0521779407-07 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:10
Fibromyalgia Filariasis 571➣Pain-based formal CBT programs can be very useful but are not
widely available
➣Biofeedback, hypnosis, relaxation techniques may be used w/
CBT or alone
Other Therapies
■Physical therapy can be helpful to educate pts on a range-of-motion
exercise program to be used at home
■Trigger point injections w/ depot steroids may be useful for regional
pain
■Alternative therapies (eg, acupuncture, chiropractic manipulation)
may also be of benefit in some instances
follow-up
■Scheduling routine follow-up appointments is preferable to pts pre-
senting w/ crises
■Focus on improving function, rather than specific symptoms
■Reinforce need for exercise, CBT-type program
■Identify & treat comorbid psychiatric diagnoses if present
complications & prognosis
Complications
■Most significant complications are decreased function, disability
■May be preventable by early intervention
Prognosis
■Likely to have chronic symptoms for life, but these can be managed
■No decrease in long-term survivalFilariasis...........................................
J. GORDON FRIERSON, MD
history & physical
History
■Exposure: Wuchereria bancrofti (causes lymphatic filariasis), trans-
mitted by mosquito. Found in Africa, Brazil, India, China, S.E. Asia,
Haiti.
■Brugia malayi (causes lymphatic filariasis), transmitted by mosquito.
Found in China, S.E. Asia.
■Loa loa (causes loaiasis), transmitted by Chrysops (deer) fly. Found
in W. and central Africa.