From neurasthenia to post-exertion disease: Evolution of the diagnostic criteria of chronic fatigue syndrome/myalgic encephalomyelitis, 2019, Murga

Abstract available in Spanish and English, rest of paper in Spanish.

Open access at www.sciencedirect.com/science/article/pii/S021265671930191X

 

Mi español no es lo suficientemente bueno para leer el estudio, ¿puede alguien resumir si es bueno o no?

 

The article is basically a narrative review of the various names and clinical definitions for CFS over the years. The article doesn't really delve into etiology nor treatment.

Google Translate conclusion:

 

That's why I like the name ME as it emphasises muscle problems and neurological problems without fatigue being there. It just wasn't seen as primary in the days before CFS.

I suppose SEID is better from that point of view as well.

 

What plan of action? Any action an ME patient takes generally makes the condition worse. There are no evidence-based treatments and no known causal mechanism.

 

The standard patter at the beginning of many articles on ME seems to be just that, something that comes from a template, or the same song sheet over and over. Always "complex" true, but it grates that authors usually say "controversial" as well. If they are biomedical scientists, with a solid grounding in ME, I hope they don't say ME is controversial. More original intros stressing the biomedical reality of ME would be very welcome.

 

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https://www.sciencedirect.com/science/article/pii/S021265671930191X

Atención Primaria
Available online 8 June 2019
In Press, Corrected

From neurasthenia to post-exertion disease: Evolution of the diagnostic criteria of chronic fatigue syndrome/myalgic encephalomyelitis

ÍñigoMurgaJosé-VicenteLafuente
https://doi.org/10.1016/j.aprim.2019.04.004Get rights and content
Under a Creative Commons license

Abstract in English and Spanish

Text in Spanish

Abstract

Changes in the terminology and diagnostic criteria for chronic fatigue syndrome/myalgic encephalomyelitis are explained in this paper.

This syndrome is a complex and controversial entity of unknown origins. It appears in the medical literature in 1988, although clinical pictures of chronic idiopathic fatigue have been identified since the nineteenth century with different names, from neurasthenia, epidemic neuromyasthenia, and benign myalgic encephalomyelitis up to the current proposal of disease of intolerance to effort (post-effort). All of them allude to a chronic state of generalised fatigue of unknown origin, with limitations to physical and mental effort, accompanied by a set of symptoms that compromise diverse organic systems.

The International Classification of Diseases (ICD-10) places this syndrome in the section on neurological disorders (G93.3), although histopathological findings have not yet been found to clarify it.

Multiple organic alterations have been documented, but a common biology that clarifies the mechanisms underlying this disease has not been established. It is defined as a neuro-immune-endocrine dysfunction, with an exclusively clinical diagnosis and by exclusion.

Several authors have proposed to include CFS/ME within central sensitivity syndromes, alluding to central sensitisation as the common pathophysiological substrate for this, and other syndromes.

The role of the family doctor is a key figure in the disease, from the detection of those patients who present a fatigue of unknown nature that is continuous or intermittent for more than 6 months, in order to make an early diagnosis and establish a plan of action against a chronic disease with high levels of morbidity in the physical and mental sphere.

Objective
To carry out a bibliographic review of the terminology and diagnostic criteria of the chronic fatigue syndrome/myalgic encephalomyelitis, in order to clarify the pathology conceptually, as a usefulness in the diagnosis of Primary Care physicians.