Case Report – “Michael”

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History

This 27 year old male presented with a 4 year history of fibromyalgia syndrome (FMS) which appeared to begin after a bad reaction to an insect bite when he was in the United States. Prior to this he was fit, active and happy. His symptoms included widespread body pain, fatigue, brain fog, extreme depression and severe difficulty with productivity – both at work and in his personal life.

Treatment
Michael was recommended for repetitive transcranial magnetic stimulation (rTMS), and underwent a 20 session treatment, using a low frequency (1Hz) protocol. This particular protocol was chosen due to its ability to calm the brain areas that have been found to be overactive in people with fibromyalgia. This has been shown to be effective for this condition by previous studies into rTMS for fibromyalgia, notably Tanwar et al (2020).

Outcome
The patient experienced improvements in energy, pain and mood from week one of treatment, and continued to feel better as he went through the full protocol. After 6 sessions he was able to work out at the gym for the first time in 4 years, and did not have any negative response to this on the following day. At this point his depression score had dropped from 52/60 to 6/60, while his pain had moved from 7/10 to 3/10, and he reported significant improvements to his concentration, mental clarity and productivity.

These improvements continued, and Michael achieved the following set of results after his 20th session:

Fibromyalgia symptoms – 83% improvement

Depression – 88% improvement

Pain – 86% improvement

Anxiety – 100% improvement

Quality of life – 83% improvement

Michael was understandably delighted with these results, especially since he was now able to go to the gym multiple times each week. He also reported significant improvements to his work productivity and social life, as well as much improved sleep.

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