Is tingling scalp a sign I’m having a stroke?
I’VE experienced a tingling feeling in the top of my head followed by dizziness. Could it be a sign of a stroke? I requested brain scans and wonder if they can detect a stroke before it occurs. I am 18 and take Vyvanse and Strattera tablets. Sarah howell, by email.
YOUR question is two-fold: what’s causing the tingling in your head and the dizziness; and second, whether brain scans you’ve had can identify a perceived stroke before it causes lasting damage.
Vyvanse (the brand name for lisdexamfeta-mine) and Strattera (atomoxetine) are medicines prescribed for attention deficit hyperactivity disorder (ADHD).
Long-term studies have confirmed their effectiveness in reducing the symptoms of hyperactivity, inattention and impulsiveness. Research has also confirmed their safety in long-term use.
But for patients on Strattera, there is an 8 per cent incidence of dizziness and a 3 per cent incidence of tingling (paresthesia in medical terminology).
Vyvanse also has a long list of potential side-effects but dangerous ones are rare at the dosages used. A six-year U.S. study showed no association with events such as heart attack or stroke. So your symptoms are likely to be sideeffects of taking Strattera and are not life-threatening.
It is not routine to be given brain scans while on these medicines, particularly not at your age. That a doctor has arranged CT and MRI scans is testimony to the severe anxiety you’ve suffered.
THERE are two main types of stroke: haemorrhagic, where a blood vessel in the brain ruptures; and ischaemic, when a blood clot blocks an artery supplying part of the brain. Both types can result in irreversible damage.
They most commonly affect older people with risk factors such as raised cholesterol, high blood pressure, heart disease or poorly controlled diabetes, which can lead to arteries in the brain rupturing; or to blood clots.
Given your age and the description in your longer letter, I am certain this does not apply to you and that your symptoms are unlikely to be signs of stroke.
To answer your question on whether scans can detect strokes — they can. If doctors suspect a patient has had a stroke, they must undergo a CT scan within three hours of symptoms appearing, to avoid lasting damage. Warning signs are loss of consciousness, a seizure, a limb becoming paralysed, blinding headaches and visual disturbances.
A CT scan — where X-rays are passed through the body (in this case, the brain) at different angles to produce detailed images — ascertains if there has been a stroke and what kind.
The effects of a haemorrhage or an ischaemic stroke can be seen immediately and relevant treatment can follow.
An MRI applies a strong magnetic field into the body to generate 3D images of internal organs and is useful for identifying the severity of a stroke as it can show damaged brain areas and blood vessels in the brain — we can also see fatty deposits that may raise the risk of another stroke.
In my view, stroke is not a hazard for you on the medication you are taking. My concern is that such worries are not always resolved by logical explanations. Your concerns are emotional, and you may benefit from some cognitive behavioural therapy, or talking therapy, to help you overcome the fears associated with your medication. Hopefully your GP will consider a referral.
I’VE tried changing my diet, washing powder and have been prescribed various creams, but cannot get rid of severe genital itching. I am 79. Name and address supplied.
IT MIGHT seem trivial to some, what you describe can be so intense and disturbing that those with this condition are often at their wits’ end, exactly as you say in your longer letter.
The symptom you describe is vaginal itching, known medically as pruritus vulvae — the itching can be accompanied by a burning sensation, redness and severe pain. It is extremely common in women of all age groups. There are many different causes and, as you say in your longer letter, you’ve been referred to gynaecologists to pin down a diagnosis.
Sadly, so far this has been unsuccessful, and I hope I can shed some light on your condition.
Itching like this can be caused by allergies, sensitivity to soaps or lotions and infection. But all these possibilities seem to have been ruled out in your case.
This leads me to conclude that you have dermatitis, a type of eczema. This occurs when the outermost layer of the skin becomes inflamed, causing redness, scaling and itching.
This inflammation can either be ‘endogenous’ in origin, where the inflammation is caused by the skin’s immune system being faulty — a problem that is inherited — or ‘exogenous’, where an external trigger, such as fabric or soap, causes a reaction that leads to chronic irritation, dryness and intense itching.
It may help to use simple petroleum jelly or other simple emollient creams, although you have tried a few to no avail.
I would, therefore, suggest discussing with your GP whether taking an antihistamine tablet would help, as this is known to help itching.
In particular, the antihistamine hydroxyzine — a dose of 10mg or 25mg taken once every night has been proven effective — so do ask and if deemed appropriate it should be prescribed.
Dermatologists may prescribe a low or medium-strength steroid such as hydrocortisone or triamcinolone ointment, for a month, only moving to a product of greater potency if this fails. These work by suppressing inflammation that will worsen dryness and itching.
But I would try the antihistamine approach first. If unsuccessful, then it is time to seek a referral to a specialist in dermatology.