Myalgic encephalomyelitis/chronic fatigue syndrome

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex, chronic disease characterized by extreme fatigue that is not improved by rest and may be worsened by physical or mental activity. The condition affects multiple systems in the body, including the neurological, immune, and metabolic systems.

Symptoms

The primary symptom of ME/CFS is a profound fatigue that is not alleviated by rest. Other symptoms include:

• Post-exertional malaise (PEM), where symptoms worsen after physical or mental exertion.
• Unrefreshing sleep.
• Cognitive impairments, often referred to as "brain fog."
• Orthostatic intolerance, where symptoms worsen when standing or sitting upright.
• Muscle and joint pain.
• Headaches of a new type, pattern, or severity.
• Sore throat and tender lymph nodes.

Post-exertional Malaise

Timeframe of PEM from daily activities

Post-exertional malaise is a hallmark of ME/CFS, characterized by a significant exacerbation of symptoms following physical or mental exertion. This can last for days, weeks, or even longer, and is often disproportionate to the level of exertion.

Quality of Life

Quality of life comparison for ME/CFS

Individuals with ME/CFS often experience a significant reduction in quality of life. The condition can severely limit daily activities and social interactions, leading to isolation and depression. The impact on quality of life is comparable to other chronic conditions such as multiple sclerosis and rheumatoid arthritis.

Diagnosis

Diagnosing ME/CFS can be challenging due to the lack of specific laboratory tests and the overlap of symptoms with other conditions. Diagnosis is primarily based on clinical evaluation and the exclusion of other possible causes of fatigue.

Exercise and Activity Management

Work rate at ventilatory threshold

Exercise and activity management are crucial in managing ME/CFS. Patients are often advised to engage in "pacing," a strategy that involves balancing activity and rest to avoid exacerbating symptoms. Graded exercise therapy (GET) has been controversial and is not universally recommended.

Epidemiology

ME/CFS incidence rate by age

ME/CFS affects people of all ages, but it is most commonly diagnosed in individuals between 40 and 60 years old. Women are more frequently affected than men. The prevalence of ME/CFS varies globally, with estimates ranging from 0.2% to 2.6% of the population.

Public Awareness and Advocacy

Petition presentation by M.E Support in Glamorgan

Public awareness and advocacy efforts have increased in recent years, with campaigns aimed at improving understanding and support for those affected by ME/CFS. Awareness ribbons and other symbols are used to promote visibility and solidarity.

Research

ME-CFS papers by year

Research into ME/CFS is ongoing, with studies focusing on potential causes, diagnostic markers, and treatment options. The condition is believed to involve a combination of genetic, environmental, and biological factors.

See also

• Fibromyalgia
• Multiple sclerosis
• Chronic pain
• Autoimmune disease