by Nathaniel F Watson, et al.
August 29, 2009
Objective: To determine the type and frequency of neurologic signs and symptoms in individuals with fibromyalgia (FM).
Methods: Persons with FM (n = 166) and pain-free 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%) [for example, X - the vagus nerve - is responsible for 'rest and digest' functions of glands, digestion, and heart rate, balancing the 'fight-or-flight' functions], 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.
Source: Arthritis and Rheumatism, Aug 27, 2009;60(9):2839-2844. Watson NF, Buchwald D, Goldberg J, Noonan C, Ellenbogen RG. University of Washington, Seattle. [E-mail: nwatson@u.washington.edu]
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