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Scalp pain

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My boss is a male, Caucasian Canadian. 45 years old, slightly over weight, no other underlying conditions. Family has a history of heart disease.

He lives in China full time managing a factory. He recently returned from a 3 week trip to India and Thailand.

He has unbearable pain on his scalp. There is no sun burn or visible injury. He says it feels like his hair hurts. It hurts the most on his bald spot. The pain appears to be migrating from the back or crown of his head onto his face. Advil had no effect.

He visited a local doctor in China. They performed a CT scan which did not reveal anything. The doctor prescribed Hydergine, which appears to be for dementia. We do not have confidence in even the best doctors that we can find in China.

Any and all non-opiate drugs can be easily bought in China over the counter.

Category: Neurologist, Medical

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Category: Pediatric Neurologist
Dr. Sudhir Kumar is online now

Expert:  Dr. Sudhir Kumar replied 4 Days.


Thank you for posting your query.
I have noted the symptoms of your boss and would like to reassure that his CT scan of brain is normal and this rules out any serious problem.

In this case, the most common causes for scalp pain could be muscle tension headache or migraine.
Migraine can be precipitated by multiple factors and it is difficult to pin point the cause.

For pain relief , he can take diclofenac 50 mg OR ibuprofen 400mg thrice a day for 3 days after a meal.
If an acute attack is not subsiding with the above tablets he can take Tablet Sumatriptan 50mg and repeat it after 2 hours if required.

After 3 days of Ibuprofen or Diclofenac if he feels no improvement, or if he feels the pain returns frequently and comes for nearly 15 days of a month, it is advisable he visits his physician and takes prophylactic treatment for the same.
For prevention of headaches, he may take divalproex or topiramate tablets. Topiramate can be started as 25mg per day and can be taken upto 100mg twice a day before or after food. Or take divalproex 250mg twice daily after food.

I would recommend him to get in touch with a local Physican and then to treatment. Important thing is that this is NOT a dangerous or serious condition and it can be easily managed.

In addition he should take care of his lifestyle, in order to decrease the pain attacks like notice what triggers the pain and avoid those triggers. Make sure he has his meals at regular intervals and does not stay hungry, makes sure he gets adequate sleep and maintains his regular sleep cycle. Try relaxation methods to deal with day to day stress.

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

Best wishes,

Dr. Sudhir Kumar
Category: Pediatric Neurologist
Senior Residency, Fellowship: DM, Neurology, CMC, Vellore, 2001
Junior Residency: MD, Internal Medicine, CMC, Vellore, 1998
Medical School: MBBS, Christian Medical College, Vellore, 1995
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