Symptoms and signs of ME, all of which are exacerbated by stress, include :
According to the Canadian Consensus Document to have ME : " A patient with ME/CFS will meet the criteria for fatigue, post-exertional malaise and/or fatigue, sleep dysfunction, and pain; have two or more neurological/cognitive manifestations and one or more symptoms from two of the categories of autonomic, neuroendocrine and immune manifestations ", plus you must have been ill for at least six months.
Source : Caruthers, et al (2003) "Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols," The Journal of Chronic Fatigue Syndrome, Vol. 11 (1) 2003, pp. 7-116. http://www.myalgic-encephalomyelitis.com/ME-CFS-canada-protocol.html
The new biomedical ME International Consensus Criteria (ICC), an attempt to identify the unique and distinctive characteristic symptoms of ME ( Carruthers et al 2011 ), uses the original clinical term of Myalgic Encephalomyelitis , in stark contrast to the prevailing vague, fatigue-based Oxford and CDC criteria which dominate at the moment. To be diagnosed as having ME :
A patient has to meet the criteria for :Postexertional neuroimmune exhaustion :
They also have to have at least one symptom from three of four neurological impairment categories :
Neurocognitive impairments :
Sleep disturbance :
Neurosensory, perceptual and motor disturbances :
The International Consensus Criteria provide a framework for the diagnosis of ME that is consistent with the patterns of pathophysiological dysfunction emerging from published research findings and clinical experience. ( Carruthers et al 2011 )
At least one symptom is required from three immune/gastro-intestinal/genitourinary impairment categories :
And at least one symptom from energy metabolism/transport impairments :
Since 1993 my wife has not known a moment’s respite from the screaming, throbbing, itching, symptoms that paralyse, numb, hurt every part of her body; sometimes I think that if took on board the full reality of my wife’s suffering I would explode.
15th July 2010
"Another morning. I lie here in the vastness of agony. There are no words to describe its onslaught. It is intense, all encompassing, everywhere. I am in it and I am it.
My whole body lies motionless. My arms above my head, impaled upon the pillow, I cannot move them. Mysterious as to how they got there, I struggle with my breathing. How long have I lain deep in this posture ? My left leg is outstretched, numbness pervades it. My right leg is bent out at an angle. I cannot feel my toes. My feet and hands pound, in the very centre, a throbbing beat of pain.
How long will this go on ? Hours probably, yet always these experiences lie within me, the pain ever present whether I am paralysed in bed or sitting on a chair. The experience is ever present within me, no matter what my external posture.
My face burns, prickles, throbs too in rhythmic unison. My face is palsied. I cannot even cry out, yet the hurt rages in me and I long to escape from this tormented place.
My head pounds inwardly and burns outwardly.
Please do not touch me. The contact will send me over the edge and still I would not be able to move.
My eyeballs throb, my lids are shut, unable to open to the dim lit room which still would pierce my eyes with pain, were they open.
My head pounds too. The pain is even worse in my arms. My arms and chest have melted into one large immense ball of throbbing agony, immobilised my body feels dead in so many ways, only alive to the pain that holds it together.
This is no odd occurrence. I return to this place again and again; always impossibly difficult to describe."