Neurological Associates

Pain Management Center

Vero Beach, Florida

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RSD PUZZLES #73
SKIN LESION AND RSD

Many thanks for your letter of September 22, 1996.

You have mentioned the fact that you were involved in two accidents. The first one resulted in RSD and was treated effectively with nerve blocks. this was followed by another accident on October 24, 1995. This near fatal accident resulted in the development of RSD in the right leg. The nerve blocks helped with treatment of the RSD in the right leg.

Now you have developed an area of skin lesion over the scalp of the head, from the forehead all the way to the vertex. You have mentioned not only reddish discoloration, but pain and tenderness in the area. You have been told that this could not be related to RSD.

The most likely diagnosis in your case is that either due to the same car accident or some other previous injury, you had an area of damage to the scalp. This has been complicated by sympathetically maintained pain (SMP). It is not at all unusual for RSD being present in upper and lower extremities and then spreading to the head and neck regions.

First of all, you need to be seen by a neurosurgeon, as well as a good dermatologist. secondly, this area should be treated with topical Lidocaine and topical Zonalon Cream, and you should definitely have a stellate ganglion nerve block to find out if the nerve block can improve your condition.

It makes no sense to come up with a separate diagnosis when you have already had RSD in two different parts of your body.

If the inflammation does not improve, I recommend treatment with I.V. Mannitol (80-100 grams, depending on your weight, in 1000 cc D5W). This should be given twice a week for three weeks and it will help the condition to clear up.

H.Hooshmand, M.D.

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Copyright © 1997-2006 H. Hooshmand, M.D. No part of this publication may be reproduced, transmitted, stored in a retrieval system other than this specific media, transcribed, or translated into any language without the expressed written permission from the author; H. Hooshmand, M.D. and Eric Phillips and CMNE. This material is for informational and education purposes. It is not meant to take the place of your physician. Before starting, changing, or stopping any treatments or medicines consult your physician.

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The material on the Neurological Associates Pain Management Center Homepage and all it's associated, linked or reference pages is for informational and education purposes. It is not meant to take the place of your physician. Before starting, changing, or stopping any treatments or medicines consult your physician. H. Hooshmand, M.D., Neurological Associates Pain Management Center and Associates will not be held liable for any damage or loss as a result of information provided on this page or associated documentation. Again, this WEB SITE is simply published as an information source and should not be used to treat or make judgments on RSD/CRPS. All associated material on this web site may not be copied, reproduced or quoted without expressed written permission from the owner; Copyright © 1999-2006 H. Hooshmand, M.D.

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This page was last updated on 3/11/2000.