[Sensory sensitization, part II: Pathophysiology in dysfunctional disorders. Understanding the inner life of the nerve pathways may explain hitherto unexplainable symptoms].
This article is based on a vast clinical experience from patients presenting with widespread pain syndromes as well as dysfunctional symptoms from inner organs. A literature survey has been performed. Allodynia and hyperalgesia that partly explain the fibromyalgia and local myalgia syndromes seem to arise from a pathophysiological process of nociceptive sensitisation. It is proposed that the concept of "sensory sensitisation dysfunctional disorders" be applied to conditions like bronchial hyperreactivity, Da Costas syndrome, Dercum's disease (Adipositas dolorosa), dry eyes and mouth syndrome, fibromyalgia, gastralgia, globus hystericus, interstitial cystitis, chronic prostatitis, irritable bowel syndrome, photo- and phonosensitivity, rhinitis, tension headache, tinnitus, vestibulitis syndrome. These dysfunctional disorders cannot be satisfactorily explained by presently known pathophysiological models like ongoing inflammatory process, tissue degeneration, fibrosis, blood vessel diseases, tumours, immune reactions, toxic or deficiency conditions, metabolic disturbances. Neurogenic mechanisms also seem to play an important role in the pathophysiology of arthritic conditions, and might be worthwhile to include in forthcoming discussions concerning the aetiology of chronic inflammatory disease.
Levander
Hans
H
Reumatologkliniken, medicindivisionen, Akademiska sjukhuset, Uppsala. hans.levander@alfa.telenordia.se
D002908:Chronic Disease; D003109:Colonic Diseases, Functional / Q000503:physiopathology; D004415:Dyspepsia / Q000503:physiopathology; D005356:Fibromyalgia / Q000503:physiopathology; D006801:Humans; D007249:Inflammation / Q000503:physiopathology; D009140:Musculoskeletal Diseases / Q000503:physiopathology; D009434:Neural Pathways / Q000503:physiopathology*; D009619:Nociceptors / Q000502:physiology*; D010146:Pain / Q000175:diagnosis / Q000503:physiopathology*; D017288:Pain Threshold / Q000502:physiology; D017699:Pelvic Pain / Q000503:physiopathology; D011602:Psychophysiologic Disorders / Q000503:physiopathology; D013001:Somatoform Disorders / Q000503:physiopathology; D013577:Syndrome