Neurologic signs and symptoms in fibromyalgia

Abstract

Objective. To determine the type and frequency of neurologic signs and symptoms in individuals with fibromyalgia (FM).Methods. Persons with FM (n ‫؍‬ 166) and painfree controls (n ‫؍‬ 66) underwent systematic neurologic examination by a neurologist blinded to disease status. Neurologic symptoms lasting at least 3 months were assessed with a standard questionnaire. We used logistic regression to evaluate the association of neurologic symptoms and examination findings with FM status. Within the FM group we examined the correlation between self-reported symptoms and physical examination findings.Results. Age-and sex-adjusted estimates revealed that compared with the control group, the FM group had significantly more neurologic abnormalities in multiple categories, including greater dysfunction in cranial nerves IX and X (42% versus 8%) and more sensory (65% versus 25%), motor (33% versus 3%), and gait (28% versus 7%) abnormalities. Similarly, the FM group had significantly more neurologic symptoms than the control group in 27 of 29 categories, with the greatest differences observed for photophobia (70% versus 6%), poor balance (63% versus 4%), and weakness (58% versus 2%) and tingling (54% versus 4%) in the arms or legs. Poor balance or coordination, tingling or weakness in the arms or legs, and numbness in any part of the body correlated with appropriate neurologic examination findings in the FM group.Conclusion. This blinded, controlled study demonstrated neurologic physical examination findings in persons with FM. The FM group had more neurologic symptoms than did the controls, with moderate correlation between symptoms and signs. These findings have implications for the medical evaluation of patients with FM.

Rethinking chronic pain in a primary care setting

“…[42] In addition to FM, Irritable Bowel Syndrome, tension-type headaches, interstitial cystitis, temporomandibular joint disease (TMD), chronic fatigue syndrome, and possibly restless leg syndrome are thought to be sensory hypersensitivity conditions ( Figure 1). [43][44][45][46] These conditions often share features typical of FM including diffuse pain in multiple body regions, fatigue, sleep disorders, memory difficulties, mood disturbance, individual or familial history of chronic pain, and increased sensitivity to sensory input in the presence of an otherwise generally normal physical examination. Furthermore, sensory hypersensitivity conditions often copresent with each other suggesting a possible common pathogenesis.…”

Medical and Psychiatric Causes of Episodic Vestibular Symptoms

“…56 Similarly, the fibromyalgia patients from the Oslo Health Study reported symptomatic dizziness or faintness within the last week 59.3% of the time versus 26% for those without fibromyalgia. 57 An independent relationship persisted after adjustment for gender, age, comorbid conditions, and use of medications, with fibromyalgia patients having 1.92 higher odds of dizziness and faintness (95% confidence interval 1.62-2.28).…”

The differential diagnosis of thoracic outlet syndrome

“…Bu hastalar sıklıkla boyundan kola doğru yayılan uyuşukluk, duyu bozukluğu, ağrı gibi şikayetlerden yakınırlar. Bu nedenle FMS sıklıkla periferik nöropati, tuzak nöropatiler gibi nörolojik bozukluklarla karışabilmektedir (59). Ayrıntılı bir nörolojik muayene ile birlikte eşlik edebilecek yorgunluk, duygudurum ve uyku bozuklukları gibi overlap sendromların araştırılması ayırıcı tanıda ileri tetkik istemeden önce yardımcı olabilir.…”