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The overwhelming exhaustive experience of exertion intolerance as experienced in Myalgic Encephalomyelitis (ME), disproportionate to energy expended, is qualitatively and quantitatively different from fatigue as normally experienced, and it is not refreshed by any amount of rest and sleep.
In addition, there is a range of symptoms, including muscle pain, cognitive dysfunction, paralysis, cardiac issues, respiratory problems, gastrointestinal dysfunction, multiple sensitivities and more systems dysfunction not present in trivial tiredness.
At the heart of the confusion between ME and CFS lie the research and clinical definitions. One of our goals is to present a clear understanding of the differences between ME and CFS.
- The physical symptoms of ME can be as disabling as multiple sclerosis, systemic lupus, rheumatoid arthritis, congestive heart failure and other chronic conditions. Research shows that people with ME score lower overall on health-related quality of life tests than most other chronic conditions.
people make good progress or recover, manycan remain ill for a number of years and may not get better. Not every ME sufferer has the potential for safe activity or stimulation limits within which they will not exacerbate their illness, which is very much the case for the very severely and profoundly affected.
List of characteristics associated with ME:
- Acute onset (associated with a virus; an enterovirus)
- The disease occurs in outbreaks as well as sporadically (the incubation period of the virus is 4-7 days)
- Damage to the central nervous system (which is observable on brain scans, and which is similar to MS)
- Consequences of neurological damage such as loss of homeostasis in many of the body’s systems
- Abnormalities seen on many different objective tests (including ESR tests, NK cells tests, Holter monitors and physical exam) within weeks of disease onset
- Seizures and paralysis
- Cognitive dysfunction, involving concentration, memory and perceptual problems
- Sensory disturbance and over-sensitivity
- Reduced circulating blood volume and associated problems such as orthostatic intolerance, neurally mediated hypotension and POTS
- Cardiac abnormalities such as tachycardia and reduced cardiac function
- Mitochondrial dysfunction, resulting in loss of energy production, and impaired immunity and cellular repair capability
- Immune dysfunction
- Delayed effect following physical, mental or sensory overexertion (24 to 72 hours or more)
- Worsening of illness, serious relapse or possibly death following overexertion
- Severe disability lasting many years (most often lifelong) which may also result in death
"In view of more recent research and clinical experience that strongly point to widespread inflammation and multisystemic neuropathology, it is more appropriate and correct to use the term 'myalgic encephalomyelitis' (ME) because it indicates an underlying pathophysiology."
- Carruthers et al, Journal of Internal Medicine
List of characteristics associated with ‘CFS’
- Gradual onset
- Onset following overwork or stress
- Onset following EBV infection (or other common viruses including flu, Ross River virus, hepatitis infections and so on)
- Fatigue or exhaustion (as the defining or most severe symptom of the illness) or symptoms referred to as vague and ‘everyday’ type symptoms
- Omission of the serious neurological and cardiac (and other) dysfunctions which define M.E.
- Emotional state, personality type or psychological history associated with causing or prolonging illness
- Short duration of illness and/or naturally resolving illness after a short period of time or illness which resolves or improves with exercise therapy, psychotherapy or antidepressant drugs (or similar)
- Mild illness which cannot result in death
"Where the one essential characteristic of ME is acquired CNS (central nervous system) dysfunction, that of CFS is primarily chronic fatigue."
● The acute onset.
● The organ pathology, particularly cardiac.
● Neurological signs in the acute and sometimes chronic phases.
● The specific involvement of the autonomic nervous system.
● The frequent subnormal patient temperature.
● The fact that chronic fatigue is not an essential characteristic of the chronic phase of ME.