This book uniquely discusses an approach to illnesses for which the causes are unknown. It fills the gaps in the literature by relaying research on functional illness, identifying and assessing various options, and indicating some decision-making suggestions that should help clinicians and patients think about therapy.
Special considerations for functional illness include “probability” explanations based on the experience of others, serious consideration of the severity of symptoms before treatments are applied, and balancing the risks, costs, and consequences of treatment; including the patient’s thoughts and attitudes is critical for success in treating functional illness.
Unique and comprehensive, Functional Illness is an invaluable reference for medical physicians of all specialties who wish to understand better and identify functional illness symptoms.
Author(s): Brian W. Blakley, Joan E. Blakley
Publisher: Springer
Year: 2023
Language: English
Pages: 337
City: Cham
Preface
Contents
1: Introduction What Is Functional Illness?
References
2: Some Basic Science and Functional Illness
The Immune System and Inflammation
Antioxidants
Physiology of Pain
Neural Pain Pathways
Is there a Convergence of Treatment of Functional Symptoms?
Anxiety by Cory Bosecke
Anxiolytic Drugs and Theta
Role of the Vestibular Nucleus
Conclusion
References
3: Altered Sensation
Introduction
Allodynia
Hyperalgesia
Hypersensitivity
Peripheral Sensitization
Summary
References
4: Stress and Functional Illness
The Physiology of Stress
Chronic Stress
The Stress Experience
Functional ENT Illness and Stress
References
5: Allergy and Environmental Illness
Allergy
Pollution in the Environment at Large
Pollution at Work Spaces—Occupational Exposure
Pollution at Work Spaces—Office Space
Pollution at Work Spaces—Sick-Building Syndrome
Air Filtration
Environmental Noise and Sound Pollution
Work Stress
References
6: Depression
Prevalence and Comorbidity
Depression as a Risk Factor for Functional Illness
Impact of Depression on Prognosis
Treatment
Medication
Psychotherapy
Brain Stimulation
References
7: Chronic Pain Syndromes: Neck Pain
Introduction
Etiology
Clinical Evaluation
History
Outcome Measures
Physical Examination
Laboratory Studies
Imaging Studies
Common Disorders
Chronic Primary Cervical Pain
Cervical Radiculopathy
Conclusion
References
8: Chronic Pain Syndromes: Shoulder Pain
Introduction
Etiology
Clinical Evaluation
Diagnostic Testing
Imaging
Electrodiagnostic Testing
Outcome Measures and Psychosocial Testing
Common Shoulder Conditions
Subacromial Pain Syndrome
Glenohumeral Joint Instability
Conclusion
References
9: Fibromyalgia
Introduction
Clinical Evaluation
Diagnostic Testing
Management
Non-pharmacological Options
Pharmacological Therapies
Other Treatments
Conclusion
References
10: Myofascial Pain
Introduction
Clinical Evaluation
Diagnostic Testing
Treatment
Conclusion
References
11: Chronic Sore Throat
Chronic Pain Syndromes—Chronic Sore Throat
Consider the Differential
Functional Causes of Chronic Sore Throat (Table 11.1)
Burning Mouth Syndrome
Chronic Fatigue Syndrome
Glossopharyngeal Neuralgia
Stylalgia/Eagle Syndrome
Hyoid Syndrome/Anterior Neck Pain Syndrome
Functional Globus Sensation
Muscle Tension Dysphonia
Psychogenic Sore Throat
Conclusion
References
12: Ear Pain and TMJ
Anatomy and Physiology of Ear Pain and Pressure
Clinical Evaluation of Ear pain and Pressure
Step 1: Consider Local Causes
Step 2: Consider Regional Causes
Step 3: Consider Systemic Causes
References
13: Functional Dizziness
Introduction
Pathology
Persistent Postural-Perceptual Dizziness
Visual Vestibular Mismatch(VVM)
Concussion
Vestibular Migraine
Cervicogenic Dizziness
Conclusion
References
14: Headaches
Facial Pain
Primary Headache Disorders
Migraine
Misdiagnosis – ‘Sinus’ Headache
Facial Pain Secondary to Rhinosinusitis
Medical Therapy
Corticosteroid Therapy in ARS
Antibiotics in ARS
Saline Irrigation in ARS
Decongestants in ARS and ABRS
Migraine Treatment
Tension-Type Headache
Diagnostic Dilemma
Facial Pain
Contact Point Headache (Sluder’s Neuralgia)
Facial Pain and the Temporomandibular Joint
Red Flags
References
15: Subjective Tinnitus
Epidemiology and Risk Factors
Classification
Acute Versus Chronic Tinnitus
Non-bothersome or Compensated Tinnitus
Bothersome or Non-compensated Tinnitus
Primary Versus Secondary Tinnitus
Presentation and Examinations
Additional Tests
Tinnitus Questionnaires
Theories of Tinnitus Etiology
Association of Hearing Loss and Tinnitus
Association of Temporomandibular Joint Disorders and Tinnitus
Association of Stress and Tinnitus
Association Between Headaches and Tinnitus
Association Between Insomnia and Tinnitus
Therapeutic Options
Patient Counseling and Education
Hearing Aids (HAs) in the Setting of Tinnitus and Hearing Loss
Cognitive Behavioral Therapy
Sound Therapy
Drugs and Tinnitus
Herbal and Other Supplements
Cannabis and Tinnitus
The Role of no Intervention
Current Research/Developments
Conclusion
References
16: Head and Neck Manifestations of Fibromyalgia and Chronic Fatigue Syndrome
Introduction
Otology
Dizziness
Rhinology
Laryngology
Temporomandibular Disorders
Chronic Pharyngitis (Table 16.2)
Conclusions
References
17: Sleep and Functional Illness
Introduction
Sleep and Health: A Psychoneuroimmunologic Perspective
Relationship of Sleep to Fatigue
What Is Fatigue?
Chronic Fatigue Syndrome and Sleep
Relationship of Sleep to Pain
Effect of Pain on Sleep
FM and Sleep
Sleep and HA
Surgical Treatment for OSA in the Context of Functional Illness
Choice of Sleep Surgery in Patients with Functional Illness
Residual Sleepiness and Fatigue After Treatment of OSA
Summary
References
18: Functional Disorders of the Larynx: Muscle Tension Dysphonia, Paradoxical Vocal Cord Dysfunction, and Globus Pharyngeus
Introduction
Muscle Tension Dysphonia
Clinical Features
Epidemiology
Pathophysiology
Diagnosis and Workup
Treatment
Summary
Paradoxical Vocal Cord Dysfunction
Clinical Features
Epidemiology
Pathophysiology
Diagnosis and Workup
Treatment
Summary
Globus Pharyngeus
Clinical Features
Epidemiology
Pathophysiology
Diagnosis
Treatment
Summary
References
19: A Psychological Approach to Functional Illness
A History of Psychological Conceptualization of Functional Illness
The Biopsychosocial Perspective
Functional Somatic Syndromes
Etiology of FSS
Psychological Assessment of Functional Illness
Psychological Treatment of Functional Illness
Cognitive-Behavioral Therapy
“Third-Wave” Cognitive-Behavioral Therapies
Acceptance and Commitment Therapy
Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT)
Hypnosis
Biofeedback
Eye Movement Desensitization and Reprocessing (EMDR)
Summary of Psychological Treatments
Strategies for Health Care Providers (HCP)
Assessment
Providing Diagnostic Feedback
Treatment Plan
Making Referrals
Summary
References
20: Pharmacologic Treatment Options in Functional Illness
Introduction
Acetaminophen
Acetaminophen in Functional Illness
Antidepressants
Antidepressants in Functional Illness
Chronic Cough
Functional Dizziness
Fibromyalgia
Chronic Fatigue Syndrome (CFS)
Somatoform Disorders
Tinnitus
Antiepileptic Drugs (AED)
Antiepileptic Drugs in Functional Illness
Chronic Cough
Fibromyalgia/Chronic Pain
Vestibular Migraine
Antipsychotics (APs)
APs in Functional Illness
Fibromyalgia
Tinnitus
Benzodiazepines (BZD)
BZDs in Functional Illness
Fibromyalgia
Functional Dizziness
Tinnitus
Muscle Relaxants
Muscle Relaxants in Functional Illness
Fibromyalgia
Chronic Orofacial Pain
Myofascial Pain Syndrome
Tinnitus
Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
NSAIDS in Functional Illness
Myofascial Pain Syndrome
Opioids
Opioids in Functional Illness
Fibromyalgia
Chronic Cough
Opioid Antagonist
Opioid Antagonists in Functional Illness
Fibromyalgia
Chronic Fatigue Syndrome
Chronic Pain Syndromes
Stimulants
Stimulants in Functional Illness
Chronic Fatigue Syndrome
Fibromyalgia
Conclusion
References
21: Pharmacology of Cannabis
Introduction
History of Cannabis Use
Discovering Its Chemical Effects
Pharmacology
Clinical Implication
Multiple Sclerosis (MS)
Pain
Glaucoma
Cannabis in Otolaryngology
Head and Neck Cancer
Otology
Sleep Medicine
Regulation
Abuse
Conclusion
References
22: Complementary and Alternative Therapies
Definitions
Historical Development of CAM
Popularity of Complementary and Alternative Medicine (CAM) Today
Why CAM Thrives
Organizations with a Dedicated Focus on Complementary Medicine
Complementary Medicine Practices Prevalent Worldwide
Acupuncture
Acupressure
Cupping
Herbal Medicine
Indigenous Traditional Medicine
Homeopathy
Traditional Chinese Medicine
Naturopathy
Chiropractic
Osteopathy
Ayurvedic Medicine
Unani Medicine
Therapeutic Massage
Hypnotherapy
Reflexology
Energy Therapies
Hydrotherapy
Exercise or Movement Therapy
Biofeedback
Bach Flower Remedies
Anthroposophic Medicine
Neural Therapy
gSo-BA Rig-PA
Siddha Medicine
Meditation
Ozone Therapy
Aromatherapy
Summary
References
23: Diets
Introduction
The Human Microbiome
ENT Diseases
Laryngopharyngeal Reflux
Oral Leukoplakia
Aphthous Ulcers
Herpes Simplex
Herpes Zoster
Xerostomia
Vertigo and Meniere’s Disease
Otitis Media and Sinusitis
References
24: Functional Medicine in the Pediatric Otolaryngology Patient
Introduction
Functional Medicine Pediatric Otolaryngology
Multidisciplinary Care of Pediatric Patients
A Functional Approach to Common Pediatric Otorhinolaryngologic Conditions
Pediatric Gastroesophageal Reflux
Allergy
Nutrition
Acid
Micronutrients
Vitamin D
Vitamin C
Vitamin A/E
Other Micronutrients and Supplements
Socioeconomic Factors
Conclusion
References
Glossary
Index
