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

[Andy]

Abstract available in Spanish and English, rest of paper 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.

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

 

[ME/CFS Skeptic]

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

 

[Snow Leopard]

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:

Conclusions
The states of chronic idiopathic fatigue associated with neurological, immunological and emotional symptoms have received many names throughout history, such as neurasthenia, epidemic neuromiastenia, ME, CFS and the current SEID proposal.

From a practical point of view, the family doctor should suspect the presence of this syndrome in a patient who reports fatigue of more than 6 months, either continuously or intermittently. All this with an analytical and exploration that do not reflect any alteration that can explain the state of weakness and disability that the patient refers to and that makes it difficult or even impossible to maintain a normal activity.

The complexity of this picture requires the collaboration of other colleagues to establish the diagnosis. To date there are no objective criteria that help in the diagnosis or monitoring of this disease, so it is necessary to investigate to clarify its etiopathogenic mechanisms.

 

[Trish]

I wish the starting point for looking at definitions would not be 'chronic idiopathic fatigue', but abnormal muscular and cognitive fatiguability and PEM. The trouble is, I think all the definitions head their list of symptoms with 'chronic disabling fatigue', which leads people studying the history off on a wild goose chase of things like neurasthenia and anything else that mentions fatigue.

This translated abstract looks like it was written by someone who has no idea about ME. Am I being too harsh? I can't read Spanish.

 

[Mithriel]

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.

 

[Sid]

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

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.

 

[DokaGirl]

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.

 

[Dx Revision Watch]

Merged thread

Moderator note:
Message copied from this thread.
https://www.s4me.info/threads/neura...elic-2019-overholser-et-al.11031/#post-198294


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.