Neurology Department, Medical School, University of São Paulo, São Paulo, Brazil.
Rheumatol Int. 2013 Aug;33(8):2009-17. doi: 10.1007/s00296-013-2675-6. Epub 2013 Feb 3.
Fibromyalgia syndrome (FS) is a chronic painful condition with sensory, motor and affective dysfunctions. Few studies had investigated the trigeminal area, and little is known about its association with hemisensory syndrome, which is characterized by chronic pain restricted to hemibody. Our objective was to investigate sensorial abnormalities with quantitative sensory testing of patients with FS and patients with hemisensory syndrome, compared to controls. Thirteen patients diagnosed with FS according to the American College of Rheumatology, and 12 patients with hemisensory syndrome were evaluated and compared to 25 age-gender-matched controls. They were investigated with a quantitative sensory testing protocol including gustative, olfactory, cold, warm, touch, vibration, electric, deep and superficial pain thresholds and the corneal reflex evaluation. The patients had higher gustative thresholds for salty and bitter. In general, patients with FS had somatosensory thresholds higher than the controls; however, patients with hemisensory syndrome had only superficial pain thresholds increased, in both body sides and not only in the area affected by pain. Patients with hemisensory syndrome can be a subgroup of FS, different from nondermatomal somatosensory deficits which are characterized by chronic pain with hypoesthesia in hemibody. The bilateral hypoalgesia supports that pain pathways play a key role in this condition, with no compromise of other sensorial modalities.
纤维肌痛综合征(FS)是一种慢性疼痛病症,伴有感觉、运动和情感功能障碍。很少有研究调查过三叉神经区域,对其与半身感觉综合征的关联也知之甚少,半身感觉综合征的特征是局限于半侧身体的慢性疼痛。我们的目的是通过对 FS 患者和半身感觉综合征患者进行定量感觉测试,来研究感觉异常。将 13 名根据美国风湿病学会诊断为 FS 的患者和 12 名半身感觉综合征患者与 25 名年龄、性别匹配的对照组进行评估和比较。他们接受了包括味觉、嗅觉、冷、热、触觉、振动、电、深和浅痛觉阈值以及角膜反射评估的定量感觉测试方案。患者的咸味和苦味味觉阈值较高。总的来说,FS 患者的体感阈值高于对照组;然而,只有半身感觉综合征患者的双侧浅痛觉阈值升高,不仅在疼痛区域,而且在整个身体两侧。半身感觉综合征患者可能是 FS 的一个亚组,与非皮节体感缺失不同,后者的特征是半侧身体的慢性疼痛伴感觉减退。双侧痛觉减退支持疼痛通路在这种情况下起着关键作用,而其他感觉模式不受影响。