25 world ME/CFS specialists with 400 years together in treating the illness have written a new consensus criteria for ME, which is being called on to be recognised world wide .. Published Journal of Internal Medicine
(this is to stop those with just severe chronic depression from falling under the old Reeves CFS definition and being diagnosed with CFS.. so the international ME criteria has been made and is being brought in)
The new International consensus criteria for ME is
Table 1 MYALGIC ENCEPHALOMYELITIS: INTERNATIONAL CONSENSUS
CRITERIA Adult and Pediatric ● Clinical and Research
Myalgic encephalomyelitis is an acquired neurological disease with complex global
dysfunctions. Pathological dysregulation of the nervous, immune and endocrine
systems, with impaired cellular energy metabolism and ion transport are prominent
features. Although signs and symptoms are dynamically interactive and causally
connected, the criteria are grouped by regions of pathophysiology to provide general
A patient will meet the criteria for post-exertional neuroimmune exhaustion (A), at
least one symptom from three neurological impairment categories (B), at least one
symptom from three immune/gastro-intestinal/genitourinary impairment categories
(C), and at least one symptom from energy metabolism/transport impairments (D).
A. Post-Exertional Neuroimmune Exhaustion (PENE pen
׳-e) Compulsory This cardinal
feature is a pathological inability to produce sufficient energy on demand
with prominent symptoms primarily in the neuroimmune regions. Characteristics are:
1. Marked, rapid physical and/or cognitive fatigability in response to exertion, which
may be minimal such as activities of daily living or simple mental tasks, can be
debilitating and cause a relapse.
2. Post-exertional symptom exacerbation: e.g. acute
flu-like symptoms, pain and worsening of other symptoms
3. Post-exertional exhaustion may occur immediately after activity or be delayed by
hours or days.
4. Recovery period is prolonged, usually taking 24 hours or longer. A
relapse can last days, weeks or longer. 5. Low threshold of physical and mental
fatigability (lack of stamina) results in a substantial reduction in pre-illness activity
Operational Notes: For a diagnosis of ME, symptom severity must result in a
significant reduction of a patient’s premorbid activity level. Mild (an approximate 50%
reduction in pre-illness activity level), moderate (mostly housebound), severe (mostly
bedridden), or very severe (totally bedridden and need help with basic functions).
There may be marked fluctuation of symptom severity and hierarchy from day to day
or hour to hour. Consider activity, context and interactive effects. Recovery time:
e.g. Regardless of a patient’s recovery time from reading for 1⁄2 hour, it will take
much longer to recover from grocery shopping for 1⁄2 hour and even longer if
repeated the next day – if able. Those who rest before an activity or have adjusted
their activity level to their limited energy may have shorter recovery periods than
those who do not pace their activities adequately. Impact: e.g. An outstanding athlete
could have a 50% reduction in his/her pre-illness activity level and is still more active
than a sedentary person.
(see rest of the criteria in next thread..)
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