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Polyneuritis/Guillain-Barre Syndrome
Published in Charles Theisler, Adjuvant Medical Care, 2023
Polyneuritis, also known as acute idiopathic polyneuritis or Guillain-Barre syndrome, is widespread inflammation of the peripheral nerves. The syndrome is characterized by progressive inflammation of multiple nerve trunks and results in symmetrical motor neuropathy (paralysis and loss of reflexes). Weakness and paralysis often begin in the feet and ascend to the other muscles. Symptoms can mimic fibromyalgia and include pain and paresthesias, difficulty using arms, hands, legs and feet, muscle weakness, and frequent falls. The autonomic nervous system can also be affected. The main causes are classified as infectious, nutritional, metabolic, and unknown.
Fibromyalgia
Published in Sahar Swidan, Matthew Bennett, Advanced Therapeutics in Pain Medicine, 2020
The causes of fibromyalgia are not clear and can vary among different people. Fibromyalgia is considered its own entity as it does not fit an autoimmune, inflammation, joint, or muscle disorder in the classic sense. Research suggests that the central nervous system in particular plays an active role in fibromyalgia pain.1 Fibromyalgia likely has a genetic component, making some people more prone to acquiring the disease and other comorbidities. There are also triggers that can worsen symptoms including diet, hormones, schedule, sleep, weather, and physical and emotional stress.1,2 Patients often experience a decreased quality of life due to discomfort and pain.
Imaging Pain in the Brain: The Role of the Cerebral Cortex in Pain Perception and Modulation
Published in Robert M. Bennett, The Clinical Neurobiology of Fibromyalgia and Myofascial Pain, 2020
M. Catherine Bushnell, Chantal Villemure, Irina Strigo, Gary H. Duncan
Fibromyalgia is a chronic pain syndrome characterized by widespread spontaneous pain, lowered pain thresholds, and muscle stiffness, in addition to other symptoms (31). At least two studies have examined neural changes related to fibromyalgia. Using single photon emission tomography, Kwiatek et al. (32) found a reduction in thalamic rCBF, consistent with brain imaging findings of other chronic pain conditions. They also observed a reduced pontine tegmental activation, which has not been observed in other conditions and the significance of which is not known. Lekander et al. (33) correlated PET blood flow measures with immune function in five fibromyalgia patients and found that natural killer cell activity correlated negatively with neural activity in S2, motor cotices, thalamus, and posterior cingulate cortex, suggesting a possible role of immune dysfunction in the pain of fibromyalgia.
Can psychological factors be associated with the severity of pain and disability in patients with fibromyalgia? A cross-sectional study
Published in Physiotherapy Theory and Practice, 2022
Bruna do Nascimento, Katherinne Franco, Yuri Franco, Cristina Nunes Cabral
Fibromyalgia is characterized by chronic generalized pain, hyperalgesia, allodynia, fatigue, sleep disturbances, morning stiffness, headaches, and paresthesias (Carville et al., 2008). Fibromyalgia is primarily accompanied by nociplastic pain (i.e. pain arising from altered nociception without clear evidence of actual or potential tissue damage that causes the activation of peripheral nociceptors and without signs of injury to or disease of the somatosensory system) (Chimenti, Frey-Law, and Sluka, 2018). Thus, central sensitization is the main pathophysiological mechanism of fibromyalgia (Häuser et al., 2015). The diagnosis of fibromyalgia can be performed clinically, and it is considered to be present when one of the four diagnostic criteria of the American College of Rheumatology are met (Wolfe et al., 2016, 2011, 2010, 1990). The overall global prevalence of fibromyalgia is 2.7%, and the female to male ratio ranges from 4:1 to 1:1 when a diagnosis is made without the tender point examination (Busch et al., 2013; Häuser et al., 2015; Queiroz, 2013). Although the prevalence of fibromyalgia is not high, patients with fibromyalgia are major consumers of health services and incur significant costs related to a loss of productivity (Annemans et al., 2008), which increases the economic impact of this condition. There is no cure for fibromyalgia, and the current recommendation is that the treatment of fibromyalgia should be personalized according to the symptoms using a multimodal approach encompassing pharmacological and nonpharmacological interventions (Häuser, Ablin, Perrot, and Fitzcharles, 2017).
BMI but not age and sex negatively impact on the outcome of pharmacotherapy in fibromyalgia: a systematic review
Published in Expert Review of Clinical Pharmacology, 2021
Filippo Migliorini, Nicola Maffulli, Jörg Eschweiler, Markus Tingart, Arne Driessen, Giorgia Colarossi
The current study presents several limitations. The short follow-up performed from most of the included studies. The demographic data were limited to sex, age and BMI, a more in-depth analysis including race and length of symptoms should be performed. The investigation of the impact of age was inconclusive. Given the limited data available, it was not possible to conduct the analyses separately for each drug. Given the universal increase of musculoskeletal pain and stiffness with aging, regardless of fibromyalgia, we would have expected a more pronounced influence of age on the PROMs examined. Future studies should explore this topic in a more systematic fashion. Other variables as well as socioeconomic status, time to diagnosis and comorbidities may be involved in the progression of fibromyalgia. Future studies should explore those factors. The present study analyzed only studies in which pharmacological treatment was instituted. However, the management of fibromyalgia may also include combination of pharmacological and non-pharmacological therapies. Thus, given these limitations, results from the present study must be interpreted with caution. Further studies are required to overcome current limitations.
Physiotherapists’ accounts of fibromyalgia: role-uncertainty and professional shortcomings
Published in Disability and Rehabilitation, 2021
Neta Roitenberg, Avihu Shoshana
Fibromyalgia is a widespread chronic pain illness occurring usually in women (3.4% for women and 0.5% for men) [1,2]. Pain is accompanied by such symptoms as fatigue, unrefreshed sleep, trouble thinking or remembering, cramps in the lower abdomen, headache, and depression [1,3]. The etiology of fibromyalgia is unknown, but factors such as dysfunction of the central and peripheral nervous systems, neurotransmitters, genetics, psychiatric disorders, and others seem to be involved [4–6]. Fibromyalgia is difficult to diagnose because there are no clear biological markers and physicians rely on the patients’ subjective complaints and on such indexes as the Widespread Pain Index and the Symptom Severity Score [1,2]. Western medicine considers fibromyalgia as a chronic condition with no cure and offers symptomatic and individualized treatment [7,8]. Treatment goals are to reduce pain and to increase patients’ level of functioning and general wellbeing [7,9,10]. Fibromyalgia patients frequently use medical services and various types of therapy, including complementary medicine, and incur high direct medical costs [11–13].