New diagnostic criteria for ME have been published by 25 authors from 13 countries, led by Canadian guidelines editors Bruce M Carruthers MD CM FRCP(C) and Marjorie I van de Sande BEd GradDip Ed, and including WAMES’ medical adviser Dr Nigel Speight. The panel used the Canadian consensus document as a starting point but made a number of significant changes, achieving 100% consensus and citing 123 publications to support its recommendations.
Main points include:
- “In view of more recent research and clinical experience that strongly point to widespread inflammation and multisystemic neuropathology, it is more appropriate and correct to use the term “myalgic encephalomyelitis”(ME) because it indicates an underlying pathophysiology.”
- “…diagnosis should be made when the clinician is satisfied that the patient has ME rather than having the diagnosis restricted by a specified time factor. Early diagnoses may elicit new insights into the early stages of pathogenesis; prompt treatment may lessen the severity and impact.”
- “A patient with ME will meet the criteria for post-exertional neuroimmune exhaustion (PENE), at least one symptom from three neurological impairment categories, at least one symptom from three immune/gastro-intestinal/genitourinary impairment categories, and at least one symptom from energy metabolism/transport impairments.”
- “Post-exertional neuroimmune exhaustion is part of the body’s global protection response and is associated with dysfunction in the regulatory balance within and between the nervous, immune and endocrine systems, and cellular metabolism and ion transport. The normal activity/rest cycle, which involves performing an activity, becoming fatigued, and taking a rest whereby energy is restored, becomes dysfunctional.”
- “Atypical Myalgic Encephalomyelitis meets criteria for post-exertional neuroimmune exhaustion but has two or less than required of the remaining criterial symptoms.”
