MEDICAL DEFINITIONS

Whether you're new to FM and/or CFS/ME, or an experienced patient, there are always new terms and terminologies coming up. In order to find the medical information you're looking for, you'll come across medical terminology and medical information you might not understand.

This page contains over 200 definitions listed below, with many new words added monthly. The words are listed in alphabetical order. You can either select a letter from the box below, or scroll down the page to reveal the word you're looking for.

Contact us if you cannot locate a specific definition.

An abnormal condition, state, or quality; irregularity; deviation.

ACE inhibitors, or inhibitors of Angiotensin-Converting Enzyme, are a group of pharmaceuticals that are used primarily in treatment of hypertension and congestive heart failure, in most cases as the drugs of first choice.

Sulfhydryl-containing ACE inhibitors:

• Captopril (Capoten®), the first ACE inhibitor

Dicarboxylate-containing ACE inhibitors. This is the largest group, including:

• Enalapril (Vasotec®/Renitec®)
• Ramipril (Altace®/Tritace®/Ramace®/Ramiwin®)
• Quinapril (Accupril®)
• Perindopril (Coversyl®)
• Lisinopril (Lisodur®/Lopril®/Novatec®/Prinivil®/Zestril®)
• Benazepril (Lotensin®)

Phosphonate-containing ACE inhibitors

• Fosinopril (Monopril®), the only member

Acidosis is an increased acidity (i.e. hydrogen ion concentration) of blood plasma. Generally acidosis is said to occur when arterial pH falls below 7.35, while its counterpart (alkalosis) occurs at a pH over 7.45. Arterial blood gas analysis and other tests are required to separate the main causes.

Gastroesophageal reflux disease (GERD) is a condition in which acids from the stomach move backward into the esophagus (an action called reflux). Reflux occurs if the muscular actions in the esophagus or other protective mechanisms fail.

The hallmark symptoms of GERD are:

• Heartburn: a burning sensation in the chest and throat
• Regurgitation: a sensation of acid backed up in the esophagus

Although acid is a primary factor in damage caused by GERD, other products of the digestive tract, including pepsin and bile, can also be harmful.

The esophagus, commonly called the food pipe, is a narrow muscular tube about nine and a half inches long. It begins below the tongue and ends at the stomach. The esophagus is narrowest at the top and bottom; it also narrows slightly in the middle. The esophagus consists of three basic layers:

• An outer layer of fibrous tissue
• A middle layer containing smoother muscle
• An inner membrane, which contains numerous tiny glands

When a person swallows food, the esophagus moves it into the stomach through the action of peristalsis, wave-like muscle contractions. In the stomach, the starch, fat, and protein in food are broken down by acid and various enzymes, notably hydrochloric acid and pepsin. The lining of the stomach has a thin layer of mucus that protects it from these fluids.

If acid and enzymes back up into the esophagus, however, its lining offers only a weak defense. The esophagus is protected using specific muscles and other factors.

The most important structure protecting the esophagus may be the lower esophageal sphincter (LES). The LES is a band of muscle around the bottom of the esophagus where it meets the stomach.

• The LES opens after a person swallows to let food enter the stomach and then immediately closes to prevent regurgitation of the stomach contents, including gastric acid.
• The LES maintains this pressure barrier until food is swallowed again.

Causes

Anyone who a large amount of acidic foods can have mild and temporary heartburn. This is especially true when lifting, bending over, or taking a nap after eating a large meal high in fatty, acidic foods. Persistent GERD, however, may be due to various conditions, including abnormal biologic or structural factors.

• Malfunction of the Lower Esophageal Sphincter (LES) Muscles
  The band of muscle tissue called the LES is responsible for closing and opening the lower end of the esophagus and is essential for maintaining a pressure barrier against contents from the stomach. It is a complex area of smooth muscles and various hormones. If it weakens and loses tone, the LES cannot close up completely after food empties into the stomach. In such cases, acid from the stomach backs up into the esophagus. Dietary substances, drugs, and nervous system factors can weaken it and impair its function.


• Impaired Stomach Function
  A study showed that over half of GERD patients showed abnormal nerve or muscle function in the stomach. These abnormalities cause impaired motility, which is the inability of muscles to act spontaneously. The stomach muscles do not contract normally, which causes delays in stomach emptying, increasing the risk for acid back up.


• Abnormalities in the Esophagus
  Some studies suggest that most people with atypical GERD symptoms may (such as hoarseness, chronic cough, or the feeling of having a lump in the throat) have specific abnormalities in the esophagus. (In one study, such abnormalities appeared in 73% of patients who had atypical symptoms.)
• Motility Abnormalities. Problems in spontaneous muscle action (peristalsis) in the esophagus commonly occur in GERD, although it is not clear if such occurrences are a cause or result of long-term effects of GERD.
• Adult-Ringed Esophagus. This condition is characterized by an esophagus with multiple rings and persistent trouble with swallowing (including getting food stuck in the esophagus). It occurs mostly in men.


• Hiatal Hernia
  The hiatus is a small hole in the diaphragm through which the esophagus passes into the stomach. It normally fits very snugly, but it may weaken and enlarge. When this happens, part of the stomach muscles may protrude into it producing a condition called hiatal hernia. It is very common, occurring in over half of people over 60 years old, and is rarely serious. Until recent years, it was believed that most cases of persistent heartburn were caused by a hiatal hernia. Hiatal hernia may impair LES muscle function. Studies have failed to confirm evidence, however, that it is a common cause of GERD, although its presence may increase GERD symptoms in patients with both conditions.

Characterized by sharpness or severity (acute pain) Having a sudden onset, sharp rise, and short course (acute disease)

Acupressure is a traditional Chinese medicine technique based on the same ideas as acupuncture. Acupressure involves placing physical pressure by hand, elbow, or with the aid of various devices on different acupuncture points on the surface of the body.

Acupuncture is a technique of inserting and manipulating filiform needles into "acupuncture points" on the body. According to acupuncture teachings this will restore health and well-being, and is particularly good at treating pain.

Acupuncture is thought to have originated in China and is most commonly associated with Traditional Chinese medicine. Different types of acupuncture (Japanese, Korean, and classical Chinese acupuncture) are practiced and taught throughout the world.

Acute respiratory distress syndrome (ARDS), also known as respiratory distress syndrome or adult respiratory distress syndrome is a serious reaction to various forms of injuries to the lung. This is the most important disorder resulting in increased permeability pulmonary edema.

ARDS is a severe lung disease caused by a variety of direct and indirect insults. It is characterized by inflammation of the lung parenchyma leading to impaired gas exchange with concomitant systemic release of inflammatory mediators causing inflammation, hypoxemia and frequently resulting in multiple organ failure. This condition is life threatening and often lethal, usually requiring mechanical ventilation and admission to an intensive care unit. A less severe form is called acute lung injury.

In anatomy, adipose tissue or fat is loose connective tissue composed of adipocytes. Its main role is to store energy in the form of fat, although it also cushions and insulates the body.

Adipocytes are the cells that primarily compose adipose tissue, specialized in storing energy as fat.

The adrenocorticotropic hormone is a peptide hormone produced and secreted by the pituitary gland. It is an important player in the hypothalamic-pituitary-adrenal axis.

Agnosia (or loss of knowledge) is a loss of ability to recognize objects, persons, sounds, shapes, or smells while the specific sense is not defective nor is there any significant memory loss. It is usually associated with brain injury or neurological illness, particularly after damage to the temporal lobe.

An abnormally high sensitivity to certain substances, such as pollens, foods, or microorganisms. Common indications of allergy may include sneezing, itching, and skin rashes.

Allodynia is pain, generally on the skin, caused by something that wouldn't normally cause pain. Many people with fibromyalgia report having this symptom. Examples of allodynia are pain caused by mild pressure from clothing, a light touch, gentle massage, or sheets rubbing against the skin.

Allodynia is believed to be a hypersensitive reaction that may result from central sensitization, which is associated with fibromyalgia. The pain signals originate with specialized nerves, called nociceptors, that sense information about things like temperature and painful stimuli right from the skin.

Pain caused by touch is called tactile allodynia, while pain caused by movement against the skin (i.e., the brush of clothing) is called mechanical allodynia. Temperature-related pain is called thermal allodynia.

Other conditions associated with allodynia include neuropathy, postherpetic neuralgia and migraines.

Alpha EEG anomaly occurs when sudden bursts of brain activity occur during a time when the brain should be in deep sleep. These periods of intense activity are measured as alpha waves on an EEG monitor. People with alpha EEG anomaly do not have difficulty falling asleep, but once they reach deep sleep, their brains begin to act like they are awake. This leaves sufferers feeling tired and drained. An alarming percentage of FM sufferers have Alpha EEG Anomaly.

Alzheimer's disease (AD), also known simply as Alzheimer's, is a neurodegenerative disease characterized by progressive cognitive deterioration together with declining activities of daily living and neuropsychiatric symptoms or behavioral changes. It is the most common type of dementia.

The most striking early symptom is loss of short-term memory (amnesia), which usually manifests as minor forgetfulness that becomes steadily more pronounced with illness progression, with relative preservation of older memories.

As the disorder progresses, cognitive (intellectual) impairment extends to the domains of language (aphasia), skilled movements (apraxia), recognition (agnosia), and those functions (such as decision-making and planning) closely related to the frontal and temporal lobes of the brain as they become disconnected from the limbic system, reflecting extension of the underlying pathological process.

The condition of having less than the normal number of red blood cells or less than the normal quantity of hemoglobin in the blood. The oxygen-carrying capacity of the blood is, therefore, decreased.

Angina is chest pain or discomfort that occurs when an area of your heart muscle doesn't get enough oxygen-rich blood. Angina may feel like pressure or squeezing in your chest. The pain also may occur in your shoulders, arms, neck, jaw, or back. Angina pain may even feel like indigestion.

Angina isn't a disease; it's a symptom of an underlying heart problem. Angina usually is a symptom of coronary heart disease (CHD), also called coronary artery disease. CHD is the most common type of heart disease in adults. It occurs if a fatty material called plaque builds up on the inner walls of your coronary arteries. These arteries carry oxygen-rich blood to your heart.

Ankylosing spondylitis is a chronic, painful, progressive inflammatory arthritis primarily affecting spine and sacroiliac joints, causing eventual fusion of the spine.

It is a member of the group of the autoimmune spondyloarthropathies with a probable genetic predisposition. Complete fusion results in a complete rigidity of the spine, a condition known as bamboo spine.

Anti-cardiolipin antibodies (ACA) are antibodies often directed against cardiolipin and found in several diseases including syphili, antiphospholipid syndrome, livedoid vasculitis, vertebrobasilar insufficiency, Behçet's syndrome, idiopathic spontaneous abortion, and systemic lupus erythematosus(SLE). They are a form of anti-mitochondrial antibody. In SLE, The anti-DNA antibodies and anti-cardiolipin act independently. In rheumatoid arthritis w/systemic sclerosis (scleroderma) these antibodies may tie two conditions together.

An antidepressant, in the most common usage, is a medication taken to alleviate clinical depression or dysthymia ('milder' depression). Several groups of drugs are particularly associated with:

MAOI's

• isocarboxazid (Marplan®)
• moclobemide (Manerix®)
• phenelzine (Nardil®)
• tranylcypromine (Parnate®)

Tricyclic's

• amitriptyline (Elavil®, Endep®)
• clomipramine (Anafranil®)
• desipramine (Norpramin®, Pertofrane®)
• doxepin (Adapin®, Sinequan®)
• imipramine (Tofranil®)
• nortriptyline (Pamelor®)
• protriptyline (Vivactil®)

SSRI's

• citalopram (Celexa®)
• escitalopram oxalate (Lexapro®)
• paroxetine (Paxil®)
• fluoxetine (Prozac®)
• fluvoxamine(Luvox®)
• sertraline (Zoloft®)

These medications are now amongst the most commonly prescribed by psychiatrists and general practitioners, and their effectiveness and adverse effects are the subject of many studies and competing claims. A number of other antidepressant drugs, notably St John's Wort, are also widely studied and used.

Antidepressants are generally, if not in pharmacology, considered separately from stimulants. They are usually taken as a course over several weeks, months or years, and have a delayed onset of therapeutic action. Drugs used for an immediate euphoric effect only are not generally considered antidepressants.

Despite the name, antidepressants are often used in the treatment of other conditions, including:

• anxiety disorders
• bipolar disorder
• eating disorders
• chronic pain conditions such as FM and CFS/ME

Some have also become known as lifestyle drugs, sometimes referred to as "mood brighteners". Conversely other medications not known as antidepressants, including anti-psychotics in low doses and benzodiazepines are also widely used to manage depression. In fact the antidepressant term is sometimes applied to any therapy (e.g. psychotherapy, electro-convulsive therapy, acupuncture) or process (e.g. sleep disruption, increased light levels, regular exercise) found to improve clinically depressed mood. It is also the case that placebos tend to have a significant antidepressant effect, so that establishing something as an antidepressant in a clinical trial involves demonstrating a significant additional effect.

Anti-anxiety medications include the >benzodiazepines, which can relieve symptoms within a short time. They have relatively few side effects:

• drowsiness and loss of coordination are most common
• fatigue and mental slowing or confusion can also occur

These effects make it dangerous for people taking benzodiazepines to drive or operate some machinery. Other side effects are rare.

Types of Anti-Anxiety Medications:

• alprazolam (Xanax®)
• buspirone (BuSpar®)
• chlordiazepoxide (Librax®, Libritabs®, Librium®)
• clonazepam (Klonopin®)
• clorazepate (Azene®, Tranxene®)
• diazepam (Valium®)
• halazepam (Paxipam®)
• lorazepam
• oxazepam (Serax®)

An antibiotic is a drug that kills or prevents the growth of bacteria. They have no effect against viruses or fungal infections. Antibiotics are one class of antimicrobials, a larger group which also includes anti-viral, anti-fungal, and anti-parasitic drugs. They are relatively harmless to the host, and therefore can be used to treat infections.

The term, coined by Selman Waksman, originally described only those formulations derived from living organisms, in contrast to "chemotherapeutic agents", which are purely synthetic. Nowadays the term "antibiotic" is also applied to synthetic antimicrobials, such as the sulfa drugs. Antibiotics are generally small molecules with a molecular weight less than 2000 Da. They are not enzymes. Some antibiotics have been derived from mold, for example the penicillin class.

A feeling of apprehension and fear characterized by physical symptoms such as:

• palpitations
• sweating
• feelings of stress

Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults. These disorders fill people's lives with overwhelming anxiety and fear. Unlike the relatively mild, brief anxiety caused by a stressful event such as a business presentation or a first date, anxiety disorders are chronic, relentless, and can grow progressively worse if not treated.

Aphasia is a loss or impairment of the ability to produce and/or comprehend language, due to brain damage.

Depending on the area and extent of the damage, someone suffering from aphasia may be able to speak but not write, or vice versa, or display any of a wide variety of other deficiencies in reading, writing, and comprehension.

Aphasia may co-occur with speech disorders such as dysarthria or apraxia of speech, which also result from brain damage.

Usually, aphasias are a result of damage to the language centers of the brain (like Broca's area). These areas are almost always located in the left hemisphere, and in most people this is where the ability to produce and comprehend language is found. However, in a very small number of people language ability is found in the right hemisphere.

In either case, damage to these language areas can be caused by a stroke, traumatic brain injury, or other head injury. Aphasia may also develop slowly, as in the case of a brain tumor or progressive neurological disease.

Apraxia is a neurological disorder characterized by loss of the ability to execute or carry out learned purposeful movements, despite having the desire and the physical ability to perform the movements.

It is a disorder of motor planning which may be acquired or developmental, but may not be caused by in coordination, sensory loss, or failure to comprehend simple commands (which can be tested by asking the person tested to recognize the correct movement from a series).

In medicine, a disease is asymptomatic while the patient does not experience symptoms. Asymptomatic diseases may not be discovered until the patient undergoes medical tests (X-rays or other investigations).

Some diseases remain asymptomatic for a remarkably long time, including some forms of cancer.

A patient's individual genetic makeup may delay or prevent the onset of symptoms.

A deposit or degenerative accumulation of lipid-containing plaques on the innermost layer of the wall of an artery.

Autoimmune diseases arise from an overactive immune response of the body against substances and tissues normally present in the body. In other words, the body attacks its own cells. Today there are more than 40 human diseases classified as either definite or probable autoimmune diseases, and they affect 5% to 7% of the population. Almost all autoimmune diseases appear without warning or apparent cause, and most patients suffer from fatigue.

The causes of autoimmune diseases are still obscure: Some are thought to be either examples of or precipitated by diseases of affluence. For example, arthritis and obesity are acknowledged to be related, and the World Health Organization states that arthritis is most common in developed countries. Most autoimmune diseases are probably the result of multiple circumstances, for example, a genetic predisposition triggered by an infection.

The autonomic nervous system is an important part of your body's central nervous system (CNS). It works automatically to help your body get on with daily living. The autonomic nervous system works alongside your body's neurotransmitters and hormones in order to ensure that your body is working correctly. It helps to control a variety of different organs in your body as well as numerous bodily systems. It has a number of responsibilities, including:

• regulation of body temperature
• maintenance of bowel and bladder function
• maintenance of heart rate

The Two Branches

There are two parts to your autonomic nervous system, which are referred to as branches. These two branches work by sending signals, or messages, using special chemicals called neurotransmitters. The branches of the autonomic system are:

• The Sympathetic System: The sympathetic system helps you to respond to conditions of stress, such as emergencies.


• The Parasympathetic System: The parasympathetic system is responsible for regulating sleep and digestion.

Neurotransmitters

In order to communicate with one another, the two branches of the autonomic nervous system use special chemical hormones, called neurotransmitters. Neurotransmitters act as vehicles, carrying information back and forth between your brain and your body. If something goes wrong with these neurotransmitters, messages from the body to the autonomic nervous system can easily be confused. Specific neurotransmitters that are thought to play a role in fibromyalgia:

• Substance P:

  Substance P is a neurotransmitter found in your spinal fluid. It helps to communicate sensations of pain to your brain and body. A number of studies have shown that fibromyalgia patients have up to three times more Substance P in their spinal fluid than healthy people. This can cause enhanced perceptions of pain, making a normally mild stimulus excruciatingly painful.


• Endorphins:
  Endorphins are hormones secreted by the body in reaction to physical stress, such as exercise or fear. Endorphins are considered a natural opioid and help your body to deal with pain and fatigue. Beta-endorphin is highly involved in pain suppression, but fibromyalgia patients appear to have only 50% of the normal levels of this endorphin. This could explain why fibromyalgia patients experience so much pain.


• Serotonin:
  Serotonin is a neurotransmitter that helps to regulate your mood. It keeps you from feeling overly depressed or manically excited. A number of studies have reported that fibromyalgia patients appear to have low levels of serotonin in their brains. Low levels of serotonin have been linked with depression, anxiety, and chronic headaches. Antidepressants that manipulate the levels of serotonin in the brain seem to alleviate these fibromyalgia symptoms.

Hormones

Along with neurotransmitters, your autonomic nervous system also relies on hormones in order to stimulate certain bodily functions. Hormones are special chemicals secreted by various glands in your body, helping to trigger growth, fertility, and other functions. Hormones that are important to your autonomic nervous system include:

• Cortisol:
  The hormone cortisol is secreted by your adrenal glands. It is released when your body is physically threatened or stressed. Commonly referred to as the "stress hormone," cortisol function tends to be abnormal in fibromyalgia patients. If you have fibromyalgia, your body often considers itself to be in a stressed state. As a result, you release more cortisol than most people. This can you leave you feeling persistently tired and drained.


• Growth Hormone:
  Growth hormone is released during exercise and deep sleep and helps to control muscle and tissue growth as well as metabolism. It helps to heal wounds and injuries incurred by your body throughout the day. People with fibromyalgia appear to have very low levels of growth hormone is their bodies. For some reason, the autonomic nervous system doesn't trigger the release of enough growth hormone to help repair muscles and tissues. To compound this, many fibromyalgia patients don't get enough deep sleep, which limits the release of growth hormone.


• Norepinephrine
  Norepinephrine is a hormone released by your adrenal gland and controlled by your sympathetic nervous system. It helps to control stress responses, such as sweating, increased heart rate, and muscle contraction. Fibromyalgia suffers appear to have lower levels of epinephrine, contributing to pain and fatigue.

• Autonomic Nervous System Dysfunction as a Fibromyalgia Cause, © 2012 Fibromyalgia-Symptoms.org

Balneotherapy is the art of water therapy, and one of aromatherapy's best friends. There is nothing quite so soothing and relaxing as a leisurely soak in a hot bath. As the warmth of the water cradles your physical body, providing relief from the constant pull of gravity, your psyche is refreshed and restored, the weight of the world momentarily lifted. Add a few drops of well-selected essential oils and you approach nirvana.

Water is nature's greatest and most effective solvent. It acts as a liquid suspension, carrying a variety of minerals and chemicals, depending on its source. When we immerse our bodies in a warm bath, our skin rapidly begins to absorb chemicals that are suspended in the water. These chemical components can make their way to our bloodstream in as little as 2 to 15 minutes. It will take a normally healthy person from half an hour to three hours to eliminate most of these chemicals through the expired breath and urine. In unhealthy or obese people, this process may take up to 10 hours. That is why adding essential oils to a bath is such an effective aromatherapy treatment.

The premise of balneotherapy is built on this solvency. Just as we absorb the essential oils we intentionally add to the water, we absorb a variety of other chemicals and minerals suspended in our water. No two waters are exactly the same. Spring waters, often thought of as pure, actually contain a variety of minerals. It is the presence of these minerals, from the depths of the earth, that makes certain spring waters highly valued for their curative properties.

Benign prostatic hyperplasia known as Benign prostatic hypertrophy or Benign enlargement of the prostate refers to the increase in size of the prostate in middle-aged and elderly men.

The benzodiazepines (pronounced ben-zoe-dye-AZE-eh-peens, or "benzos" for short) are a class of psychoactive drugs considered as minor tranquilizers with varying

• hypnotic
• sedative
• anxiolytic
• anticonvulsant
• muscle relaxant
• amnestic

properties which is brought upon by this class of drug slowing down the central nervous system. This makes benzodiazepines useful in treating:

• anxiety
• insomnia
• agitation
• seizures
• muscle spasms
• alcohol withdrawal

They can also be used before certain medical procedures such as:

• endoscopies
• dental work
• medical procedures where tension and anxiety are present
• and prior to some unpleasant medical procedures to induce amnesia for the procedure

Another use is to counteract anxiety-related symptoms upon initial use of SSRI's and other antidepressants, or as an adjunctive treatment.

All benzodiazepines have an addictive potential. Use of benzodiazepines should only commence after medical consultation and prescribed the smallest dosage possible to provide an acceptable level of symptom relief. Dependence varies for the benzodiazepines used, with some reporting Alprazolam dependence in as little as three days.

Types of Benzodiazepines:

• Alprazolam (Xanax®)
• Diazepam (Valium®)
• Lorazepam (Ativan®)
• Clonazepam (Klonopin®)
• Oxazepam (Serax®)

Berylliosis or chronic beryllium disorder (CBD) is an occupational lung disease. It is a chronic allergic-type lung response and chronic lung disease caused by exposure to beryllium and its compounds. The condition is incurable but symptoms can be treated.

Biofeedback is a form of complementary and alternative medicine which involves measuring a subject's bodily processes such as blood pressure, heart rate, skin temperature, galvanic skin response (sweating), and muscle tension and conveying such information to him or her in real-time in order to raise his or her awareness and conscious control of the related physiological activities.

By providing access to physiological information about which the user is generally unaware, biofeedback allows users to gain control over physical processes previously considered automatic. Interest in biofeedback has waxed and waned since its inception in the 1960s; at the beginning of the 21st century it is undergoing something of a renaissance, which some ascribe to the general upswing of interest in complementary and alternative medicine modalities.

Broca's area is the section of the human brain (in the opercular and triangular sections of the inferior frontal gyrus of the frontal lobe of the cortex) that is involved in language processing, speech production and comprehension.

Broca's and Wernicke's areas are found unilaterally in the brain. Broca's area is named after the 19th century physician Paul Broca.

Bruxism or teeth grinding, frequently affects people with FM. Bruxism is thought to be a part of a disease that is closely related to FM, called Temporomandibular Joint Disorder (TMJD).

This disorder causes muscle pain in the face, neck, shoulders, and back, and often leads to grinding of the teeth. 75% of people with FM also have TMJD. Bruxism usually occurs when you are sleeping. For some reason, sufferers begin to clench the muscles in their face causing their teeth to grind together.

Often, bruxism occurs during sleep; even during short naps. In a typical case, the canines and incisors are commonly moved against each other laterally, i.e. with a side to side action. This abrades tooth enamel, removing the sharp biting surfaces and flattening the edges of the teeth. Sometimes, there is a tendency to grind the molars together, which can be loud enough to wake a sleeping partner. Some will clench without significant side to side jaw movement. Bruxism is one of the most common sleep disorders.

Thirty to forty million Americans grind their teeth on a nightly basis. Given enough time, dental damage will usually occur. Bruxism is the number one cause of occlusal disease and a significant cause of tooth loss.

Over time, bruxing shortens and blunts the teeth being ground, and may lead to pain in the joint of the jaw, the temporomandibular joint, or headache. Most people are not aware of their bruxism and only five to ten percent will develop symptoms such as jaw pain and headache. Teeth hollowed by previous decay (caries) may collapse; the pressure exerted by bruxism on the teeth is extraordinarily high.

A recently introduced device called the BiteStrip enables at-home overnight testing for Sleep Bruxism and might help diagnose bruxism before damage appears on the teeth. The device is a miniature electromyograph machine that senses jaw muscle activity while the patient sleeps. A dentist can establish the frequency of bruxing, which helps in choosing a treatment plan. Anyone having major occlusal rehabilitation should be aware that bruxism can and does ruin dental work.

Operating under the control of a complex internal electrical system, the heart beats out a continual rhythm from a few weeks after conception until death. This rhythm is ordinarily even and regular, changing speed as necessary to adjust to the body's need for oxygen.

Sometimes, however, the heart's rhythm becomes disturbed ("arrhythmic"). The most common and benign form of arrhythmia is the common "heart palpitation," known technically as sinus arrhythmia. Generally, these are felt as a short run of thumps or flutters in the chest. Sinus arrhythmia is often caused by stress and anxiety. It poses no danger, although it can be annoying.

More serious forms of heart arrhythmia may occur as well. In later life, many people develop atrial fibrillation, a condition in which part of the heart contracts at excessive speed and another part follows along irregularly. Although some people live for years in a state of atrial fibrillation, this is a potentially dangerous condition that requires medical attention.

Other forms of heart arrhythmia are more dangerous still, including ventricular tachycardia and ventricular fibrillation. These frequently occur after a heart attack. They are often heralded by ventricular premature complexes.

Conventional treatment for arrhythmia depends on the type involved. Sinus arrhythmias are often left untreated. More serious rhythm disturbances are addressed through the use of medications, defibrillation, or a pacemaker.

Note: Heart arrhythmias are far too dangerous for self-treatment. In all but the most obviously benign cases, medical supervision is mandatory.

Cardiomyopathy, which literally means "heart muscle disease", is the deterioration of the function of the myocardium (i.e., the actual heart muscle) for any reason. People with cardiomyopathy are often at risk of arrhythmia and/or sudden cardiac death.

Carpal tunnel syndrome (CTS) is a medical condition in which the median nerve is compressed at the wrist, leading to pain, paresthesias, and muscle weakness in the forearm and hand. A form of compressive neuropathy, CTS is more common in women than it is in men, and, though it can occur at any age, has a peak incidence around age 42. The lifetime risk for CTS is around 10% of the adult population.

CTS became widely known to the general public in the 1990s as a result of the significant increase in chronic wrist pain due to the rapid expansion of office jobs. Other conditions may also be misdiagnosed as carpal tunnel syndrome.

Catastrophizing is an irrational thought a lot of us have in believing that something is far worse than it actually is. Catastrophizing can generally can take two forms.

The first of these is making a catastrophe out of a situation. For instance, if you're a salesperson and haven't made a sale in awhile, you may believe you are a complete and utter failure and you will lose your job. In reality, it may only be a temporary situation, and there are things that you can do to change this situation. Another example is believing that if you make one small mistake at your job, you may get fired. This kind of Catastrophizing takes a current situation and gives it a truly negative "spin."

The second kind of Catastrophizing is closely linked to the first, but it is more mental and more future oriented. This kind of Catastrophizing occurs when we look to the future and anticipate all the things that are going to go wrong. We then create a reality around those thoughts (e.g. "It's bound to all go wrong for me…"). Because we believe something will go wrong, we make it go wrong.

Any of a group of chemically related neurotransmitters, as epinephrine and dopamine, that have similar effects on the sympathetic nervous system.

Celiac Disease is an autoimmune disorder of the small bowel that occurs in genetically predisposed individuals in all age groups after early infancy. Symptoms may include diarrhea, failure to thrive (in children) and fatigue, but these may be absent and associated symptoms in all other organ systems have been described.

Sensitization is a gradual change in how your immune system reacts to a particular substance. The result of sensitization is an allergy.

In central sensitization, the entire central nervous system becomes sensitized to a stimulus. This is a proposed mechanism for many of the symptoms of fibromyalgia and chronic fatigue syndrome, including the way the body amplifies pain signals.

The central nervous system represents the largest part of the nervous system, including the brain and the spinal cord. Together with the peripheral nervous system, it has a fundamental role in the control of behavior. The central nervous system is contained within the dorsal cavity, with the brain within the cranial sub cavity, and the spinal cord in the spinal cavity.

Cerebral palsy (CP) is an umbrella term encompassing a group of non-progressive, non-contagious neurological disorders that cause physical disability in human development, specifically the human movement and posture.

Cerebrospinal fluid (CSF) is a clear bodily fluid that occupies the subarachnoid space and the ventricular system around and inside the brain.

More specifically the CSF occupies the space between the arachnoid mater (the internal layer of the brain cover, meninges) and the pia mater (the most superficial layer of the brain). Moreover it constitutes the content of all intra-cerebral (inside the brain, cerebrum) ventricles, cisterns and sulci (singular sulcus), as well as the central canal of the spinal cord.

It is an approximately isotonic solution and acts as a "cushion" or buffer for the cortex, providing also a basic mechanical and immunological protection to the brain inside the skull.

Cervical spinal stenosis or cervical spinal compressions is a neurological condition associated with fibromyalgia syndrome that can cause great discomfort. Also referred to as cervical stenosis, this condition has symptoms that are similar to common fibromyalgia symptoms and current studies are investigating whether individuals with fibromyalgia syndrome have higher incidences of cervical spinal stenosis.

Cervical spinal stenosis is a condition that affects an individual's spinal canal. The spinal canal runs the length of the spine and is located behind the vertebrae (bony blocks of the spinal canal). Running from the brain throughout the body, the spinal canal contains the spinal cord as well as the nerve roots, which are central to proper neurological functioning.

In cervical spinal stenosis, a narrowing of the spinal canal occurs. This spinal constriction results in irritation and tightening of the nerves and can also cause a blockage of cerebrospinal fluid, thereby affecting the nervous system.

Channelopathies are diseases caused by a mutation or mutations in genes coding for ion channel subunits or proteins that regulate them.

There are a large number of distinct dysfunctions known to be caused by ion channel mutations. The genes for the construction of ion channels are highly conserved amongst mammals and one condition, hyperkalemic periodic paralysis, was first identified in the descendants of Impressive, a pedigree race horse.

The channelopathies of human skeletal muscle include hyper-, hypo- and normokalemic (high, low and normal potassium blood concentrations) periodic paralysis, myotonia congenita and paramyotonia congenita.

Chiari malformation is a condition that causes brain tissue to settle into the spinal canal. It develops where your skull and neck (cervical spine) come together; when part of the skull is either too small or misshapen, part of the brain can settle into the foramen magnum. The foramen magnum is a large opening at the bottom of your skull. Nerves from the brain go through it and into the spinal canal, joining the spinal cord.

The brain shouldn't press through the foramen magnum; there should only be nerves in there. If the brain does press into the foramen magnum, that's a Chiari malformation.

You can visualize a Chiari malformation by thinking about a funnel. The foramen magnum is the skinny part at the bottom, and above that is where the brain should rest. With a Chiari malformation, though, the brain goes into the skinny part of the funnel.

More About Chiari Malformation

• Chiari Malformation: A Basic Overview
• Chiari Malformation and Fibromyalgia
• Management of Chiari Malformation and Fibromyalgia

Chiropractic is an alternative medical system. It takes a different approach from standard medicine in treating health problems.

The basic concepts of chiropractic are:

• Your body has a powerful self-healing ability
• Your body's structure (mainly the spine) and its function are related
• The goal of chiropractic therapy is to normalize this relationship

Chiropractic professionals are doctors of chiropractic, or D.C.s. They use a type of hands-on therapy called spinal manipulation or adjustment. Many people visit chiropractors for treatment of low back pain.

A chronic illness is one that persists for a long time, usually more than three months.

By analogy, this adjective has come to describe problems which cannot be solved in a short time, or which will recur regardless of action.

Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) ia a poorly understood, highly debilitating disorder of uncertain cause/causes, which is thought to affect approximately 4 per 1,000 adults in the United States and other countries, and a smaller fraction of children.

This disorder is marked by chronic mental and physical exhaustion, often severe, and by other specific symptoms, arising in previously healthy and active persons. Despite promising avenues of research, there remains no objective pathological finding which is widely accepted to be diagnostic of CFS/ME. It remains largely a diagnosis of exclusion, made on the basis of patient history and symptomatic criteria, although a number of tests exist which can help aid diagnosis.

More about CFS/ME can be found here.

Having to do with the examination and treatment of patients. A laboratory test may be of clinical value (of use to patients).

Coagulopathy is a medical term for a defect in the body's mechanism for blood clotting. While there are several possible causes they generally result in excessive bleeding and a lack of clotting.

Pertaining to cognition, the process of knowing and, more precisely, the process of being aware, knowing, thinking, learning and judging.

The study of cognition touches on the fields of psychology, linguistics, computer science, neuroscience, mathematics, ethology and philosophy.

Cognitive Behavioral Therapy is a form of psychotherapy that emphasizes the important role of thinking in how we feel and what we do.

Cognitive-behavioral therapy does not exist as a distinct therapeutic technique. The term "cognitive-behavioral therapy" is a very general term for a classification of therapies with similarities. There are several approaches to cognitive-behavioral therapy, including Rational Emotive Behavior Therapy, Rational Behavior Therapy, Rational Living Therapy, Cognitive Therapy, and Dialectic Behavior Therapy.

However, most cognitive-behavioral therapies have the following characteristics:

• CBT is based on the Cognitive Model of Emotional Response. Cognitive-behavioral therapy is based on the idea that our thoughts cause our feelings and behaviors, not external things, like people, situations, and events. The benefit of this fact is that we can change the way we think to feel / act better even if the situation does not change.


• CBT is Briefer and Time-Limited. Cognitive-behavioral therapy is considered among the most rapid in terms of results obtained. The average number of sessions clients receive (across all types of problems and approaches to CBT) is only 16. Other forms of therapy, like psychoanalysis, can take years. What enables CBT to be briefer is its highly instructive nature and the fact that it makes use of homework assignments. CBT is time-limited in that we help clients understand at the very beginning of the therapy process that there will be a point when the formal therapy will end. The ending of the formal therapy is a decision made by the therapist and client. Therefore, CBT is not an open-ended, never-ending process.


• A sound therapeutic relationship is necessary for effective therapy, but not the focus. Some forms of therapy assume that the main reason people get better in therapy is because of the positive relationship between the therapist and client. Cognitive-behavioral therapists believe it is important to have a good, trusting relationship, but that is not enough. CBT therapists believe that the clients change because they learn how to think differently and they act on that learning. Therefore, CBT therapists focus on teaching rational self-counseling skills.


• CBT is a collaborative effort between the therapist and the client. Cognitive-behavioral therapists seek to learn what their clients want out of life (their goals) and then help their clients achieve those goals. The therapist's role is to listen, teach, and encourage, while the client's roles is to express concerns, learn, and implement that learning.

Cognitive Therapy (CT) is a type of psychotherapy developed by psychiatrist Aaron T. Beck in the 1960s. Becoming disillusioned with long-term psychodynamics approaches based on gaining insight into unconscious emotions and drives, Beck came to the conclusion that the way in which his clients perceived and interpreted and attributed meaning - a process known scientifically as cognition - in their daily lives was a key to therapy.

Albert Ellis was working on similar ideas from a different perspective, in developing his Rational Emotive Behavior Therapy (REBT). Beck initially focused on depression and developed a list of "errors" in thinking that he proposed could cause or maintain depression, including arbitrary inference, selective abstraction, over-generalization, and magnification (of negatives) and minimization (of positives). Cognitive therapy seeks to identify and change "distorted" or "unrealistic" ways of thinking, and therefore to influence emotion and behavior.

A surgical procedure that involves connecting a part of the colon onto the anterior abdominal wall, leaving the patient with an opening on the abdomen called a stoma. This opening is formed from the end of the large intestine drawn out through the incision and sutured to the skin. After a colostomy, feces leave the patient's body through the stoma, and collect in a pouch attached to the patient's abdomen which is changed when necessary.

A concomitant (existing or occurring with something else) but unrelated pathological or disease process. In medicine, comorbidity describes the effect of all other diseases an individual patient might have other than the primary disease of interest. The Charlson Comorbidity is the most widely accepted, validated method, currently used to quantify such comorbidity.

An unhealthy state, such as in "this is a progressive condition."

To suggest or imply in addition to literal meaning.

Cortisol is the body's primary stress hormone. When the brain stimulates its release in response to physical or emotional stress, the adrenal glands secrete cortisol into the blood. Cortisol helps the body regulate blood sugar levels and blood pressure. It also is an anti-inflammatory, an anti-allergic agent and reduces the actions of the immune system. Many synthetic versions of cortisol, such as hydrocortisone, have medicinal uses.

Studies show cortisol levels are low in many people with fibromyalgia and chronic fatigue syndrome and could be what makes it so difficult to deal with stress, either physical (such as infection or exertion) or psychological. Studies of cortisol replacement, however, have had inconsistent results.

Tietze's Syndrome, also known as Costochondritis, is a benign inflammation of one or more of the costal cartilages.

Tietze's Syndrome and Costochondritis were initially described as separate conditions, the sole difference being that in Tietze's Syndrome there is swelling of the costal cartilages. It is now recognized that the presence or absence of swelling is only an indicator of the severity of the condition. It was at one time thought to be associated with, or caused by, a viral infection acquired during surgery, but this is now known not to be the case. Most sufferers have not had recent surgery.

While the true causes of Tietze's Syndrome are not well understood, it often results from a physical strain or minor injury, such as repeated vomiting or impacts to the chest. It has even been known to occur after hearty bouts of laughter.

Although patients will often mistake the pain of Tietze's Syndrome for a myocardial infarction (heart attack), the syndrome does not progress to cause harm to any organs.

Doctors often reassure patients that their symptoms are not associated with a heart attack, although they may need to treat the pain, which in some cases can be severe enough to cause significant but temporary disability to the patient.

Junction of the rib into cartilage in the anterior chest.

Crohn's disease is a chronic, episodic, inflammatory condition of the gastrointestinal tract characterized by transmural inflammation (affecting the entire wall of the involved bowel) and skip lesions (areas of inflammation with areas of normal lining in between).

Crohn's disease is a type of inflammatory bowel disease (IBD) and may sometimes affect any part of the gastrointestinal tract from mouth to anus; as a result, the symptoms of Crohn's disease can vary between affected individuals.

The main gastrointestinal symptoms are abdominal pain, diarrhea (which may be bloody), and weight loss. Crohn's disease can also cause complications outside of the gastrointestinal tract such as skin rashes, arthritis, and inflammation of the eye.

Curettage, in surgery, is the use of a curette to remove tissue by scraping or scooping. It may be used to obtain a biopsy of a mass to determine if it is a granuloma, neoplasm, or some other tumor.

It is often employed prior to definitive excisional surgery to more precisely delineate the extent of a tumor. In selected cases, curettage may be employed to treat certain 'low risk' skin cancers.

Cushing's syndrome is a hormonal disorder caused by prolonged exposure of the body's tissues to high levels of the hormone cortisol. Sometimes called hypercortisolism, Cushing's syndrome is relatively rare and most commonly affects adults aged 20 to 50. People who are obese and have type 2 diabetes, along with poorly controlled blood glucose - also called blood sugar - and high blood pressure, have an increased risk of developing the disorder.

Cyanosis refers to the bluish coloration of the skin due to the presence of deoxygenated hemoglobin in blood vessels near the skin surface.

Cytokines are proteins released by the cells in your immune system that help regulate your immune response.

It's possible that people with chronic fatigue syndrome (CFS or ME/CFS) have high levels of cytokines, which, along with several other factors, indicates that their immune system is active even when no virus is present. However, there is conflicting evidence as to whether increased levels of cytokines and other manifestations of immune dysfunction are associated with flares of CFS.

Cytomegalovirus (CMV), is a genus of Herpes viruses. In humans the species is known as Human herpes virus 5 (HHV-5). The name means "very big cell virus".

It is the process by which amino acids are broken down. The amino group is removed from the amino acid and converted to ammonia. The rest of the amino acid is made up of mostly carbon and hydrogen, and is recycled or oxidized for energy.

Causing a loss of strength or energy.

Major depressive disorder (also known as recurrent depressive disorder, clinical depression, major depression, unipolar depression, or unipolar disorder) is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities. The term "major depressive disorder" was selected by the American Psychiatric Association to designate this symptom cluster as a mood disorder in the 1980 version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), and has become widely used since. The general term depression is often used to denote the disorder; but as it can also be used in reference to other types of psychological depression, it is disfavored over more precise terminology for the disorder in clinical and research use. Major depression is a disabling condition which adversely affects a person's family, work or school life, sleeping and eating habits, and general health. In the United States, around 3.4% of people with major depression commit suicide, and up to 60% of people who commit suicide had depression or another mood disorder.

The diagnosis of major depressive disorder is based on the patient's self-reported experiences, behavior reported by relatives or friends, and a mental status exam. There is no laboratory test for major depression, although physicians generally request tests for physical conditions that may cause similar symptoms. The most common time of onset is between the ages of 20 and 30 years, with a later peak between 30 and 40 years.

Typically, patients are treated with antidepressant medication and, in many cases, also receive psychotherapy or counseling. Hospitalization may be necessary in cases with associated self, neglect or a significant risk of harm to self or, as rarely is the case, to others. A minority are treated with electroconvulsive therapy (ECT), under a short-acting general anaesthetic. The course of the disorder varies widely, from one episode lasting weeks to a lifelong disorder with recurrent major depressive episodes. Depressed individuals have shorter life expectancies than those without depression, in part because of greater susceptibility to medical illnesses and suicide. It is unclear whether or not medications affect the risk of suicide. Current and former patients may be stigmatized.

Diabetes mellitus is a metabolic disorder characterized by hyperglycemia (high blood sugar) and other signs, as distinct from a single disease or condition.

The term "disease" refers to an abnormal condition of an organism that impairs function. In human beings, "disease" is often used more broadly to refer to any condition that causes discomfort, dysfunction, distress, social problems, and/or death to the person afflicted, or similar problems for those in contact with the person.

In this broader sense, it sometimes includes injuries, disabilities, disorders, syndromes, infections, isolated symptoms, deviant behaviors, and atypical variations of structure and function, while in other contexts and for other purposes these may be considered distinguishable categories.

Classifying a condition as a disease is a social act of valuation, and may change the social status of the person with the condition (the patient). Many conditions are only recognized as diseases within a particular culture. Sometimes the categorization of a condition as a disease is controversial within the culture.

In anatomy, adipose tissue or fat is loose connective tissue composed of adipocytes. Its main role is to store energy in the form of fat, although it also cushions and insulates the body.

Dopamine is a neurotransmitter in the central nervous system that helps regulate many things in the body, including movement, balance, walking, feelings of motivation, happiness, sexual desire, pleasure, reward, immune function, insulin regulation, physical energy, thinking, and short-term memory. Your body also uses dopamine to produce norepinephrine.

Studies show that people with fibromyalgia and chronic fatigue syndrome frequently have low dopamine levels. Other disorders linked to dopamine dysregulation include ADD/ADHD, Parkinson's disease, irritable bowel syndrome, restless leg syndrome, and multiple psychiatric conditions.

Dopaminergics are substances that affect the neurotransmitter dopamine or the components of the nervous system that use dopamine. Dopamine is produced in the synthesis of all catecholamine neurotransmitters, and is the rate limiting step for this synthesis. Dopaminergic nootropics include dopamine precursors and cofactors, agonists, MAOIs, and dopamine reuptake inhibitors:

• L-dopa - Prescription drug. Precursor to the neurotransmitter dopamine. Parkinson disease treatment.


• Phenylalanine (requires Vitamin B6 and Vitamin C) - Essential amino acid. Precursor to dopamine, stimulant, sleep reducer.


• Theanine - Found in tea. Increases serotonin, GABA and dopamine levels in the brain. Increases alpha-wave based alert relaxation.


• Tyrosine (requires Vitamin B6 and Vitamin C) - Amino acid. Precursor to dopamine, anti-depressant, sleep reducer.


• Vitamin C- improves cardiovascular elasticity and integrity, membrane stabilizer and major anti-oxidant (protects brain cells and prevents brain cell death), cofactor in the production of the neurotransmitters dopamine and serotonin.


• Vitamin B6 - co-factor used by the body to produce dopamine.


• Yohimbine - boosts dopamine levels through an unknown mechanism. Sometimes used as an aphrodisiac. Poses health risks: it is a neuro-paralytic which slows down breathing and induces acidosis, some symptoms of which are malaise, nausea, and vomiting. Contraindicated for users of megadoses of acidic vitamins or nutrients.


• MAOIs such as Selegiline which inhibits MAO-B (an enzyme that breaks down dopamine) thus raising dopamine by partially inhibiting its breakdown. (In large doses it also inhibits MAO-A).


• Tolcapone - Inhibits COMT (an enzyme that breaks down the neurotransmitters dopamine, epinephrine, and norepinephrine) and increases performance in tasks depending on working memory in individuals with the val/val and val/met genotype of the val158Met polymorphism of the catechol-O-methyltransferase gene, while decreasing it in presence of the met/met version. Tolcapone presents the risk of deadly side effects.


• Buproprion atypical antidepressant. Dopamine reuptake inhibitor.


• Dopamine agonists such as pergolide

A placebo is an inactive substance (often a sugar pill) given to a patient in place of medication. Clinical trials show that between 30% to 40% of people will show improvement when given a placebo because they believe it will work.

In drug trials, a control group is given a placebo while another group is given the drug being studied. That way, researchers can compare the drug's effectiveness against the placebo's effectiveness.

In a double-blind, placebo-controlled clinical trial, neither the patients nor the researchers know who is getting a placebo and who is getting the treatment. Because patients don't know what they're getting, their belief about what will happen doesn't taint the results. Because the researchers don't know either, they can't hint to patients about what they're getting, and they also won't taint results through their own biased expectations about what the results will be.

Dysarthria is a speech disorder resulting from neurological injury. Any of the speech subsystems (respiration, phonation, resonance, prosody, articulation and movements of jaw and tongue) can be affected.

The speech is due to some disorder in the nervous system, which in turn hinders control over for example tongue, throat, lips or lungs. Swallowing problems are often present.

Dysbiosis is the abnormal state of ecoorgan located at gut, vagina or skin. Dysbiosis is due to outgrowth of pathogenic bacteria, parasites or fungus. It can be effectively treated using Bioecological Medicine.

Impaired or abnormal functioning. Difficult function or abnormal function.

Dysmenorrhea is a condition that causes extremely painful menstrual cramps. The cramps produced by dysmenorrhea can range in intensity, from highly uncomfortable to debilitating. Typically, the cramps caused by the disorder last anywhere from a few hours to a few days, though some women can experience extreme cramping for as long as a week. Cramping originates in the uterus, but there can also be abdominal cramps and pain in the lower back, thighs, and down the backs of the legs. About 10% of women with dysmenorrhea are bedridden for 3 days every month.

Dyspepsia refers to disorders of the stomach involving symptoms such as heartburn, nausea, pain, or general discomfort.

Dysphoria is generally characterized as an unpleasant or uncomfortable mood, such as sadness (depressed mood), anxiety, irritability, or restlessness. Etymologically, it is the opposite of euphoria.

Dysphoria refers only to a condition of mood and may be experienced in response to ordinary life events, such as illness or grief. Additionally, it is a feature of many psychiatric disorders, including anxiety disorders and mood disorders.

Dysphoria is usually experienced during depressive episodes, but in people with bipolar disorder, it may also be experienced during manic or hypomanic episodes. Dysphoria in the context of a mood disorder indicates a heightened risk of suicide.

Dyspnea - shortness of breath - or short of breath is perceived difficulty breathing or pain on breathing. It is a common symptom of numerous medical disorders.