J Clin Neurol.  2015 Apr;11(2):188-191. 10.3988/jcn.2015.11.2.188.

The Overlap between Fibromyalgia Syndrome and Myotonia Congenita

• Nam TS
• Choi SY
• Park DJ
• Lee SS
• Kim YO
• Kim MK

• KMID: 2242665
• DOI: http://doi.org/10.3988/jcn.2015.11.2.188

Abstract

BACKGROUND
Fibromyalgia syndrome (FMS) is a complex disorder characterized by chronic widespread pain (CWP), multiple areas of tenderness, sleep disturbance, fatigue, and mood or cognitive dysfunction. Myotonia congenita (MC) is an inherited myopathic disorder that is caused by mutations in the gene encoding the skeletal muscle chloride channel, which can infrequently manifest as generalized muscle cramps or myalgia.
CASE REPORT
The first case was a 33-year-old woman who complained of CWP and chronic headache occurring during pregnancy, and the second case was a 37-year-old man with CWP and depression who suffered from cold-induced muscle cramps. These two patients were initially diagnosed with FMS by rheumatologists, based on CWP of longer than 3 months duration and mechanical tenderness in specific body regions. However, these two FMS patients were subsequently also diagnosed with MC.
CONCLUSIONS
These two cases are the first report of an overlap of CWP between FMS and MC.

Keyword

fibromyalgia; chronic pain; myotonia congenita

MeSH Terms

Adult
Body Regions
Chloride Channels
Chronic Pain
Depression
Fatigue
Female
Fibromyalgia*
Headache Disorders
Humans
Muscle Cramp
Muscle, Skeletal
Myalgia
Myotonia Congenita*
Pregnancy
Chloride Channels

Figure

• 

  Fig. 1 Representative electropherograms of the mutations of CLCN1 found in the patients and controls. The mutated sequences are indicated by red arrows, and black arrows indicate the wild-type sequences at the corresponding location. A and B: Forward and reverse complement electropherograms of case 1 reveal a heterozygous G-to-A substitution at position 950 (c.950G>A, p.Arg317Gln). D and E: Forward and reverse complement electropherograms of case 2 reveal a heterozygous T-to-C substitution at position 1679 (c.1679T>C, p. Met560Thr). C and F: Representative electropherograms of 200 normal South Korean controls.

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