Fibromyalgia and Epilepsy

What is Fibromyalgia?

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, fibromyalgia is a chronic disorder that causes pain and tenderness throughout the body, as well as fatigue and insomnia. Fibromyalgia affects women more often than men and are usually diagnosed around thirty-five to forty-five years of age (U.S. Dept. of Health and Human Services, 2021). According to the CDC, fibromyalgia affects around four million Americans, or two percent of the population.

Fibromyalgia and Epilepsy

Studies have shown a connection between fibromyalgia and psychogenic non-epileptic seizures (PNES). According to the article,?The relation of fibromyalgia and fibromyalgia symptoms to self-reported seizures,?the first detailed study to find a relation between seizure disorders and fibromyalgia took place in 2005. Population studies found an increased prevalence of fibromyalgia in patients with epilepsy and in clinical studies, a strong association between PNES and fibromyalgia (Rasker et. al., 2021).

Individuals who have epileptic seizures can also develop fibromyalgia. In the article,?Fibromyalgia and seizures,?a case study was conducted to determine how frequently fibromyalgia is associated with different paroxysmal neurological disorders as well as PNES. The study concluded that out of the study, eleven percent of the participants had epileptic seizures and seventy-four percent had PNES (Tatum et. al., 2016).

Diagnosis

According to Mayo Clinic, to be tested for fibromyalgia, a patient must be experiencing symptoms for at least three months, and be experiencing pain in at least four of the five following areas:

• Left upper region, including shoulder, arm, or jaw
• Right upper region, including shoulder, arm, or jaw
• Left lower region, including hip, buttock, or leg
• Right lower region, including hip, buttock, or leg
• Axial region, which includes neck, back, chest, or abdomen

(Mayo Clinic, 2021)

In addition to a physical examination, a physician will order tests to rule out conditions with similar symptoms. These tests are:

• Complete blood count
• Erythrocyte sedimentation rate
• Cyclic citrullinated peptide test
• Rheumatoid factor
• Thyroid function tests
• Anti-nuclear antibody
• Celiac serology
• Vitamin D

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Signs and Symptoms

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the main symptoms of fibromyalgia are:

• Chronic, widespread pain throughout the body or at multiple sites. Pain is often felt in the arms, legs, head, chest, abdomen, back, and buttocks. People often describe it as aching, burning, or throbbing
• Fatigue or an overwhelming feeling of being tired
• Trouble sleeping

Other symptoms may include:

• Muscle and joint stiffness
• Tenderness to touch
• Numbness or tingling in the arms and legs
• Problems with concentrating, thinking clearly, and memory (sometimes called “fibro fog”)
• Heightened sensitivity to light, noise, odors, and temperature
• Digestive issues, such as bloating or constipation

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Treatment

There are two main types of treatment for individuals with fibromyalgia, medication and therapies. According to Mayo Clinic, the goal of treating with medication is to alleviate pain and help improve sleep. Listed below are the treatment options physicians prescribe to their patients:

• Pain relievers: over the counter medication such as Tylenol (acetaminophen), ibuprofen (Advil, Motrin, etc.), or naproxen sodium (Aleve) may help to alleviate pain. Opioid medications are discouraged due to side effects, possible addiction, and can worsen symptoms over time.
• Antidepressants: Duloxetine (Cymbalta) and milnacipran (Savella) can help to alleviate pain and fatigue. Your physician may prescribe amitriptyline or cyclobenzaprine to help promote sleep.
• Anti-seizure drugs: Medications that are used to treat epilepsy can help in alleviating certain types of pain. Gabapentin (Neurontin) can help in reducing fibromyalgia symptoms. Pregabalin (Lyrica) was the first drug approved by the Food and Drug Administration to treat fibromyalgia.

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Therapies that are used to treat fibromyalgia include:

• Physical therapy: physical therapists can teach exercises to improve strength, flexibility, and stamina. Water-based exercises such as swimming can be helpful and alleviate inflammation.
• Occupational therapy: Occupational therapists can help make adjustments to one’s work area or the way certain tasks are performed to help alleviate stress.
• Counseling: Talking to a therapist can help strengthen one’s abilities and teach strategies when dealing with stressful situations.

(Mayo Clinic, 2021)

Conclusion

Fibromyalgia is a chronic disorder that causes pain and tenderness throughout the body, as well as fatigue and insomnia. Studies has shown that people with both epileptic and psychogenic non-epileptic seizures can have fibromyalgia. There are a number of things that physicians must look for to make a proper diagnosis for fibromyalgia. Chronic pain, fatigue, and insomnia are the most common symptoms of fibromyalgia. Medication and therapies can help to alleviate pain, reduce stress, improve sleep, and improve overall quality of life.

Resources:

Centers for Disease Control and Prevention (2020). Fibromyalgia.?Centers for Disease Control and Prevention.?Retrieved from:?https://www.cdc.gov/arthritis/basics/fibromyalgia.htm

Mayo Clinic (2021). Fibromyalgia, Diagnosis and Treatment.?Mayo Clinic.?Retrieved from:?https://www.mayoclinic.org/diseases-conditions/fibromyalgia/diagnosis-treatment/drc-20354785

National Institute of Arthritis and Musculoskeletal and Skin Diseases (2021). Fibromyalgia.?National Institutes of Health.?Retrieved from:?https://www.niams.nih.gov/health-topics/fibromyalgia

Rasker, J. J., Wolfe, F., Klaver-Krol, E. G., Zwarts, M. J., & Ten Klooster, P. M. (2021). The relation of fibromyalgia and fibromyalgia symptoms to self-reported seizures. PloS one, 16(2), e0246051.?https://doi.org/10.1371/journal.pone.0246051

Tatum, W.O., Langston, M.E., and Acton, E.K. (2016). Fibromyalgia and seizures.?Epileptic Disorders, 18:?148-154. Retrieved from:?https://doi.org/10.1684/epd.2016.0823

U.S. Department of Health and Human Services (2021). Fibromyalgia.?U.S. Dept. of Health and Human Services, Office on Women’s Health.?Retrieved from:?https://www.womenshealth.gov/a-z-topics/fibromyalgia