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April2015 Vol.52 Issue:        2        Table of Contents
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Fibromyalgia: Clinical Evaluation, Electrophysiological Assessment and Serum Serotonin Level Measurement

Nihal Z. El Shazly1, Shereen F. Sheir2, Shaheera M. Moustfa1, Shereen H. Debala3

Departments of Neurophysiology1, Neurology2, Cairo University; Rheumatology3, Police Hospital; Egypt


Fibromyalgia (FM) is a chronic pain illness. The causes of FM are not fully understood. Biochemical, metabolic and disturbed immune-regulatory abnormalities were suggested as possible causes of FM. Objective: The study aims at the evaluation of serum serotonin in FM and its correlation with the pain and the possible electrophysiological abnormalities. Methods: Thirty patients suffering from FM (diagnosed according American College of Rheumatology for classification of FM ) ,  not under any medical treatment  had  i) An evaluation of  serum serotonin ii) quantitative electromyography (qEMG) iii) Sympathetic skin response test (SSR). Results: Serum Serotonin (SSL) level was significantly lower in FM patients compared to control group. A SSL 400 ng/L was found to be a cut off point for existence of the disease. SSR latency as well tends to be longer in FM patients. The qEMG showed motor unit potential de-synchronization, temporal dispersion and increased size. Conclusion: FM is a disease of low serotonin levels. Determination of SSL is a sensitive and selective test to assist in the diagnosis and follow up of FM patients. The value of SSR latency and qEMG tests still need to be verified however, they can be used to follow up the effects of the pharmacological and non-pharmacological treatments of FM. [Egypt J Neurol Psychiat Neurosurg.  2015; 52(2): 101-110]

 Key Words: fibromyalgia, quantitative EMG, serum serotonin, sympathetic skin response.

Correspondence to Nihal El Shazly, Assistant Professor of Clinical Neurophysiology; Cairo University, Egypt. Email:

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