Der klinisch-internistische Befund unter besonderer Berücksichtigung vegetativer und funktioneller Störungen bei der generalisierten Tendomyopathie (GTM)

Summary

Diagnosis of a primary functional syndrome requires:

• 1) the exclusion of an underlying organic condition;

• 2) the proof of criteria, including symptoms and clinical signs are necessary for positive diagnostics, and include the progression of symptoms, the history, neurotic symptoms, chronological connections with life events, age, and related symptoms as described by von Uexküll: globus sensation in the throat, paresthesia, breathing irregularities, cardiac sensations, restlessness, poor concentration, as well as general fatigue, anxiety, depression, sleep disturbance, as well as constipation and/or diarrhea, headaches, dysuria, and “atypical” pain syndromes.

Clinically, we must consider vegetative and functional symptoms: cold hands and feet (Raynauds phenomenon), oral and/or ocular dryness (Sicca syndrome), hyperhydrosis, neurological indications, dermographism, vertigo (and under what conditions), extrasystoles, tenderness of the colon (irritable bowel syndrome), tender points in general, and posture faults (spine).

The most frequent functional syndromes in general medicine: cardiovascular, gastrointestinal, respiratory, urinary, and musculoskeletal system, must be excluded.

Our first results in 12/15 patients with primary/secondary GTM revealed significantly more frequent vegetative, functional, and psychopathological symptoms in comparison to controls (33 patients).