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alt="You are not entitled to access the full text of this document" title="You are not entitled to access the full text of this document" width=12 height=14"> <a href="http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6W78-48J07YW-8&_user=10&_coverDate=04%2F30%2F2003&_rdoc=1&_fmt=high&_orig=article&_cdi=6620&_sort=v&_docanchor=&view=c&_ct=697&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=4441fd4627a8b23bb38620bcb4801954">Physiopathologie de la douleur de la fibromyalgiea>alt="Close" title="Close" onmouseover="javascript:this.src='/scidirimg/btn_xclose_hov.gif';" onmouseout="javascript:this.src='/scidirimg/btn_xclose.gif';">a>alt="You are not entitled to access the full text of this document" title="You are not entitled to access the full text of this document" width=12 height=14"> <a href="http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6VMG-4PPWK5Y-B&_user=10&_coverDate=02%2F29%2F2008&_rdoc=1&_fmt=high&_orig=article&_cdi=6150&_sort=v&_docanchor=&view=c&_ct=697&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=7c9358e7318bc4abdcb6bbf208173102">La fibromyalgiea>Les critères de classification de l’American College of Rheumatology font l’objet de critiques quant à leur utilisation comme critères de diagnostic. Bien que les symptômes psychiatriques y soient constants, la fibromyalgie n’est assimilable à aucune maladie psychiatrique caractérisée. L’imagerie fonctionnelle cérébrale fournit des arguments pour un dysfonctionnement des centres supraspinaux de régulation de la douleur.
La fibromyalgie est une entité clinique autonome. Les connaissances sur sa physiopathologie progressent, mais restent à confirmer. Une approche personnalisée et pluridisciplinaire, incluant l’explication du syndrome, est très profitable aux patients. La fibromyalgie est le plus souvent compatible avec la poursuite d’une activité professionnelle, au besoin aménagée, et ne justifie qu’exceptionnellement une prise en charge de maladie invalidante.
We review the current knowledge about fibromyalgia, adding to the clinical aspects, the nosology, epidemiology and pathogenesis. The therapeutic and social management of these suffering patients are discussed.
The limitations of the American College of Rheumatology classification criteria used as diagnostic criteria are discussed. Fibromyalgia is not a simple psychiatric disorder, even if psychiatric symptoms are constantly found. Based on functional brain imaging, there is some evidence pointing to an abnormal function of the supra-spinal centres for pain regulation.
Fibromyalgia is a clinical autonomous entity. Physiopathology knowledge is improving, but must be confirmed by new research. Patients will take profit of multimodal individualized treatment programs, including explanations about the diagnosis. In most cases, fibromyalgia is compatible with the maintenance of a professional activity, possibly adapted to the patient. Recognized disability requiring compensation is infrequent.
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