Trial By Error: Professor Jonathan Edwards’ View of ME (includes discussion of exercise and long-term harm)

http://www.virology.ws/2019/12/02/trial-by-error-professor-jonathan-edwards-view-of-me/

 

Brilliant

 

Thank you @Jonathan Edwards.

I could not help but read the comments at the bottom of the article, with the usual fights about ‘ME is not CFS’ and ‘it’s the enterovirus, stupid’. I am so over that.

 

A no-nonsense thing of beauty. Brilliant overview.

But the “CFS” term has no pros to it whatsoever, even in the broadest and most philosophical view.

 

Jo's article is discussed here as well, https://www.s4me.info/threads/helpf...cal-me-research-jonathan-edwards-essay.12589/ (Members only thread).

 

https://twitter.com/user/status/1201926420735414273

https://twitter.com/user/status/1201927575964192768

 

Yes, I have looked through them. I am happy to listen to every view but I have not so far changed my own.

 

The comments are a bit spicy but I'm glad to see people express their views directly.

One of the main points of contention is subgroups (or some are saying totally different conditions) but I tend to think that by studying severe patients and/or large numbers of patients (e.g. biobank), the signal(s) will come through despite 'impure' sampling - when we manage to look in the right place.

 

It didn't seem like subgroups to me - more that CFS is not ME.

 

Is that contentious? It was once generally accepted that all ME was CFS, but not all CFS was ME. They are only words and definitions. They mean what you want them to mean.

 

A portion of the latest comment. That seems worth responding to. I vaguely remember that SPECT scan is another questionable or nonspecific diagnostic test promoted by an elite ME expert. Am I wrong?

As for the second paragraph, I would say the true ME crowd has a tendency to engage in illness denial and superficially authoritative but substanceless talk to dazzle the uninformed. Exactly like the CBT/GET crowd.

 

I shall have to research some history. I was unaware that brain scans were readily available in 1955.

 

I think it would be counterproductive to try to engage with comments on Virology blog. The place for rational discussion is here, I think.

The point about brain lesions on imaging is intriguing. I think there is a false argument involved.
As I understand it:

1. The epidemic at the Royal Free, and maybe also in Iceland and elsewhere, was said to include cases of paralysis and also perhaps some cranial nerve lesions.

2. Paralysis occurs in poliomyelitis because of lower motor neurone cell body damage in the cord and is flaccid (floppy).

3. Perhaps because of other neurological findings as well as paralysis at Royal Free it was suggested that it might be due to an infection that produced not just myelitis but encephalitis as well - encephalomyelitis.

4. When encephalitis produces paralysis it is always (long term) a spastic paralysis. As far as I know none of the RF cases had spastic paralysis and nobody with ME since has been found to have spastic paralysis.

5. So the reason for calling ME encephalomyelitis was based on a mistake. It was not based on finding brain lesions on scans because there were no scans then. It was based on an inference of brain lesions that in hindsight was not good neurology.

6. So there is no reason to think that brain lesions on scans in any way point to a diagnosis of ME. If anything the presence of brain lesions in someone with clinical ME points to them having some other undiagnosed encephalopathy, not the illness Ramsay reported. The illness Ramsay reported did not include evidence of brain lesions.

 

It would be interesting to know which of the Royal Free cases were the ones which went on to have the protracted illness, and which recovered. Were they among the twenty "serious" cases reported by M and B - or were they from apparently less "florid" cases? Is that reported anywhere? I have not seen it.

It seems telling that M and B reported, in 1970, that one case remained ill for a year. Some detailed research there, then.

 

Behan tracked most of them down and found most though I do not know how many ) had recurrent/ lingering illness for the rest of their lives- it is in the youtube clip from Scottish BBCAlba that is on a different thread
It may be this one ( no mic on work computer and no headphones with me)

https://www.youtube.com/watch?v=lKSC0OS6Zdo

 

Ha! I like to think SOME rational discussion can take place there as well!!

 

Thanks @Amw66.
Starts about 2.30