Fibromiyalji Sendromu ve Nöropatik Ağrı

Year 2018, Volume: 1 Issue: 1, 26 - 31, 01.07.2018

Meryem Kösehasanoğulları , Nihal Yılmaz

Abstract

Fibromiyalji sendromu yaygın vücut ağrısı ve belirli
anatomik bölgelerde hassas noktaların varlığı ile karakterize, etiyoloji net
olarak bilinmeyen, iş gücü kaybı ve yaşam kalitesinde bozulmaya yol açan kronik
bir kas-iskelet sistemi hastalığıdır. Fibromiyalji
sendromunda en sık görülen ve karakteristik semptomlar yaygın ağrı, sabah
katılığı, yorgun uyanma ve uyku bozukluğudur. Aile öyküsü olanlarda
fibromiyaljinin daha fazla görülmesi genetik faktörlerin rol aldığını
düşündürmektedir. Fibromiyaljili hastaların
ağrılı uyaranlara daha duyarlı olduğu gösterilmiştir. Fibromiyalji sendromunun
etiyopatogenezi üzerine uzun yıllardır birçok çalışma yapılmakta olup
multifaktöryel mekanizmalar olduğu görüşü ağırlık kazanmaktadır. Bu faktörler
genetik nedenler, immunolojik mekanizmalar ve santral ve periferik teoriler
olarak alt başlıklarda toplanmaktadır. Fibromiyaljinin sıklıkla santral
sensitivite sendromları ile beraber olması, glutamat ve P maddesi gibi ağrı
nörotransmitterlerinin artmış olması, noradrenalin, serotonin ve dopamin gibi
antinosiseptif nörotransmitter düzeylerinin azalmış olması, ektopik
deşarjlar/periefrik sensitizasyon/ Aβ liflerinin reorganizasyonu ve
hiperaljezi ve allodinin varlığı fibromiyaljinin nöropatik ağrı sendromun bir
parçası olabileceğini düşündürmektedir.
Son yıllarda
yapılan çalışmalar santral mekanizmaların etkinliğini desteklemektedir Nöropatik ağrı ve fibromiyalji sendromu ilişkisi literatürde yapılan az sayıda çalışmada
gösterilmiştir. Son yıllardaki çalışmalarda fibromiyalji sendromu
ile küçük lif polinöropatisi sıklığının saptanması ile periferik sisteminde
olaya katkı sağladığı görüşü gündeme gelmiştir Bu
yazıda fibromiyalji sendromu ve nöropatik ağrı son gelişmeler ışığında tekrar
gözden geçirilecektir. 

Keywords

Fibromiyalji, nöropatik ağrı, santral sensitizasyon

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