Relation of cervical spine disease in patients of scalp dysesthesia

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Author: 
Dr. Supriya Kumar Mandal, Dr. Barindranath Mallick, Dr. Ranjan Bhattacharyya, Dr. Sumita Bhattacharyya, Dr. Utpal Ray and Dr. Madhab Kr Mondal
Abstract: 

Background: Scalp dysesthesia is a common mode of presentation in rural West Bengal. The study aims at finding radiological correlation withbnimaging of cervical spine with the presenting symptoms.
Introduction: Most of these cutaneous pain symptoms are not attributed to any pathophysiology. The range of complaints vary widely from tingling, stinging to severe itching leading to scratch-itch cycle.
Methodology: The study used a cross-sectional, case control design with sample size n=40 with healthy volunteers (n=40) included for comparison. The OPD patients were interviewed by principal investigator (Psychiatrist) to find out any Axis I disorder corroborated by another psychiatrist. The radiological finding had been carefully analyzed by two residents and verified by senior faculty from Deptt of Radiology.
Results: The loss of curvature is significantly high among patient group (P=0.011). Comparison of cervical vertebra of both patient and control group showed that, there is no significant difference in between the patient and control group. Reduction of inter-vertebral disc found significantly high at the level of C4-5 (P= 0.033*) and C5-6(P= 0.012) in patient group in comparison to control group.
Conclusions: Scalp dysesthesia does not seem to follow a dermatomal distribution given that the most common location in the present study was C5-C6. The symptoms of scalp dysesthesia may be related to chronic tension placed on the occip itofrontalis muscle and scalp aponeurosis (galea aponeurotica) secondary to underlying cervical spine disease, rather than psychiatric causes.

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