Peripheral Vestibular Function in Patients with Fibromyalgia

Abstract

Background: Fibromyalgia (FM) is a non-inflammatory musculoskeletal chronic syndrome, whose etiology is unknown, characterized by diffuse pain, many patients with FM were reported to have dizziness which is attributed to hypotension and the autonomic nervous system (ANS) dysfunction. Aim: To improve management of patients with fibromyalgia having dizziness. Objective: to assess peripheral vestibular functions in patients with fibromyalgia. Subjects and Methods: After obtaining approval from the Ethics Committee of the Suez Canal University Hospital (registration number:3646) and written informed patient consent, a Cross-sectional study was conducted at Suez Canal University hospital from June 2018 to December 2019 in the Audio-Vestibular Clinic of the E.N.T department, including 30 female subjects whose age ranged from 22 to 50 years and were divided into Study group that comprised patients diagnosed with fibromyalgia and Control group rather healthy individuals. The vestibular assessment was done using pure tone audiometry, Bedside tests, and video-nystagmography (VNG). Results: There was no statistically significant difference between both groups regarding results of bedside examinations and VNG results as a caloric test (p-value = 0.6) however, there was a trend towards positive results and an increase in vestibular weakness in the fibromyalgia group compared to the control group. Conclusion: Fibromyalgia is unlikely to be a cause of peripheral vestibular dysfunction, so vestibular testing is not routinely recommended for such patients.

Assessment of Audiovestibular function in Fibromyalgia Patients

“…This was in agreement with Mohamed et al [19] and Koca et al [20] who stated that the vertigo prevalence was found high with 60% and 84 % frequency respectively in patients with fibromyalgia. According to Mohamed et al [19] the overall dizziness handicap inventory scores were significantly higher in the FM group.…”

“…This was in agreement with Mohamed et al [19] and Koca et al [20] who stated that the vertigo prevalence was found high with 60% and 84 % frequency respectively in patients with fibromyalgia. According to Mohamed et al [19] the overall dizziness handicap inventory scores were significantly higher in the FM group. They found 78% of FM patients complained of disequilibrium for a long time with complaints of vertigo (mean of 30 months) that could be associated to musculoskeletal problems.…”

“…Mohamed et al [19] their study examined subjects with FM with bedside examinations, they found no spontaneous nystagmus, no gaze-evoked nystagmus, and no post headshaking nystagmus. However ,there was deviation in the stepping test in 3 (20%) patients of fibromyalgia .They explained their results by decompensation or imbalance of vestibular system.…”

“…This could be explained by the use of medications that include analgesics and antidepressants, which may trigger dizziness and drowsiness as adverse effects (reported in 8% of all patients using these drugs), especially when used for a prolonged period of time (the mean duration of consumption in the current study was 1.5 years). Additionally, dizziness may develop if an SSRI is abruptly discontinued Mohamed et al [19] . However, in their study, Mohamed et al [19] they reported that fibromyalgia is unlikely to be a cause of peripheral vestibular dysfunction.…”

“…Additionally, dizziness may develop if an SSRI is abruptly discontinued Mohamed et al [19] . However, in their study, Mohamed et al [19] they reported that fibromyalgia is unlikely to be a cause of peripheral vestibular dysfunction. Thus, no vestibular testing is needed for such patients.…”