Background & Aims
Cranial neuropathic symptoms can manifest as pain but also as paresthesia. Unlike headaches, cranial paresthesia are less reported. This study aimed at describing socio-demographic and clinical characteristics of recurrent cranial paresthesia (RCP) and their response to treatment.
Methods
This was a descriptive and prospective study, carried out from June 2022 to May 2023 at the outpatient neurology clinic of the Bafoussam Regional Hospital in Cameroon. We included patients consulting for cranial paresthesia and/or headache with a normal brain computed tomography scan who gave their written consent to participate to this study. Participants underwent a complete neurological, otologic and psychiatric examination. Patients with tinnitus and psychotic traits were excluded. A good response to treatment was considered as a 50% or more reduction in symptoms frequency and severity after three months of treatment.
Results
We included 395 patients. Seven were excluded for tinnitus (5) or psychotic traits (2). Among participants, 53 (13.7%, 68% females) had recurrent cranial paresthesias. Mean age (SD) of participants was 51.1 (16.0) years, with extremes of 21 and 84 years. The median duration of symptoms was six months. Recurrent cranial paresthesias were described as tingling (49.1%), ‘blowing’ (32.7%), or ‘fluid flow’ (20%). RCP were mainly diffuse on the skull (62.2%) or located on the vertex (20.8%). Identified triggering factors were stress (21%) and mild head trauma (13.2%). Symptoms were continuous in 60% of cases, and associated to insomnia (52%), pericranial allodynia (42%) and headaches, with tension-type (28.3%) and migraine-like (11.3%) phenotypes. A good response to treatment with amitriptylin and mexazolam was obtained in 57% of cases.
Conclusions
Recurrent cranial paresthesias are not rare, and are mainly seen in median age women. They can cause significant burden to patients, at a level that they seek medical consultation. Some clinical analogies with tension-type headache suggest a peripheral and central sensitization of the trigemino-cervical complex as a potential pathophysiological determinant of this condition, with paresthesias representing the non painful side of this continuum. More studies are needed to better characterize this syndrome.
References
Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. (2018). Cephalalgia : an international journal of headache, 38(1), 1–211. https://doi.org/10.1177/0333102417738202
Alkhateeb, W., Krishnaraj, A., & Saini, V. (2023). Single Patient Multiple Explosions: A Case Report on Exploding Head Syndrome. Cureus, 15(8), e44437. https://doi.org/10.7759/cureus.44437
Presenting Author
Yannick Fogang
Poster Authors
Topics
- Other