I have a few vexing questions!

As many of you who have been on this board for a couple of years since my first appearance will be aware, in August 2007 I was diagnosed with Peripheral Neuropathy due to symptoms of body wide parasthaesias and dysathaesias..

Many tests ensued, of which all were, by and large, negative.

Time has moved on and the neuropathic symptoms have remained, along with worsening pain but more of the 24/7 muscle aches/pain and stiffness variety. I have also earlier this year been diagnosed with fairly severe Gastroparesis and Oesophageal paralysis.

Several doctors have felt that I have Fibromyalgia (because of multiple compatible symptoms) and I have now been referred to a 'relatively' expert Fibromyalgia specialist here in Melbourne next week – hopefully the last of many specialists!

Much is yet to be empirically discovered about Fibromyalgia, however one current stream of thought is that Fibromyalgia is a syndrome of pain sensitisation. http://www.pathoutofpain.com.au/info...der_fibro.html

Does this mean therefore that the pain I am experiencing is neuropathic pain but not Peripheral Neuropathy per sé? What is the technical difference I wonder?

In the current state of knowledge of Fibromyalgia, it is considered a complex disorder of possibly several bodily systems such as Endocrinological, Rheumatological, perhaps Immunological and Neurological. Therefore should one expect that a Neurologist would be somewhat informed enough to proffer a possibility of Fibromyalgia as the cause of a person’s symptoms, in the absence of any other abnormal testing?

If Fibromyalgia can be set off by a post viral incident and Gastroparesis can also be set off by a post viral incident why is there not more knowledge of this around amongst doctors as I would have thought that Gastroparesis allied with Fibromyalgia would have been more common?

Also in my case the Gastroparesis manifested one year plus, after the ??PN symptoms. If post viral Gastroparesis onset is usually only a few days or weeks at the most, after a viral incident is it possible that I have had several ‘viral’ episodes to cause both Fibromyalgia and Gastroparesis and why so lucky??? Or is it just another evolving symptom of a relentless condition that is never going to stop throwing up curve balls?

So confusing!!!!

I think that the 'jury is still out' on Fibromyalgia.
It seems that when doctors cannot seem to get a direct diagnosis,
they pass the ball to Fibromyalgia. Some docs (esp neuros) don't seem to think that there is such a condition as Fibromyalgia. They think that it's just a 'dumping ground' for a bunch of undiagnosed related conditions.
It is the newer term, rather than say it is 'idiopathic' they can finally have a condition as a cause.
But the 'jury is still out' for some.

I had a doctor who was a GP hoslitic doc but an MD suggest fibro to me and also a anestesolgist. For me it turned out no but I also thought a rheumatologist would be more the specilaty but I could be wrong. I know that the pain doc said there was that test I think trigger points for fibro. I am confused on your ? but do you think you have fibro on top of the current or that the current may be misdx? If in addition would the treatment be about finding the right meds for relief? I am sorry I may be so confused. Just hope you feel better and get some answers

There are 18 specified tender points for fibro. You need at least 11 of those to diagnose fibro. That's what I have found in researching it. http://www.fibromyalgia-symptoms.org...diagnosis.html

I have been told, that by and large the 18 tender points are falling into some disfavour and don't tend to be used for diagnosing Fibro now. Some may still do it. I will see what the Rheumatolgist cum Fibro specialist says about this next week when I have a consultation.

There are some more equivocal tests which currently tend to be only done for research purposes rather than diagnostic purposes and these are lumbar puncture for some compound in the CSF and also functional PET scans which are showing some promise....however they are all still a bit pie in the sky! At least research is happening!

Yes Daniella, my questions may seems somewhat more like statements rather than questions which I am throwing out to the universe, as I myself am relatively befuddled as to whether all my symptoms are in fact explained by Fibromyalgia or whether there is other pathology going on - the chicken and the egg so to speak!

I know that my very brilliant Endocrinologist says that 'Fibromyalgia' is a REAL condition and that my symptoms are very valid. She doesn't think the jury is still out on the condition actually existing, just on causes, clear diagnostics and treatment - LOL!!

Fibro and MS show low B12 levels in the CSF.

http://www.ncbi.nlm.nih.gov/pubmed/9310111

for MS:
http://www.biomedexperts.com/Abstrac...fter_high-dose

I grew old thinking fibromyalgia was a psychological condition, however, I dont feel my "psychological" problems are from anything other than the pain, etc. My neuro talked to me long and hard and assured me this condition was real. Too bad it isnt as obvious as a broken leg...then maybe "people" would understand both PN and fibromyalgia.

As I understand it Neuropathic pain is just that, i.e . pain which is caused by a nerve disorder. It is a symptom rather than a (specific) cause. In any particular case, the cause may be difficult to determine.

PN is when the disorder is of the "peripheral" nervous system, meaning generally nerves in the extremities - legs, arms etc - as opposed to the "central" nervous system - spinal cord etc

I realise that this probably does little to help in your case but it is useful to be clear about the terms.

For more information including a long list of the cause of Neuropathic pain, see http://www.patient.co.uk/showdoc/40025146/