Arthritis Rheum. 2009 Aug 27;60(9):2839-2844. [Epub ahead of print]
Watson NF, Buchwald D, Goldberg J, Noonan C, Ellenbogen RG.
University of Washington, Seattle.
PMID: 19714636
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%) 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.
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