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Author(s):
Daria A. Trojan, MD, MSc, Neil R. Cashman, MDObjective: To determine prospectively the occurrence and clinical characteristics of fibromyalgia in patients serially presenting to a postpolio clinic. Fibromyalgia may mimic some of the symptoms of postpoliomyelitis syndrome, a disorder characterized by new weakness, fatigue, and pain decades after paralytic poliomyelitis.
Design: Case series.
Setting: A university-affiliated hospital clinic.
Patients: One hundred five patients were evaluated with a standardized history and physical examination during an 18-month period. Ten patients were excluded because of the absence of past paralytic poliomyelitis.
Interventions: Patients with fibromyalgia were treated with low-dose, nighttime amitriptyline hydrochloride or other conservative measures.
Main Outcome Measures: Patients with fibromyalgia had diffuse pain and 11 or more of 18 specific tender points on examination (American College of Rheumatology criteria, 1990). Patients with borderline fibromyalgia had muscle pain and five to 10 tender points on physical examination.
Results: Ten (10.5%) of 95 postpolio patients met the criteria for fibromyalgia, and another 10 patients had borderline fibromyalgia. All patients with fibromyalgia complained of new weakness, fatigue, and pain. Patients with fibromyalgia were more likely than patients without fibromylagia to be female (80% vs 40%, P<.04) and to complain of generalized fatigue (100% vs 71%, P=.057), but were not distinguishable in terms of age at presentation to clinic, age at polio, length of time since polio, physical activity, weakness at polio, motor strength scores on examination, and the presence of new weakness, muscle fatigue, or joint pain. Approximately 50% of patients in both the fibromyalgia and borderline fibromyalgia groups responded to low-dose, nighttime amitriptyline therapy.
Conclusions: (1) Fibromyalgia occurs frequently in a postpolio clinic. (2) Fibromyalgia can mimic some symptoms of postpoliomyelitis syndrome. (3) Fibromyalgia in postpolio patients can respond to specific treatment.
Author(s):
Dr. E.G. Dowsett MBChB, Dip Bact.
Author(s): Jane ColbyDr. Richard Bruno, whose research into post-polio conditions is sometimes quoted in support of a connection between Polio and CFS/ME, clarifies his position in Polio and CFS/ME - Dr. Bruno's response to people who write about "poliovirus causing CFS".
It is the intention of the Lincolnshire Post-Polio Network to make all the information we collect available regardless of our views as to it's content. The inclusion of a document in this library should not therefore be in any way interpreted as an endorsement.
People who had polio and are experiencing new symptoms need to be assessed by medical professionals who are experienced in Post-Polio to determine what is wrong and to give correct advice. We can only make these documents available to you. YOU must then take what you believe to be relevant to the medical professional you are seeing. We are collecting and collating everything we can to enable medical professionals to make informed decisions. Other medical conditions must be looked for first, Post-Polio Syndrome is by diagnosis of exclusion.
Whether you are a Polio Survivor, a friend or relation of a Polio Survivor, or a Medical Professional, we would advise you use this catalogue only to assist in determining your reading priorities. Every article in this library is likely to contain information of interest to both Polio Survivors and Medical Professionals.
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© Copyright The Lincolnshire Post-Polio Network 1997 1998 1999 2000 2001 2002
Document preparation: Chris Salter, Original
Think-tank, Cornwall, United Kingdom.
Primary Document Reference: <URL:http://www.ott.zynet.co.uk/polio/lincolnshire/library/cc_4.html>
Secondary Document Reference: <URL:http://www.zynet.co.uk/ott/polio/lincolnshire/library/cc_4.html>
Last modification: 7th January 2002
Last information content change: 19th February 2001
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