ago.
Category: Medical
Expert:  DrOAB replied 7 years ago.



Please clarify:


Any history of nasal allergies or nasal sinus infection (sinusitis)?

Did the neurologist request a head MRI or CT scan?

Customer: replied 7 years ago.

Yes I did have my MRI of my head, and nothing was showing. He told me that I do not have anything wrong with my head.

4 years ago I injured my tail bone....I had inflamation. Many times the pain comes back. Is it possible that the pain from tail bone causing the burning on my head?

I went for acupuncture for 4 months, it seems that it is helping, but after few days pain is back. My acupunctures is telling me that is a stress, that my body due to a stress is producing a heat, and that is why I have the burning. She told me that this is why I even have top of my tongue white.I do exercise almost every day, to release stress. I just want to make sure I have a right diagnoses.

Thank you

Expert:  DrOAB replied 7 years ago.

Injury to the coccyx bone may result in arachnoiditis with burning pain to the lower back and legs, but I would not expect it to affect sensation at the top of your head unless there was some sort of upward-spreading damage to the spinal cord.


Stress can indeed cause unusual mind-body symptoms, but it may be difficult to prove a psychosomatic association.


I have seen one case where a sphenoid sinusitis (sinus infection) caused vertex (top of the head) pain, which promptly resolved with an antibiotic course. However, you report a normal MRI without any sign of sinus abnormality.


Is there any visible rash, hair loss, or other skin change where you sense this burning?

Have topical or oral medications been tried with any benefit?

Customer: replied 7 years ago.

My first visit was to a dermatologist. I think I spent over $300 dollars on different types of the topical creams, and some kind on liquid medication, but nothink was helping.

Hair loss? hmmm...I think my hair are thiner, but that can be because of my age.

Trust me, I spent many hours in many doctors offices, but nobody seems to have an answer for me. This started in August '08 on my vacation at the beach, so I really thoughnt that I just had a sunburn, then it went away for few weeks, and the pain came back. That is went I started to be treated by dermatalogist, after 3 months he told me he can not help me, so I went to my primery doctor, and visit more specialist, and did many test. Acupuncturest was my last option, but it release my pain only for few days and then its is very expensive. I just want idea, what else is there for me.

Expert:  DrOAB replied 7 years ago.

OK, the pain started after sun exposure. Chronic pain after a sunburn alone would be unusual, but if the sunburn were to activate a dormant shingles (herpes zoster virus) infection, then that could cause lasting neuralgia (nerve-based pain, often described as a burning or stabbing sensation) that might respond to oral antiviral medication. You might consider this if you ever had chickenpox or shingles (especially on the scalp).


Vitamin deficiency (e.g., vitamin B12 deficiency) can result in peripheral neuropathy (nerve dysfunction), so testing for and treating such deficiencies may also help.


Since acupuncture did provide temporary relief, topical anesthetic treatment might also help: you probably already tried topical pramoxine 1%, so perhaps lidocaine 5% topical patches might help. Topical capsaicin (Zostrix) is frequently used for diabetic neuropathy, so its use can be considered.


Some oral and intravenous pain relief medications used by pain medicine specialists include: oral amitryptyline (10-50 mg) with either gabapentin (2400 mg per day) or pregabalin (600 mg per day); intravenous lignocaine. Is there a pain medicine specialist in your area who can evaluate you? The Pain Clinic reference:


One study showed a pain relief period of several weeks after intradermal injection of Botox, so you can discuss this treatment option with a dermatologist familiar with this medication. Intradermal Botox reference:

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