Sibel EYİGÖR, Yeşim KİRAZLI

Nöropatik ağrı açısından fibromyalji sendromu

Klinik kullanımda lehte sonuçları olmasına rağmen, migren tedavisinde büyük oksipital sinir bloğunun (GON) etkisine dair az sayıda kanıt bulunmaktadır. Bir ön çalışmayla migren ataklarının önlenmesinde % 0,5 Fibromyalji sendromu (FMS), sinir sistemindeki primer anormalliklerin kliniğe yansıması ile karşımıza çıkan kronik ağrı sendromlarından biridir. FMS’lu hastalar, nöropatik ağrının yaygın klinik özelliklerini göstermektedirler. Bu semptom ve bulguları açıklayacak mekanizma halen anlaşılmış değildir. Santral ağrının hiperaljezi, allodini, ağrı ilişkili beyin bölgelerinin anormal aktivasyonu, anormal temporal sumasyon gibi nöropatik ağrı sendromu konusunda güçlü kanıtlara neden olan bir takım anormallikleri, FMS’lu hastaların çoğunda gözlenmektedir. Bu yeni bilgiler, santral sinir sisteminde sensitizasyon ve sempatik hiperaktiviteyle ilişkili, FMS’unun nöropatik ağrı sendromu olabileceğini düşündürmektedir. Bu farklı bakış açısı, tedavi ve çalışmalar için yeni kapılar açılmasına neden olmaktadır. Bu derlemede, FMS’unun nasıl nöropatik ağrı sendromu ile ilişkilendirildiğine dair bilgilerin sentezi yapılacaktır.

Anahtar Kelimeler:

Nevralji, Fibromiyalji, Ağrı

Fibromyalgia syndrome from the perspective of neuropathic pain

Fibromyalgia Syndrome from the Perspective of Neuropathic Pain Fibromyalgia syndrome (FMS) is one of the several chronic pain syndromes and have been proposed to reflect some primary abnormality of the nervous system. Patients with FMS display common clinical features with neuropathic pain. The responsible mechanisms for symptoms and signs are still unknown. Mounting evidence was shown for central pain processing abnormalities in almost all FMS patients. These anomalies including hyperalgesia, allodynia, abnormal activation of pain-related brain regions and abnormal temporal summation of second pain in FMS patients strongly indicate a neuropathic pain syndrome. This new information led to the proposal that FMS may be a neuropathic pain syndrome maintained by central nervous system sensitization and sympathetic hyperactivity. This different perspective on FMS opens new avenues for research and treatment. In this review, a synthesis of the information about how FMS is related to neuropathic pain syndromes is provided.

Keywords:

Neuralgia, Fibromyalgia, Pain,

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