List of symptoms in ME CFS/ICC/PENE

Post-exertional Neuroimmune Exhaustion (PENE) is a compulsory neuroimmune symptom in the International Consensus Criteria diagnostic criteria for Myalgic Encephalomyelitis. PENE is also known as Post-exertional Malaise (PEM).

This cardinal feature is a pathological inability to produce sufficient energy on demand with prominent symptoms primarily in the neuroimmune regions. Characteristics are:


 * Marked, rapid physical and/or cognitive fatigability in response to exertion, which may be minimal such as activities of daily living or simple mental tasks, can be debilitating and cause a relapse.
 * Post-exertional symptom exacerbation: e.g. acute flu-like symptoms, pain and worsening of other symptoms.
 * Post-exertional exhaustion may occur immediately after activity or be delayed by hours or days.
 * Recovery period is prolonged, usually taking 24 hours or longer. A relapse can last days, weeks or longer.
 * Low threshold of physical and mental fatigability (lack of stamina) results in a substantial reduction in pre-illness activity level.

Learn more

 * List of symptoms in ME/CFS


 * International Consensus Criteria