الفهرس 
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Abstract
Summary
This was a case-control study, the study groupincluded 60 adult subjects, having fibromyalgia, of both genders, age ranged from18 to 50 years. They were collected from adults who attend theRheumatology Outpatient clinic, Beni-Suef UniversityHospital. The audiovestibular assessment was performed at the AudioVestibular Unit, faculty of Medicine in Beni-Suef UniversityHospital, while the Control group included 60 healthy non-fibromyalgia individuals from relatives of the cases. They were selected to be age and gender matched to the cases.
The aim of the studywas to evaluate the audiovestibular function in patients diagnosed with fibromyalgia.
An informed consent was obtained from all participants after explaining the purpose and the methodology of the study to them and all research was approved by the Local Ethics Committee on research involving human subjects of Beni-Suef Faculty of Medicine.
The main results of the study revealed that:
• The mean PTA thresholds at 250 Hz ,2000Hz and 4000Hz in study group weresignificantly higher than the mean PTA thresholds in control group.
• There was a significant linear positive correlation between disease duration and PTA thresholds at 500Hz, 4000 Hz, and 8000 Hz.
• SRT was significantly higher in study group than control in spite of being within normal range.
• Tympanometry revealed type A tympanogram with preserved acoustic reflexes at 500Hz and 1000Hz both study group and controls but AR was significantly absent in study group than controls at 2000Hz and 4000Hz.
• ABR results revealed significant delay in absolute peak latency of waves V and the interpeak latency of the III –V and I–V in study group. Also V/I amplitude ratio was significantly decreased in study group and there was a significant linear positive correlation between disease duration and ABR V latency, ABR I-V IPL ABR III-V IPL.
• cVEMP showed a significant delay of P13 and N23 latencies and a significant decrease in IP amplitude and AR in study group in spite of being in normal value. There was a significant negative linear correlation between disease duration and cVEMP asymmetry ratio only in study group.
• oVEMP showed no significant difference in N10 latency,p15 latency and AR between control and study group but there was significant decrease in IP amplitude only in study group. There was no significant correlation between disease duration and oVEMP in study group.
• There was a significant higher proportion of positive head impulse test 10.0%, positional test 11.67%, fukuda stepping test 18.3% and romberg test 18.3% in study group than controls. Head shaking test was positive in 6.7% of study group with no significant difference between both groups.
• VNG results, there was no spontaneous nystagmus in all subjects in both groups. Smooth pursuit test was symmetrical with significant low gain in study group. Saccade test showed insignificant increase in latency and significant decrease in velocity and accuracy in study group while optokinetic test was equal in both sides in all subjects in both groups.
• Positional test and Dix-hallpike test were significant abnormal in 11.7% of study group.
• Caloric test showed unilateral weakness in 21.7% of controls and 30% of study group with no significant difference between 2 groups.
• This study showed thatdizziness, headache and tinnitus, were frequently seen in patients with FMS. It also showed number of cases complaining of hearing loss, imbalance,sleep disorders, sense of knuckle head, blurring of vision and falls. These symptoms did not show any relation with disease duration except for hearing loss that showed a statistically significant association with longer disease duration.
• Short FES revealed high percentage with moderate concern followed by low concern then high concern with fallingandno significant correlation with disease duration.
• Patients with high scores of short FES in study group were complaining of dizziness, falls and headache.
• There was a significant linear negative correlation between short FES and cVEMP P13 latency, N23 latency, IP amplitude and AR in study group.
• There was a significant linear negative correlation between short FES and oVEMP N10 latency and asymmetry ratio while the correlation was positive with p15 latency.
So, we conclude that audiovestibular dysfunction is not rare in the FMS and audiovestibular assessment should be routinely performed for patients of fibromyalgia and for a more thorough evaluation.