FIBROMYALGIA. AN “ATYPICAL” SYNDROME

Abstract

Fibromyalgia is a chronic, distressing syndrome, which is characterized by the presence of widespread, atypical muscular pain, together with tender or trigger points. most of the patients exhibit a wide range of symptoms and signs, such as chronic fatigue, sleep disturbances, memory impairment, tension headache, muscle weakness and stiffness, hypothymic mood and irritable bowel syndrome. There is a high rate of comorbidity between fibromyalgia and chronic fatigue syndrome, rheumatologic and psychiatric disorders. The diagnosis of the syndrome is generally difficult. several neurological, rheumatologic and psychiatric disorders should be excluded. The cause of the syndrome is unknown. It is generally attributed to the dysfunction of neurotransmitters that regulate sleep patterns, mood, psychomotor activity and pain, such as serotonin, noradrenalin, substance P and glutamate. The therapeutic approach of fibromyalgia is based upon the aforementioned hypothesis. Agents such as duloxetine, pregabalin and gabapentin have been proven useful for the amelioration of fibromyalgia’s pain symptoms. case study. A 32 years old female patient has been suffering from muscular pain and paresthesias for the last three years. They are exclusively located at the left half of the body. The patient also exhibits tender points and complains of chronic fatigue, sleep disturbances, gait problems, difficulty in concentration and short term memory impairment. she went through a complete clinical and laboratory examination without any pathological findings. The initial diagnosis of multiple sclerosis was not justified by the mrI findings. she did not suffer from any psychiatric disorder. The patient was diagnosed with fibromyalgia and was treated with gabapentin. The follow up examination showed a significant reduction in the patient’s symptoms, according to the FIQ and Fss scales. Discussion. This particular patient manifested some interesting differentiations from the usual clinical pattern of fibromyalgia. The symptoms and signs were exclusively located at the left part of the body, including the face and the extremities. no concomitant mood or anxiety disorder was detected. Furthermore, in contradiction to the patient’s complains about memory impairment, no memory deficits were found, as she was examined with the wms-II scale.