Spasmophilia comorbidity in fibromyalgia syndrome.

OBJECTIVES: To evaluate the role of spasmophilia (SP) in fibromyalgia syndrome (FM). METHODS: Three hundred and fourteen patients (280 F, 34 M) with a diagnosis of FM or FM and spasmophilia (FM+SP) were recruited. Clinical assessment of patients and controls included the Questionnaires FIQ, HAQ and the tender point (TP) count. Life-time or ongoing psychiatric aspects were evaluated by trained psychiatrists by means of the classic scales: Structured Clinical Interview (SCID) for DSM-IV. The following analysis were evaluated: cytokine (IL1, IL2, IL6, IL8, IL10), TNF-α, cortisol, GH, ACTH, IGF1, 5HT, intracellular Mg, plasma calcium p(Ca), PTH, (25(OH)D) and thyroid functionality. Some typical symptoms were investigated. RESULTS: Eighty-one patients resulted positive for spamophilia (FM+SP), while 233 resulted negative for spasmophilia (FM). The mean TP number resulted higher in the FM group (15.33±3.88) with respect to FM+SP (12.88±6.17, p=0.016), while FIQ and HAQ did not differ between the two studied groups. FM patients exhibited a higher frequency of psychiatric disorders with respect to FM+SP patients (72% FM vs. 49% FM+SP, p<0.01). In particular the frequency of depression was 65.5% FM vs. 35% FM+SP (p<0.01). CONCLUSIONS: The presence of spasmophilia seems to influence psychiatric comorbidity which was less prevalent in FM+SP patients. FM is indeed characterised by an abnormal sensory processing of pain that seems to result from a combination of interactions between neurotransmitters, stress, hormones and the nervous system; spasmophilia would seem to be more linked to a dysfunction at the neuromuscular level.

Spasmophilia: a clinical neurophysiopathological and biochemical study.

Spasmophilia is a problem much debated as regards its nosographic location. Its paroxysmal onset in a "neurotic" patient has confined spasmophilia within a psychiatric syndromic complex for many years. In the present study, strict clinical criteria used in selecting a population of spasmophilic patients included clinical, neurophysiological, biohumoral and psychological evaluations, providing further information about the real organic features of this syndrome. Moreover, on the basis of an organic pathogenetic hypothesis, all patients were administered medical therapy which resulted in clinical amelioration in a significant number of cases.

[Psychopathologic aspects of tetanic seizures]. / Aspects psychopathologiques des crises de tétanie.

In that work, the tetanic's depresses are taken out from the sphere of spasmophilie , concept that the authors take as no pertinent. Those depresses find again the sphere of the nevrosis . It is an answer to the anguish and to the oedipus-problematic of the subject. The authors, by making clear their remarks with several observations, circle the clinic constants escorting the birth of depresses, the bodily expression of the anguish, the psycho-motive peculiarity of the tetanic and the phenomenon of repetition. The authors conclude with a thought over the sense of the symptoms, and over a psycho-somatic medicine that essentially refers to the relation between the doctor and the patient.

[Tetany in autonomic vascular dystonia in children]. / Tetaniia pri vegetososudistoi distonii u detei.

The results of examining patients aged 10 to 15 years suffering from vegetovascular dystonia (VVD) associated with the tetanic syndrome (TS) are provided. Patients with VVD not associated with the TS, and healthy patients of the comparable age made up the control. Use was made of the electrophysiological techniques (EEG, EMG, REG), vegetological methods (background, reactivity, activity support), neuropsychological (MMPI, Spielberger and Izenk tests), polygraphic and biochemical methods. The authors describe a number of disease characteristics (predominance of the latent forms of the TS, the normal calcemic pattern of tetany, etc). Emphasize the role of nongross lesions of the nonspecific integrating brain systems in the genesis of the given syndrome determined by perinatal injury to the brain.

[Symptomatology in 162 patients with spasmophilia (chronic idiopathic or constitutional tetany). A statistical analysis using a computer (author's transl)]. / Symptomatologie observée chez 162 malades classés comme spasmophiles (tétanie chronique idiopathique ou constitutionnelle). Résultats d'une analyse statistique à l'aide d'un ordinateur.

A computer was used for a statistical analysis of the results of treatment in 162 patients (130 women and 32 men with an average age of 29 years), with chronic idiopathic tetany. Symptoms leading to diagnosis were mainly feelings of ill-health (27.2 %), motor disorders (19.7 %), and sensory problems (19.1 %). The onset of acute attacks is related, more especially, to psychogenic factors. The frequency of the various clinical manifestations, and their symptomatic grouping were analyzed. The clinical profile is similar in both sexes apart from 7 of the 89 items: lipothymia, abnormal feelings of warmth, pseudo-contraction of the larynx, abnormalities of the exoskeleton, and digestive disorders are more frequent in women, while precordalgia is more often present in men. Factorial analysis of correspondence between 38 variables reveals a very large dispersion of the variables, as the first three factors, which are the most significant, supply only 30% of the total information. Furthermore, very few variables share significant relationships in each factor. In spite of the amount of information collected, this dispersion of the symptomatology does not permit the definition of one or more profile-types of spasmophilia.

[Nosography of neuroses. 7. Relation between neurotic syndromes and the spasmophilic syndrome]. / Studi sulla nosografia delle nevrosi: 7) Rapporti tra sindromi nevrosiche e sindrome spasmofilica.

The investigators have examined the literature dealing with the psychic symptomatology that generally accompanies tetanic and spasmophilic phenomena, particularly the psychic and characterological substratum of patients affected by such symptoms. By focusing their inquiry on the spasmophilic symptoms displayed by neurotic patients, rather than on the psychic disturbances of patients with spasmophilic symptoms, the following considerations emerge: The widely held view that psychic disturbances in spasmophilic patients can be fitted into the classic picture of asthenic, anxious or depressive disorders is not tenable. The erethistic syndrome with its characteristics of generalized irritability and hyperexcitability, described by us in 1966, is the one most frequently exhibiting spasmophilic symptoms. Therefore, nervous erethism encompasses the most important characteristics of erethistic neurosis as well as of spasmophilia. A connection between the psychological and biological aspects of neurotic conditions is again foreseeable, especially in the light of recent discoveries on normocalcemic spasmophilia. In conclusion, it is intriguing to speculate that the neuropsychic disturbances of spasmophilia fit into the larger conception of nervous erethism and that the psychic and somatic phenomena of both have the same biological origin.

The hyperventilation syndrome: a neurosis or a manifestation of magnesium imbalance?

It has been proven with clinical, psychological and electromyographic tests that the hyperventilation (HV) syndrome cannot be separated from so-called genuine tetany. Tetanic patients with and without HV are characterized by a significant hypocalcemia; but a significant hypomagnesemia is exclusively found in tetanic patients with HV attacks. Possible pathogenic mechanisms are discussed which may explain the HV attacks as a consequence of primary magnesium deficiency.

Repetitive electromyographic activity, spasmorhythmia and spasmophilia.

Spasmorhythmia (SR) can be defined as repetitive electromyographic activity lasting for longer than 4 min under conditions of cuff-induced ischemia. In a study on more than 180 'normal' subjects, this electrical anomaly was found in 21% of men and 30% of women, and was independent of age. Spontaneous variation in SR several hours or weeks apart is relatively slight, an average of 2 min, with the electrical diagnosis being confirmed by a second test in three quarters of cases. Correlations between SR and magnesium metabolism have not been proved as yet. SR has no pathological significance on its own. It assumes diagnostic importance when found in association with various vascular conditions; when found in association with a characteristic symptomatology, it may be used to support a diagnosis of latent tetany.