[Juvenile primary fibromyalgia syndrome--review]

Abstract

Fibromyalgia syndrome is known to cause significant morbidity among adults characterised by widespread musculoskeletal pain, stiffness, fatigue, non-restorative sleep, cognitive dysfunction and diminished physical function. Although well-recognised in adults, the impact of the syndrome in the paediatric population has only recently been addressed. The estimated prevalence of juvenile primary fibromyalgia syndrome (JPFS) is 1.2%-6.2%. Prevalence is higher in girls than boys, and peaks at the time of puberty. JPFS is of unknown aetiology, characterised by numerous symptoms that mimic the symptoms of adult fibromyalgia syndrome, the most prevalent being sleep disturbance, widespread persistent musculoskeletal pain and fatigue. JPFS has a major influence on health, physical function and quality of life. The diagnosis of JPFS is based on the criteria defined by Yunus and Masi (1985), which include generalised musculoskeletal aching at three or more regions for at least three months and at least five of eighteen typical tender points. The precise cause of JPFS is unknown, but there is an emerging understanding that the development of this syndrome is related to many factors, such as genetic and anatomic factors, disordered sleep and psychological distress. According to emerging studies, a multidisciplinary treatment may be helpful in treating JPFS. Multicomponent treatment that includes attendance by patient and parents, sleep hygiene with or without medication, physical training and cognitive behavioural therapy, is advocated.