 EditorialDysautonomia, fibromyalgia and reflex dystrophyJean Eisinger  Unit Infomyalgies, Centre Hospitalier, 83056 Toulon, France  author email corresponding author email
Arthritis Research & Therapy 2007,
9:105doi:10.1186/ar2212 See related review by Martinez-Lavin, http://arthritis-research.com/content/9/4/216, related letter by Fèlix and Fontenele, http://arthritis-research.com/content/9/5/404, related letter by Martinez and Cassol, http://arthritis-research.com/content/10/6/408 and related response by Eisinger, http://arthritis-research.com/content/10/6/409 Abstract
Autonomic nervous system dysfunction observed in fibromyalgia, characterized without exception by a sympathetic hyperactivity and hyporeactivity, has been reported. However, several studies demonstrated reduced levels of norepinephrine and neuropeptide Y at rest and after tilt table in some patients, which was improved by beta-stimulating agents. These findings support heterogeneity in fibromyalgia-associated dysautonomia. Fibromyalgia could be a generalized sympathetic dystrophy since both conditions are activated by trauma and partly linked to sympathetic mechanisms. Yet they differ on several points: hormonal and neurochemical abnormalities are observed in fibromyalgia whereas activation by peripheral trauma and hyperosteolysis are observed in reflex sympathetic dystrophy. | 
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