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Fibromyalgia is a common condition characterized by widespread pain and additional symptoms affecting various systems and organs. The American College of Rheumatology (ACR) criteria are used for clinical diagnosis, although no disease biomarkers have been identified and the pathomechanisms remain unclear. New perspectives have emerged regarding the role of small fiber pathology in fibromyalgia, with many patients displaying decreased intraepidermal nerve fiber density. Small fiber changes may have a pathophysiological role in fibromyalgia and should be differentiated from small fiber neuropathy. The wide phenotypic spectrum of fibromyalgia includes presentations similar to small fiber neuropathy, and it is unclear whether fibromyalgia with or without small fiber pathology can be seen as a unique condition. The NPSG guidelines provide a valuable tool for diagnostic and pathophysiological issues, and future research is expected to better characterize and classify subgroups of fibromyalgia and related conditions. [Extracted from the article]

This article presents a letter to the editor regarding a patient with chronic inflammatory demyelinating polyneuropathy who became unresponsible to conventional treatments and experienced a dramatic and long-lasting improvement following a prolonged treatment with interferon-alpha 2a.

Bilateral facial palsy is a common sign of autoimmune myasthenia gravis (MG). However, facial muscle weakness without clinical signs of extraocular muscle (EOM) involvement is extremely rare. We describe a late onset generalized MG presenting with facial weakness and bulbar signs without EOM deficits. The diagnosis was based on neurophysiological assessment and positive acetylcholine receptor antibody titer. Thymoma was excluded. The clinical response to corticosteroids, pyridostigmine and intravenous immunoglobulin was complete. EOM weakness was never observed during a 3-year follow-up, also during a later exacerbation of MG. [ABSTRACT FROM AUTHOR]