Post by TishArby on Apr 9, 2002 14:40:09 GMT -5
Overlapping Syndromes
Fibromyalgia syndrome (FMS), chronic fatigue syndrome (CFS), multiple chemical sensitivity syndrome (MCS), myofascial pain syndrome (MPS), and other conditions form a family of overlapping syndromes. In fact, researcher Muhammad Yunus, M.D., of the University of Illinois College of Medicine claims, most patients have more than one syndrome. Thus, he views FMS and CFS as being part of a larger spectrum of conditions, which he calls Dysregulation Spectrum Syndrome or DSS (see diagram below). Dr. Yunus uses the term dysregulation to mean biophysiological abnormalities, possibly in the neuro-hormonal system.
Backing up Dr. Yunus’ commentary are studies by Dedra Buchwald, M.D., of the University of Washington, Anthony Komaroff, M.D., of Brigham and Women’s Hospital and Don Goldenberg, M.D., of Newton-Wellesley Hospital. It is always important to keep these overlapping syndromes in mind because the presence of one or more syndromes could impact your treatment. These three researchers have shown that CFS and FMS overlap in patients by as much as 75%. When it comes to MCS, this syndrome is present in roughly 50% of FMS and CFS diagnosed patients.
Most practicing physicians and researchers alike will tell you that the chronic pain diagnosis a person first receives is often colored by their chief symptom complaint. For example, widespread muscular pain is often diagnosed by rheumatologists as FMS. A person who is overcome by extreme fatigue and flu-like symptoms might consult an infectious disease expert and receive the diagnosis of CFS. A person who has severe jaw pain might see a dentist and be told that they have temporomandibular joint dysfunction (TMJD). People who appear to have allergic-type symptoms to a number of chemicals, foods or odors may be informed by an allergist that they have MCS. Similar situations occur with the other conditions in the family of Dysregulation Spectrum Syndrome.
Two common sleep disorders that may be present in FMS/CFS patients are: restless leg syndrome (RLS) and periodic limb movement during sleep (PLMS). According to sleep researcher Harvey Moldofsky, M.D., of the University of Toronto, RLS has been described as someone playing soccer all night long. The patient’s arms and legs just can’t stay still. PLMS may feel like a startling response that occurs when you think you have reached the last step going down a flight of stairs and you fling your limbs to catch your balance as you discover that there is one step remaining. Both RLS and PLMS can cause continuous arousal movements during sleep and impede your ability to get a restful night’s sleep.
Referring to the specific sleep disorders of RLS and PLMS, Dr. Yunus comments that a sleep study might be helpful if a physician suspected either condition. First of all, it may offer an objective test finding that is lacking for most FMS/CFS patients. Secondly, the treatment for RLS or PLMS is a benzodiazepine with anti-seizure properties such as Klonopin (clonazepam). The most commonly used medications for FMS/CFS, such as tricyclics like Elavil, can actually make this subgroup (30%) of patients worse. Therefore, it is important that you assist your physician by providing accurate symptom information to help identify related syndromes. This can aid in the development of appropriate treatment strategies.
Fibromyalgia syndrome (FMS), chronic fatigue syndrome (CFS), multiple chemical sensitivity syndrome (MCS), myofascial pain syndrome (MPS), and other conditions form a family of overlapping syndromes. In fact, researcher Muhammad Yunus, M.D., of the University of Illinois College of Medicine claims, most patients have more than one syndrome. Thus, he views FMS and CFS as being part of a larger spectrum of conditions, which he calls Dysregulation Spectrum Syndrome or DSS (see diagram below). Dr. Yunus uses the term dysregulation to mean biophysiological abnormalities, possibly in the neuro-hormonal system.
Backing up Dr. Yunus’ commentary are studies by Dedra Buchwald, M.D., of the University of Washington, Anthony Komaroff, M.D., of Brigham and Women’s Hospital and Don Goldenberg, M.D., of Newton-Wellesley Hospital. It is always important to keep these overlapping syndromes in mind because the presence of one or more syndromes could impact your treatment. These three researchers have shown that CFS and FMS overlap in patients by as much as 75%. When it comes to MCS, this syndrome is present in roughly 50% of FMS and CFS diagnosed patients.
Most practicing physicians and researchers alike will tell you that the chronic pain diagnosis a person first receives is often colored by their chief symptom complaint. For example, widespread muscular pain is often diagnosed by rheumatologists as FMS. A person who is overcome by extreme fatigue and flu-like symptoms might consult an infectious disease expert and receive the diagnosis of CFS. A person who has severe jaw pain might see a dentist and be told that they have temporomandibular joint dysfunction (TMJD). People who appear to have allergic-type symptoms to a number of chemicals, foods or odors may be informed by an allergist that they have MCS. Similar situations occur with the other conditions in the family of Dysregulation Spectrum Syndrome.
Two common sleep disorders that may be present in FMS/CFS patients are: restless leg syndrome (RLS) and periodic limb movement during sleep (PLMS). According to sleep researcher Harvey Moldofsky, M.D., of the University of Toronto, RLS has been described as someone playing soccer all night long. The patient’s arms and legs just can’t stay still. PLMS may feel like a startling response that occurs when you think you have reached the last step going down a flight of stairs and you fling your limbs to catch your balance as you discover that there is one step remaining. Both RLS and PLMS can cause continuous arousal movements during sleep and impede your ability to get a restful night’s sleep.
Referring to the specific sleep disorders of RLS and PLMS, Dr. Yunus comments that a sleep study might be helpful if a physician suspected either condition. First of all, it may offer an objective test finding that is lacking for most FMS/CFS patients. Secondly, the treatment for RLS or PLMS is a benzodiazepine with anti-seizure properties such as Klonopin (clonazepam). The most commonly used medications for FMS/CFS, such as tricyclics like Elavil, can actually make this subgroup (30%) of patients worse. Therefore, it is important that you assist your physician by providing accurate symptom information to help identify related syndromes. This can aid in the development of appropriate treatment strategies.
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