Myalgic Encephalomyelitis (ME) 

Myalgic Encephalomyelitis (ME) is a severe chronic illness in which symptoms are worsened by physical exertion. In some countries and some literature, ME is referred to as Chronic Fatigue Syndrome (CFS).

The term Myalgic Encephalomyelitis can be broken down as “My” referring to muscle and “algic” to pain. “Encephalo” referring to the brain, “myel” to spinal cord and “it is” denotes inflammation.

ME is an acquired illness that affects all body systems; predominantly the neurological, endocrine and immune systems. It is classified as a neurological illness in the World Health Organization (WHO) International Classification of Diseases and can be severely debilitating. Many people become ill after a bought of the flu or another illness.

Based on the Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols (Carruthers et al. Journal of Chronic Fatigue Syndrome 11, no 1 (2003) 7-115) (also known as the Canadian Consensus Document), in order to be diagnosed, a patient must have the following:

1. New onset of Fatigue: unexplained recurrent physical and mental fatigue that significantly alters activity level.

2. Post-Exertional Fatigue: After physical activity there is an increase in symptoms and/or an extended recovery period usually lasting a day or more.

3. Sleep Dysfunction: There is unrefreshed sleep and/or difficult getting to or maintaining sleep.

4. Pain: There is a significant degree of muscle pain. Pain can also be experienced in the joints and is often widespread and changes location. Often there is a new onset of headaches post-illness. Headaches may be of a difference quality and in a different location than in the past.

5. Two or more Neurological/Cognitive Manifestations:

confusion, impairment of concentration and short term memory; disorientation; difficulty with information processing, categorizing, and word retrieval; and perceptual and sensory disturbances. The Expert Panel describes overload phenomena – cognitive and sensory – i.e. heightened sensitivity to lights and noise – and/or emotional overload, which may lead to “crash” periods and /or emotional symptoms.

6. At least one symptom from two of the following categories:

• a. Autonomic Manifestations: blood pressure abnormalities, particularly when rising from lying or seated position, often called delayed postural hypotension’ light-headedness; nausea and irritable bowel syndrome’ urinary frequency and bladder dysfunction; heart palpitations, shortness of breath with physical activity.
• b. Neuroendocrine Manifestations: “Thermostat” regulation is lost, presenting as lowered body temperature with significant daily fluctuation, sweating episodes, recurrent feelings of feverishness and cold extremities; intolerance of extremes of heat and cold; significant weight change – lack of or abnormal appetite; worsening of symptoms with stress.
• c. Immune Manifestations: Tender lymph nodes; recurrent sort throat, recurrent flulike symptoms; general malaise: new sensitivities to food, medications, and/or chemicals.

7. The illness is chronic and lasts for at least six months in adults, three months in children. It usually has a distinct onset, although it may be gradual.

For more information, please read the Canadian Consensus documents.

The following videos will give you a good introduction to ME.