Neurological Conditions

Cervical spinal stenosis, Arnold Chiari malformation and fibromyalgia have remarkably similar symptomology. Often fibromyalgia patients relate the onset of their symptoms occurring after a whiplash or other neck injury. It is important that even before a fibromyalgia diagnosis is made that the patient be given a detailed neurological examination.  If more than a few neurological findings appear during the examination, i.e. hyper-reflexes, dizziness, staggering gait, etc, then an MRI might be appropriate to rule out either a cervical spinal cord compression and/or a Chiari malformation. Often neurological findings in fibromyalgia are thought to be too soft to indicate a comorbid neurological condition.  One way a doctor might discover whether a patient has a cervical neck abnormality is to have the person stand with his/her head tilted back for 20-30 seconds and then to redo the examination.  Another simple test is for the doctor to administer a gag reflex test which consists of swabbing the back of the throat with a Q-tip.  This should cause the person to "gag" if it doesn't then an MRI of the foramen magnum (back of the head) should be prescribed.  Sadly, many fibromyalgia patients are overlooked as potential neurological candidates because of the perceived soft neurological responses to the physical examination.  A list of knowledgeable neurosurgeons are included on this site for your review.