Douleur et Analgésie

, 1:159 | Cite as

Syndrome Polyalgique Idiopathique Diffus Fibrosite. Fibromyalgie primitive

  • M. F. Kahn
Article

Résumé

Parmi le lot des patients consultant pour des douleurs diffuses, chroniques, un groupe relativement homogène, de sexe le plus souvent féminin, a été récemment isolé. Leurs douleurs sont à prédominance axiale sans que l’on puisse déterminer avec précision la structure en cause. Il s’y associe souvent une fatigabilité musculaire et divers troubles peu spécifiques comme l’insomnie et une colopathie fonctionnelle. Les examens cliniques, paracliniques et anatomiques ne montrent rien de précis. Le contexte psychonévrotique n’est ni constant ni univoque. Il existe des points douloureux nombreux et reproductibles, là encore à prédominance axiale. La physiopathologie, et même pour certains l’existence de ce syndrome, restent sujets à caution. Outre les hypothèses psychosomatiques en perte de vitesse, on envisage soit une affection tendinomusculaire encore inconnue dans son mécanisme, ou un trouble chronique de la perception douloureuse. Le traitement consiste d’abord à reconnaître l’affection et faire comprendre au patient qu’il est cru. Les thérapeutiques physiques, les méthodes psychocorporelles sont parfois efficaces. Les tricycliques à petites doses ont été essayés avec succès. L’affection est appelée dans les pays de langue anglaise: fibromyalgie primitive. En raison des incertitudes qui continuent à planer sur son identification et son mécanisme, nous avons proposé le terme de Syndrome Polyalgique idiopathique Diffus (SPID).

Summary

Among the patients presenting with chronic diffuse pain, a relatively homogenous subset, mostly women, has recently emerged. Pain is usually predominantly axial, but it is so far impossible to precise the suffering structure. Muscular fatigability and some ill defined troubles such as insomnia and chronic colopathy are frequently associated. Clinical, biological and anatomical examination fail to demonstrate any specific sign of a known condition. Psycho-neurotic environment is neither usual nor univocal. Trigger painful area, mostly axial, can be found in great number. Pathophysiology, and even for some authors, actual autonomy of this syndrome remain controversial. Psychosomatic origin is less and less accepted. The possibility of some so far unknown tendinomuscular condition is raised. A chronic trouble in endogenous pain control mechanism is also advocated. Treatment includes recognition of this condition for the patient, who must be aware that she is believed. Physical therapy, bio-feedback-derivated methods receive some credit. Tricyclic have been tried with some success. English speaking authors have coined the names Fibrositis and Primitive fibromyalgia for this condition. Considering the incertainty which still remain concerning the identification and the mechanism, we have suggested to coin the name Diffuse Idiopathic Polyalgic Syndrome (DIPS).

Key words

Primitive Fibromyalgia fibrositis polyenthesopathy Diffuse Idiopathic Polyalgic Syndrome 

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Copyright information

© Springer-Verlag 1988

Authors and Affiliations

  • M. F. Kahn
    • 1
  1. 1.Clinique rhumatologiqueFaculté Xavier-Bichat (Université Paris 7)ParisFrance

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