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Encyclopedia > Myalgic Encephalomyelitis
Myalgic Encephalomyelitis
Classification & external resources
ICD-10 G93.3

Myalgic Encephalomyelitis (M.E.), pronounced [my-al'jik en-sef'a-lo-my'e-ly'tis], is also known as Post-Viral Fatigue Syndrome (PVFS) (ICD10 - G93.3) and affects the central nervous system (CNS), immune, and many other systems and organs. Image File history File links Broom_icon. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // G00-G99 - Diseases of the nervous system (G00-G09) Inflammatory diseases of the central nervous system (G00) Bacterial meningitis, not elsewhere classified (G01) Meningitis in bacterial diseases classified elsewhere (G02) Meningitis in other infectious and parasitic diseases classified elsewhere (G03) Meningitis due to other and unspecified causes (G04) Encephalitis, myelitis... Categories: Medicine stubs | Immune system ... // G00-G99 - Diseases of the nervous system (G00-G09) Inflammatory diseases of the central nervous system (G00) Bacterial meningitis, not elsewhere classified (G01) Meningitis in bacterial diseases classified elsewhere (G02) Meningitis in other infectious and parasitic diseases classified elsewhere (G03) Meningitis due to other and unspecified causes (G04) Encephalitis, myelitis... A diagram showing the CNS: 1. ... A scanning electron microscope image of a single neutrophil (yellow), engulfing anthrax bacteria (orange). ...



M.E. is also frequently called Chronic Fatigue Syndrome (CFS) as the diagnostic criteria defined by the American Centers for Disease Control and Prevention (CDC) in 1994 for CFS[1] also encompass most of the criteria used for M.E. However, many consider the CDC-defined CFS (CDC-CFS) to encompass a large group of syndromes of potentially multiple etiologies. In the United Kingdom, Canada and other Commonwealth nations the term CFS tends to refer to the criteria defined by Sharpe at al in 1991[2] (known as the Oxford criteria or Oxford-CFS) which are much more loosely defined than CDC-CFS. Please see: Chronic Fatigue Syndrome which also contains a lot of information relevant to M.E.. Chronic fatigue syndrome (CFS) is one of several names given to a poorly understood, highly debilitating disorder of uncertain cause, which is thought to affect approximately 4 per 1,000 adults[1] in the United States and other countries, and a smaller fraction of children. ... The Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, is recognized as the leading United States agency for protecting the public health and safety of people. ... Etiology (alternately aetiology, aitiology) is the study of causation. ... Chronic fatigue syndrome (CFS) is one of several names given to a poorly understood, highly debilitating disorder of uncertain cause, which is thought to affect approximately 4 per 1,000 adults[1] in the United States and other countries, and a smaller fraction of children. ...



Currently there is no simple diagnostic test for M.E. which is a diagnosis of exclusion. However, M.E. has many unique biological traits and an inexpensive and effective diagnostic test is the focus of much research. The term diagnosis of exclusion (per exclusionem) refers to a medical condition whose presence cannot be established with complete confidence from examination or testing. ...



Typical symptoms include: extreme debilitating fatigue, post-exertional malaise, pain, muscle weakness, poor memory and concentration, orthostatic intolerance, digestive disturbances, hypersensitivity and immune system weakness. Symptoms range from mild to life-threateningly severe. All types of people at all ages are affected. In many cases, onset is linked to a viral infection. Other triggers may include an operation or an accident, although some people experience a slow, insidious onset. ME is an almost permanent illness with only a 5% recovery rate within the first two years and a declining recovery rate thereafter. Orthostatic intolerance is the failure of the body to properly adjust to an upright position, especially with respect to blood flow, heart rate, and blood pressure. ... Hypersensitivity refers to undesirable (damaging, discomfort-producing and sometimes fatal) reactions produced by the normal immune system. ...

Contents

In Brief

  • Myalgic Encephalomyelitis means "inflammation of the brain and spinal cord with muscle pain".
  • Post-viral [fatigue] syndrome (PVS or PVFS) is classed by the World Health Organisation in the same category as ME and is frequently considered to be the same illness. However, according to original ME researcher Dr. Melvin Ramsay, "The crucial differentiation between ME and other forms of post-viral fatigue syndrome lies in the striking variability of the symptoms not only in the course of a day but often within the hour. This variability of the intensity of the symptoms is not found in post-viral fatigue states" (Ramsay 1989). Advocates argue that other post-viral syndromes (such as post-polio syndrome) do show similar variability, and point to the striking similarity between Post-Viral Fatigue Syndrome and M.E. symptoms, noting that many cases of M.E. are triggered by a viral illness.

Post-polio syndrome (PPS) is a condition that frequently affects survivors of poliomyelitis, a viral infection of the nervous system, after recovery from an initial paralytic attack of the virus. ...

Symptoms

ME is characterised by severe, disabling physical and mental fatigue, both of which are markedly exacerbated by relatively small amounts of exertion. This fatigability is accompanied by what is termed ‘post-exertional malaise’ whereby there is a delayed impact so that symptoms are at their worst later the same day, or the next day, following activity. The way in which fatigue is described in ME is very different from normal everyday tiredness and from that seen in other medical conditions.


There are several other characteristic clinical features which can assist in diagnosis, including: Cognitive impairment, particularly relating to short-term memory, concentration and attention span, word-finding abilities, and ability to properly organise thoughts.


Pain, which is often persistent and may be severe. This can be muscular, rheumatic (joint pain), or neuropathic (nerve pain). Neurological dysfunction presenting as dizziness, increased sensitivity to stimuli, postural hypotension (a significant fall in blood pressure upon standing).


Headaches, which may be migrainous in character. Sleep disturbance which may range from hypersomnia (increased sleep requirements) early on, through to insomnia as the illness becomes chronic.


Immunological dysfunction presenting as sore throats, enlarged glands, flu-like feelings. Endocrine and hypothalamic dysfunction presenting as disturbances in temperature control.


Alcohol intolerance, drug and chemical sensitivities. More serious neurological symptoms occur in a minority of patients, particularly those at the severe end of the spectrum. These may include double vision, blackouts, atypical convulsions, loss of speech, and loss of swallowing – which may require assisted feeding.


Primary Symptoms

Post-Exertional Malaise


Disabling Physical and Mental Fatigue


Cognitive impairment


Pain


Neurological dysfunction


postural hypotension


Headaches


Sleep disturbance


Immunological dysfunction


Impaired temperature control


Alcohol intolerance, drug and chemical sensitivities


Secondary Symptoms

...


Treatment

There is currently no accepted cure and no universally effective treatment. Those treatments which have helped reduce particular symptoms in some people have unfortunately proved ineffective or even counterproductive in others. An early diagnosis together with adequate rest during the acute phase and during any relapse appear to bring the most significant improvement.


Prognosis

PLEASE NOTE - before considering prognosis, it is important to obtain a positive diagnosis, which should be determined only by a suitably qualified medical professional.



Most people with ME fall into one of four groups:


1) The majority, who tend to follow a fluctuating pattern with both good and bad periods of health. Relapses or exacerbations are often precipitated by infections, operations, temperature extremes or stressful events.


2) Those who manage to return to completely normal health, even though this may take a considerable period of time. The percentage falling into this category is fairly small.


3) A significant minority, who remain severely affected and may require a great deal of practical and social support.


4) A few, who show continued deterioration, which is unusual in ME. When this occurs, a detailed medical assessment is advisable to rule out other possible diagnoses.


Several research studies looking at prognosis in ME have now been published (Bombardier and Buchwald 1995; Hinds et al 1993; Sharpe et al 1992; Vercoulen et al 1996; Wilson et al 1994). Results from these studies indicate that ME often becomes a chronic and very disabling illness with complete recovery only occurring in a small minority of cases. The high level of debility and disability associated with ME often stems from a combination of symptoms.


Studies which have examined functional status and quality of life measures (Buchwald et al 1996; Komaroff et al 1996; Schweitzer et al 1995) also confirm that the scale of impairment across a range of physical and mental activities can be just as great or greater than is seen in many other chronic medical conditions.


Diagnosis

Course

Epidemiology

History

Myalgic Encephalomyelitis

Myalgic Encephalomyelitis (inflammation of the brain and spinal cord with muscle pain) as a disease entity has been recognized and described in the medical literature since 1938, with the seminal paper being that by Wallis in 1957; Sir Donald Acheson's (a former Chief Medical Officer) major review of M.E. was published in 1959[3]; in 1962 the distinguished neurologist Lord Brain included M.E. in his textbook of neurology, and in 1978 the Royal Society of Medicine accepted M.E. as a distinct clinical entity. In 1988 both the UK Department of Health and Social Services and the British Medical Association officially recognized it as a legitimate and potentially distressing disorder. Opponents of the term M.E. maintain there is no inflammation, although there are cases of CDC-CFS that present inflammation (see Sophia Mirza). Dr Walter Russell Brain the first Baron Brain of Eynsham (1895-1966) was a United Kingdom neurologist. ... The Logo and Coat of Arms of the Society. ... The Department of Health headquarters in Whitehall The Department of Health is a department of the United Kingdom government. ... The logo of the association. ... Sophia Mirza (1974–2006) was the first person in the United Kingdom whose cause of death was recorded as Chronic Fatigue Syndrome (CFS). ...


Controversy

ME has attracted more than its fair share of controversy. Initially, and for many years, there was a debate as to whether it was actually an illness at all. Although the situation is still not perfect, many influential bodies, (The World Health Organisation, the Department of Social Security, the Department of Health, the Royal Colleges of Physicians, Psychiatrists and General Practitioners amongst them) are now in agreement that it is real.


Two major questions now occupy the minds of the people involved - these questions are: "What is it?" and "What is to be done about it?"


While there is a degree of consensus on the different things which can trigger ME, what then causes it to become chronic has become a topic of hot debate. Loosely, views are split into two schools of thought: one which favours 'psychiatric' or 'behavioural' reasons and the other (supported by patient groups) which argues 'physical' reasons. There is also an argument which proposes that no such distinction should be made.


The second point, 'What is to be done about it?' attracts equally heated debate. Until more information is known, there will remain a wide range of views on how people can be helped. Research into causes, treatment methods and cures continues. Treatment is often aimed at reducing symptoms and can encompass a range of 'mainstream' and 'complementary' methods, ranging through drugs, homoeopathy, behavioural therapies, acupuncture, diet changes and beyond.


Etiology and Pathophysiology

Social issues

In some the effects may be minimal but in a large number, lives are changed drastically: in the young, schooling and higher education can be severely disrupted; in the working population, employment becomes impossible for many. For all, social life and family life become restricted and in some cases severely strained. People may be housebound or confined to bed for months or years.


Popular culture references

Ricky Gervais makes several references to ME in his stand up tour 'Fame'. Ricky Dene Gervais (IPA: ) (born June 25, 1961) is an Emmy, Golden Globe and BAFTA award-winning British comic writer and performer from Reading, Berkshire. ...



Captain Robert J. Dodds is currently suffering from M.E and has been the last 2 years and a half Captain is a rank or title with various meanings. ...


in Grange Hill Series 19 (1996) Jessica Arnold suffers from M.E. Grange Hill is a British childrens television drama series which is shown on BBC One. ...


References

  1. ^ Fukuda K, Straus S, Hickie I, Sharpe M, Dobbins J, Komaroff A (1994). "The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group.". Ann Intern Med 121 (12): 953-9. PMID 7978722.  case definition
  2. ^ Sharpe M, Archard L, Banatvala J, Borysiewicz L, Clare A, David A, Edwards R, Hawton K, Lambert H, Lane R (1991). "A report--chronic fatigue syndrome: guidelines for research.". J R Soc Med 84 (2): 118-21. PMID 1999813.  -476446699 at GPnotebook(details, details)
  3. ^ Acheson E (1959). "The clinical syndrome variously called benign myalgic encephalomyelitis, Iceland disease and epidemic neuromyasthenia.". Am J Med 26 (4): 569-95. PMID 13637100. 

GPnotebook is a British medical database for general practitioners (GPs. ...

External links

  • The ME Association of the UK
  • Action for ME, UK
  • Association of Young People with ME, UK
  • The 25% ME Group for severely affected sufferers in the UK
  • East Lancs ME Support Group, North West England, UK
  • Myalgic Encephalomyelitis Society of America. Accessed 2007-05-16

  Results from FactBites:
 
Myalgic Encephalomyelitis (493 words)
Myalgic Encephalomyelitis is a mysterious illness (usually known as M.E.) that appeared in the latter half of the 20th century, although researchers now suspect it had been unrecognized for much longer.
Myalgic Encephalomyelitis affects the whole system, varying in intensity from one person to another.
Myalgic Encephalomyelitis is reported by its victims who do not have it very severely, as being a “yoyo” existence.
Myalgic Encephalomyelitis - definition of Myalgic Encephalomyelitis in Encyclopedia (3939 words)
Myalgic Encephalomyelitis - definition of Myalgic Encephalomyelitis in Encyclopedia
Chronic fatigue syndrome (CFS) is a condition of excessive fatigue, cognitive impairment and other varied symptoms.
Myalgic Encephalomyelitis Myalgic Encephalitis (ME); outside the United States, "ME" is in common use, meaning "infection and swelling of the brain with muscle pain" or "infection of the brain with muscle pain" respectively.
  More results at FactBites »

 
 

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