Neuropathic symptoms are highly prevalent in our cohort of fibromyalgic patients.
Diagnostic test to confirm small-fibers involvement were sparsely reported.
Detecting neuropathic symptoms may assist clinicians in therapeutic management.
Recent studies have highlighted that about 50% of fibromyalgic patients has a neuropathy of small- and/or large-fibers which could partially explain the puzzling symptoms of fibromyalgia (FM). Our aim was to investigate the estimated prevalence of self-reported neuropathic pain and small-fiber neuropathic symptoms (SFNS) indicative for the presence of small-fiber pathology in FM patients.
A nationwide sample of patients was recruited to participate in an on-line survey. Two groups of patients were considered in post-hoc analysis: those positive (FM+) to the Fibromyalgia Research Criteria (FRC) and those complaining typical symptoms of fibromyalgia without fulfilling the FRC (FM−).
We collected data from 854 patients (749 FM+ and 105 FM−). Patients that scored=50/100 at the Neuropathic Pain Symptoms Inventory (NPSI), indicating severe neuropathic pain, were 57.3% (62.4% in FM+ and 21.0% in FM−). Around 46% of patients presented three or more SFNS that could be suggestive of small fiber pathology, the most frequent being dry eyes/mouth, allodynia, and dyshidrosis. The NPSI score showed significant moderate/strong associations with disability (Spearman's rho=0.61), pain (rho=0.66), stiffness level (rho=0.46), number of painful sites (rho=0.40), and SFNS (rho=0.44). Despite the high prevalence of neuropathic pain and other symptoms attributable to potential small and/or large fibers pathology, neurophysiologic investigations were performed in 43.6% of cases and skin punch biopsy only in 1.9% of patients enrolled, as well as the assumption of anti-neuropathic pain drugs (13.2%).
Our findings underscore the high estimated prevalence of neuropathic pain and SFNS in FM patients.El texto completo de este artículo está disponible en PDF.
Keywords : Neuropathic pain, Fibromyalgia, Small fiber neuropathy, Survey
Vol 88 - N° 4Artículo 105153- juillet 2021 Regresar al número
Bienvenido a EM-consulte, la referencia de los profesionales de la salud.
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