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Neurologia 2008-Nov

[Is fibromyalgia a neurological disease?].

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The key feature of fibromyalgia is a chronic pain picture located in different structures of the musculoskeletal system, but without any evidence of disease in them. Besides pain, patients with fibromyalgia often describe tiredness, sleep disorders, headache, and emotional problems, as well as many other psychosomatic complaints. Genetic and environmental factors have been implied in the pathogenesis of fibromyalgia, its perpetuation being explained by an alteration of the nociceptive system, thus leading to a neuroendocrine syndrome of chronic stress. Although research has provided a significant amount of data, there is no definite biomarker for fibromyalgia so far. The disease can appear alone or associated, among other diseases, with rheumatoid arthritis, erythematous systemic lupus, myopathies and multiple sclerosis. Fibromyalgia generally has very important repercussions on family, social and professional life of the patient, especially considering that therapeutics (aerobic exercise, antidepressants and antiepileptic drugs) have hardly shown any effectiveness. However, achieving a precise diagnosis, being able to transmit it to patients in a realistic way, along with attaining an optimally personalized treatment, are of primary importance, among other things, in order to reduce possible iatrogenesis caused from an individual viewpoint in a problem with multiple aspects.

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