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Myalgic Encephalomyelitis (abbreviated ME) is a chronic, inflammatory, primarily neurological disease that is multisystemic, affecting the central nervous system (CNS), immune system and cardiovascular system, the endocrinological system and musculoskeletal system. ME can cause a wide variety of symptoms, including changes in sensory tolerance, visual problems, exertional muscle weakness, difficulties with coordination and speech, severe fatigability, cognitive impairment, problems with balance, subnormal or poor body temperature control (due to circulation issues) and severe pain. ME will cause a degree of impaired mobility and disability in all cases. The degree of impairment and complexity depends on the degree of diffuse brain injury and end organ involvement.

Myalgic Encephalomyelitis affects the brain and spinal cord which control the body, allow thought and sensory processing, causing dysautonomia, impaired thinking and loss of internal homeostasis, the process whereby the body maintains a consistent internal environment in response to external stressors. Cellular metabolism and communication is disrupted, causing inefficiency in all biological processes. This includes the cellular mitochondria which process fuel to make energy, resulting in a deficiency of adenosine-triphosphate ATP with a chronic, severe, measurable loss of sustainable strength on exertion. A hallmark of ME is intolerance to previously trivial effort and deterioration through persistent or repeated exertion (often resulting in relapse).

Current theory suggests ME results from a persistent viral infection and/or attacks by an individual's immune system on the nervous system, musculoskeletal system, and blood vessels. It has been classified by the World Health Organisation as an organic brain disease since 1969. There is a controversial view that ME is not a chronic infectious or autoimmune disease, but rather a illness triggered by infection along with stress. Usually proponents of this school disdain the term ME, claiming it to be inaccurate. Although more than 50 years of research and clinical observation informs knowledge of ME pathology, its exact cause remains unknown and more research is required particularly for treatment.

ME patients are barred from donating blood or organs in the United Kingdom.

Myalgic encephalomyelitis is a relapse-remitting disease with new symptoms occurring either in discrete relapses (or "crashes") or slowly accruing over time. Between relapses, symptoms may resolve completely with sufficient rest, BUT permanent neurologic problems usually persist, especially as the disease advances. ME currently does not have a cure, though some treatments such as antivirals are being trailed which may at least slow the appearance of new symptoms.

ME affects all ages, with peak incidence typically between 20 and 40 years, and is more common in women than in men.

The name Myalgic Encephalomyelitis refers to the inflammation of the brain and spinal cord accompanied by muscle pain.

In 1988 The US Centers for Disease Control (CDC) for reasons best known to them dismissed fifty years of research and decided to treat the Lake Tahoe outbreak as a new illness, which they christened chronic fatigue syndrome (CFS). CFS is a highly contentious concept to patients and specialists alike. Because of the similarity in terminology, CFS is often confused with "chronic fatigue". A study found that while most medical trainees consider the symptom complex of CFS to be a serious illness resulting in poor quality of life, the "chronic fatigue syndrome" name may be regarded less seriously than the name "myalgic encephalopathy".[] Another study found that nurses and physician assistants viewed a patient's CFS symptoms as more severe and disabling if they were told the patient had a more medical sounding accurate diagnosis of "chronic neuroendocrineimmune dysfunction syndrome".[]

Patients and specialists alike had long lobbied for a name and definition change or reversal of "CFS". In January 2007 The American "CFS Name Change Advisory Board" consisting of doctors Bateman, Bell, Cheney, Jason, Klimas, Lapp, and Peterson agreed that ""CFS downplays the severity of the disease and is hurtful to patients" and publicised their deliberation that CFS should now be termed ME.

The core symptom of ME is muscle fatigability following minimal exertion plus delayed recovery of muscle power. Ramsay, a world authority on ME referred to a diagnostic triad of muscle fatigability, central nervous system involvement and impaired circulation. However, ME affects many bodily systems and other symptoms include increased sensitivity to light and sound (photosensitivity, hyperacusis) and general migraine-like sensory intolerance, changes in sensation (hypoesthesia), muscle spasms (myclonus or fasciculation), or difficulty initiating movement (transient paralysis); difficulties with coordination and balance (ataxia); problems in speech and verbalisation (Dysarthria, Dysphasia), visual problems (Nystagmus (involuntary twitching or rolling of the eyes), blurred vision), and acute or chronic pain, difficulty standing (orthostatic intolerance), cardiopulmonary symptoms (palpitations, dysrhythmia and dyspnea), sleep dysregulation (hypersomnia, insomnia or sleep reversal), gastroenteric difficulties, cognitive impairment, or emotional symptomatology (emotional lability or depression). Side effects much like that seen in polio, M.S., or A.I.D.S. What differentiates ME from similar conditions is the close link with exertion and the variability, not only from day to day, but from hour to hour.

ME is diagnosed definitively using case history to look for a distinctive pattern and type of symptoms and signs. Diagnosis necessitates involvement of the CNS and muscoskeletal symptomology.

There are no accepted clinical criteria for ME but all descriptions tend to emphasize muscle fatigability and central nervous system involvement. The Canadian Consensus criteria represents international efforts to standardize the diagnosis of ME using clinical data and laboratory data but are controversial. The list of symptoms is long and there is therefore a danger of misdiagnosis. Research criteria based on Ramsay's descriptions have been used in various studies e.g. Costa et al, 1995.

Generally consistent findings of a novel low molecular weight antiviral protein (Rnase-L) have shown promise as a potential diagnostic test for CFS and may be relevant to ME. Another test which may become important in the future is an assay of genes for the immune system and mitochondria, however, these tests are so far seen as discretionary. Without research criteria for ME, it is not possible to confirm that abnormalities found in people with chronic fatigue syndrome are also generalizable to ME.

The signs and symptoms of ME can be similar to other medical problems, such as multiple sclerosis, Lyme disease, lupus, anemia, cancers, and other autoimmune problems, such as lupus, sarcoidosis. Additional testing may be needed to help distinguish ME from these other problems.