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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 8999
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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I had eyebrow hair grafts taken from the back of my scalp.

Customer Question

I had eyebrow hair grafts taken from the back of my scalp. 1st time was in 2006. After healing, no pain or problems. Some grafts came out so I had second procedure in 2011. After healing again no pain or problems ensued. Then I had one more procedure of same in Jan. 2015. 4 months later I began to get tingling sensations at thickest edges of brows with tingling & crawling sensations and pulsing movements at times in brow forehead region. I had gone off Effexor as it was no longer working & I thought it was withdrawals. These symptoms lasted from April to late June and from August the symptoms seemed to resolve. I felt no symptoms from August to late September. I am medium half pack day smoker. In mornings after sleep, symptoms weren't felt. Gradually after a few cigarettes the tingling would lightly begin on eyebrow edges and in evenings, after few more cigs, tingling would crawl and tingling from eyebrows, sides of nose extending to cheeks nearest to upper sides of nose. This proceeded for a while with same pattern. I reduced smoking.
In November the symptoms got worse upon waking even if had no cigarettes & proceeded to worsen daily. I saw a neurologist who put me on Gabapentin which vaguely took away pain of pins and needles but did not help pulsing sensations in brow and forehead area so after 2 weeks I ceased to use them. The Gabapentin made me anxious and hard to sleep so I used Zopliclone at low doses and when they stopped working, I used higher doses as without them sleep was harder than ever. I used them for 3 months at sometimes 2-4 pills towards evening. I reduced them and found they stopped working so I asked doctor for Clonazepam due to longer half life and have been using off and on for 2 months. They don't help with sleep only mildly help nerve pain. Then pain began to get worse and I still smoked and whereas before I felt pain only sometimes throughout day, I now feel it all day every day from morning to night. Since November it has become chronic. I tried nerve blocks and didn't help. I saw nerve block specialist for cortisone where incisions were made to see if it is increased scar tissue recently but can't be sure as cortisone doesn't help nerve pain. As of past month, the procerus muscle located between brows has also become painful at first with dull tingling, then I had cortisone injected into that area few weeks ago and now each morning it is dull ache in that area in addition to other symptoms.
I have also felt tingling around inner corner of eyes and have been told it is infraorbital nerve. I reduced smoking but pain is felt all day and I have no diagnosis.
Could it be possible that numerous surgeries caused scar tissue worsened with time and smoking or is it possible that a nerve in those areas was injured during last procedure? Pain lasts all day and has robbed me of joy of life. I had nerve conduction studies and am waiting for results. Do you have an idea of a diagnosis and if it is scar tissue and if cortisone will over time improve this or make worse? It was injected into small fiber nerves where I had grafts not main supranerves. Lastly do you think if a nerve was injured could surgical repair be accomplished this late after surgery? I am desperate with no diagnosis and want to die from pain which never stops. It makes life and sleep misery and I cry everyday from fear that no one will help me. Please let me know what you think. I am at my wits end. Thank you, Kim.
Submitted: 6 months ago.
Category: Neurology
Expert:  Dr. Frank replied 6 months ago.
HI Kim. You have a difficult problem, as I might guess you had some reactive inflammatory change with the last grafting, and that is causing you a localized "small fiber" neuropathy, leading to pain. You mentioned the infraorbital nerve, I was thinking the supraorbital nerve (that you can feel in the supraorbital notch) and/or the supraciliary nerve which is more medial, under procerus. Anyway, I assume that the conduction studies of those nerves, when you get them, will be normal. My suggestion? Has anyone suggested BOTOX injections into those areas around your eyes? BOTOX might help for pain as well as for relaxing some of the subcutaneous tissue. It has become a major treatment for pain in the scalp, as well as for intractable migraine. I would ask your neurologist if he does migraine/botox, and/or a dermatologist/plastic surgeon. Also the pain management docs are using BOTOX for pain. Please get back to me to discuss this further and I will reply. I can also call you if you need that type of service. JA charges extra, but if interested, put your number and a time to call in the box, and we can discuss this further. Or just write back. If satisfied with this answer, please remember to rate this service by clicking on the rating stars, as that is how I am compensated for this work. Thanks Dr frank

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