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Common symptoms in ME/CFS
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'''Common symptoms in ME/CFS''' include [[post-exertional malaise]], multiple types of [[fatigue]], and a range of [[Nervous system|neurological]], [[Cardiovascular system|cardiovascular]], [[Metabolic|energy metabolism]] and [[Endocrine system|endocrine symptoms]].<ref name=":3">{{citation | last1 = Carruthers | first1 = BM | author-link1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | author-link3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | author-link4 = Nancy Klimas | last5 = Broderick | first5 = G | author-link5 = Gordon Broderick | last6 = Mitchell | first6 = T | author-link6 = Terry Mitchell | last7 = Staines | first7 = D | author-link8 = Donald Staines | last8 = Powles | first8 = ACP | author-link8 = A C Peter Powles | last9 = Speight | first9 = N | author-link9 = Nigel Speight | last10 = Vallings | first10 = R | author-link10 = Rosamund Vallings | last11 = Bateman | first11 = L | author-link11 = Lucinda Bateman | last12 = Bell | first12 = DS | author-link12 = David Bell | last13 = Carlo-Stella | first13 = N | author-link13 = Nicoletta Carlo-Stella | last14 = Chia | first14 = J | author-link14 = John Chia | last15 = Darragh | first15 = A | author-link15 = Austin Darragh | last16 = Gerken | first16 = A | author-link16 = Anne Gerken | last17 = Jo | first17 = D | author-link17 = Daehyun Jo | last18 = Lewis | first18 = DP | author-link18 = Donald Lewis | last19 = Light | first19 = AR | author-link19 = Alan Light | last20 = Light | first20 = KC | authorlink20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 = S | authorlink21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 = J | authorlink22 = John McLaren-Howard | last23 = Mena | first23 = I | authorlink23 = Ismael Mena | last24 = Miwa | first24 = K | authorlink24 = Kunihisa Miwa | last25 = Murovska | first25 = M | authorlink25= Modra Murovska | last26 = Stevens | first26 = SR | authorlink26 = Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012 | isbn = 978-0-9739335-3-6 | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf }}</ref><ref>{{Cite journal | last = De Becker | first = P. | last2 = McGregor | first2 = N. | last3 = De Meirleir | first3 = K. | date = 2001-09-15 | title = A definition-based analysis of symptoms in a large cohort of patients with chronic fatigue syndrome | url =https://onlinelibrary.wiley.com/doi/pdf/10.1046/j.1365-2796.2001.00890.x | journal = Journal of Internal Medicine|volume=250 | issue = 3 | pages = 234β240|doi=10.1046/j.1365-2796.2001.00890.x|issn=0954-6820}}</ref><ref>{{Cite journal | last = Jason | first = Leonard A. | last2 = Sunnquist | first2 = Madison | last3 = Brown | first3 = Abigail | last4 = Evans | first4 = Meredyth | last5 = Vernon | first5 = Suzanne D. | last6 = Furst | first6 = Jacob | last7 = Simonis | first7 = Valerie | date = 2014-01-01 | title = Examining case definition criteria for chronic fatigue syndrome and myalgic encephalomyelitis |url =https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3912876/ | journal = Fatigue : biomedicine, health & behavior|volume=2 | issue = 1 | pages = 40β56|doi=10.1080/21641846.2013.862993|issn=2164-1846|pmc=3912876|pmid=24511456}}</ref><ref name=":2">{{Cite journal | last = Carruthers | first = Bruce M. | last2 = Jain | first2 = Anil Kumar | last3 = De Meirleir | first3 = Kenny L. | last4 = Peterson | first4 = Daniel L. | last5 = Klimas | first5 = Nancy G. | last6 = Lerner | first6 = A. Martin | last7 = Bested | first7 = Alison C. | last8 = Flor-Henry | first8 = Pierre | last9 = Joshi | first9 = Pradip | date = May 2002 | title = Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Clinical Working Case Definition, Diagnostic and Treatment Protocols |url =http://www.investinme.org/Documents/PDFdocuments/CanadianDefinitionME-CFS.pdf#page=10 | journal = Journal of Chronic Fatigue Syndrome|language=en|volume=11 | issue = 1 | pages = 7β115|doi=10.1300/j092v11n01_02|issn=1057-3321|via=}}</ref> [[Myalgic encephalomyelitis]] (ME) and [[chronic fatigue syndrome]] (CFS) is often referred to as [[ME/CFS]] as it is clear there are common onsets and symptoms shared by both the disease [[Myalgic encephalomyelitis|ME]] and the symptoms that define [[Chronic fatigue syndrome|CFS]]. ==Chronic Fatigue Syndrome== [[:Media:Common ChronicFatigueSyndrome Symptoms.png|<div style="color:black; float: left"> {{Bar chart | title = <div style="font-size:1.4em; margin-bottom: 0.4em;">Common Symptoms in Chronic Fatigue Syndrome</div> | bar_width = 15 | width = 30 | width_units = em | label_type = Symptom | label1 = Fatigue - persist or relapsing* | label2 = Significant reduction in activities* | label3 = Symptoms last over 6 months* | label4 = Post-exertional malaise | label5 = Memory & concentration probs | label6 = Unrefreshing sleep | label7 = Headaches - new or different | label8 = Muscle pain (myalgia) | label9 = Sore throat | color = rgb(100,200,200) | data_type = Mild to Severe<br> Symptom % | data_max = 101 | data1 = 100 | data2 = 100 | data3 = 100 | data4 = 96 | data5 = 98 | data6 = 99 | data7 = 90 | data8 = 96 | data9 = 81 | col2_data_type = Moderate to Severe<br> Symptom % | col2_data_max = 101 | col2_data1 = 95 | col2_data2 = 100 | col2_data3 = 100 | col2_data4 = 86 | col2_data5 = 80 | col2_data6 = 92 | col2_data7 = 50 | col2_data8 = 73 | col2_data9 = 31 |caption= '''Source: Jason et al. 2014''' }} <nowiki>*</nowiki>Required symptom, can be mild </div>]] <br>Jason et al. (2014) found these symptoms were the most common among people who met the Fukuda criteria, which are the symptoms normally used to diagnose in the US and UK. <br style="clear:both">Approximately 60% of people with Chronic Fatigue Syndrome also meet the criteria for M.E.<ref name=":0" /> {| class="wikitable sortable alternance" style="background:white; font-size:125%;" ! Symptom !! Mild to Severe<br>Symptom !! Moderate or Severe<br>Symptom |- | Fatigue - persist or relapsing* || 100 || 95 |- | Substantial reduction in activities* || 100 || 100 |- | Symptoms last over 6 months* || 100 || 100 |- | Post-exertional malaise || 96 || 86 |- | Memory & concentration difficulties || 98 || 80 |- | Unrefreshing sleep || 99 || 92 |- | New or different headaches || 90 || 50 |- | Muscle pain (myalgia) || 96 || 73 |- | Sore throat || 81 || 31 |- | Joint pain (arthralgia) || 86 || 65 |- | Lymph node pain || 81 || 44 |} <nowiki> *</nowiki>Required symptom, can be mild == Myalgic Encephalomyelitis == [[:Media:Common ME Symptoms.png| <div style="color:black; float: left"> {{Bar chart | title = <span style="font-size:125%">Common Myalgic Encephalomyelitis Symptoms</span> | bar_width = 15 | width_units = em | float = left | color1 = rgb(250, 0, 0) | caption = '''Sources: Jason et al. 2016, Intl Consensus Criteria 2011''' | label_type = Symptom | label1 = <span style="font-size:115%">50% reduction in previous activity level</span> | label2 = <span style="font-size:115%">Post-exertional neuroimmune exhaustion</span> | label3 = <hr>Fatigue - moderate or severe | label4 = <hr>Minimum exercise makes you tired | label5 = Next-day soreness after mild activity | label6 = Physically drained/sick after mild activity | label7 = Dead, heavy feeling after start of exercise | label8 = Mentally tired after slightest effort | label9 = <hr>Unrefreshing sleep | label10 = Difficulty paying attention for long | label11 = Muscle pain (myalgia) | label12 = <hr>Sensitive to smells/foods/drugs/chemicals | label13 = Flu-like symptoms | label14 = Irritable bowel problems | label15 = <hr>Feeling hot / cold for no reason | data_type = % | data_max = 100 | data1 = 100 | data2 = 100 | data3 = 80 | data4 = 82 | data5 = 79 | data6 = 77 | data7 = 73 | data8 = 68 | data9 = 82 | data10 = 77 | data11 = 69 | data12 = 67 | data13 = 64 | data14 = 56 | data15 = 58 | comment1 = Required | comment2 = Required | comment3 = | comment4 = PENE | comment5 = | comment6 = | comment7 = | comment8 = | comment9 = Neuro | comment10 = | comment11 = | comment12 = Immune / GI / Urinary | comment13 = | comment14 = | comment15 = Ion transport / Metabolism }} </div>]] <br>Myalgic Encephalomyelitis diagnosis requires more symptoms than Chronic Fatigue Syndrome diagnosis.<ref name=":3" /> People with M.E. typically meet the CFS criteria as well, and were found to have more severe symptoms and reduced functioning overall.<ref name=":0">{{Cite journal | last = Jason | first = Leonard A | authorlink = Leonard Jason | last2 = Sunnquist | first2 = Madison | authorlink2 = Madison Sunnquist | last3 = Brown | first3 = Abigail | author-link3 = Abigail Brown | last4 = Evans | first4 = Meredyth | author-link4 = Meredyth Evans | last5 = Newton | first5 = Julia L | author-link5 = Julia Newton | date = January 2016 | title = Are Myalgic Encephalomyelitis and chronic fatigue syndrome different illnesses? A preliminary analysis |url =https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4125561/ | journal = Journal of health psychology|volume=21 | issue = 1 | pages = 3β15|doi=10.1177/1359105313520335|issn=1359-1053|pmc=4125561|pmid=24510231|via=}}</ref> <br style="clear:both"> == Long list of symptoms == The Canadian Consensus Criteria lists these as known symptoms in Appendix 4. {{Collapse-this|Cognitive symptoms|* difficulties [[processing information]] * [[concentration problems]] * [[confusion]] * [[word-finding difficulties|difficulties with word retrieval]] * word mix-ups * [[short-term memory]] difficulties * slowness in [[cognitive processes]]|collapsed}}{{Collapse-this|Motor and balance|* [[muscle weakness]] or [[paralysis]] * poor balance, [[ataxia]] & [[tandem gait]] * clumsiness & tendency to drop things * difficulty in tandem gait * atypical [[paraesthesia|numbness or tingling]]|collapsed}}{{Collapse-this|Sleep disturbances|* [[hypersomnia]] or [[insomnia]] * [[unrefreshing sleep|non-refreshing sleep]]|collapsed}} ==Symptom recognition== The [[DePaul Symptom Questionnaire]] can be used to assess symptoms of both M.E. and CFS.<ref name=":0" /> The [[Canadian Consensus Criteria]] (Appendix 4) also contains an extensive list of possible symptoms. <ref name=":2" /> The severity of illness and overall health can be assessed using the [[Short Form 36-Item Health Survey|SF-36]] health survey.<ref name=":0" /> ==Notable studies== ===Castro-Marrero et al. 2017=== [http://www.euromene.eu/workinggroups/pubblications/Comorbid%20illness%20in%20Spanish%20CFS%20patients-2.pdf Comorbidity in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Nationwide Population-Based Cohort Study] * 1757 Spanish subjects who met both the 1994 CDC/Fukuda definition and Canadian Consensus Criteria for CFS/ME. Table 2 gives prevelance of each ME/CFS symptom in the Canadian Consensus Criteria === Jason et al. 2016 === [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4125561/ Are Myalgic Encephalomyelitis and chronic fatigue syndrome different illnesses? A preliminary analysis.] * Myalgic Encephalomyelitis (International Consensus Criteria) symptoms are compared with symptoms of patients meeting the Chronic Fatigue Syndrome Fukuda criteria but not the M.E. criteria. Those meeting the M.E. criteria were also found to meet the CFS criteria, and to have more severe symptoms. ===Jason et. al 2014=== [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3912876/ Examining case definition criteria for chronic fatigue syndrome and myalgic encephalomyelitis] * 236 patients completed the DePaul Symptom Questionnaire, rating the frequency and severity of 54 symptoms, compared to controls. ===de Becker et al. 2010=== [https://onlinelibrary.wiley.com/doi/pdf/10.1046/j.1365-2796.2001.00890.x A definition-based analysis of symptoms in a large cohort of patients with chronic fatigue syndrome] * A study of 2073 patients complaining of chronic fatigue (CF) in Brussels. Table 1 and Table 2 show the how many patients had each symptom according to whether they met the Fukuda criteria, the Holmes criteria or had chronic fatigue without CFS. 1578 CFS patients fulfilled the Fukuda criteria (called the "CFS group") and 951 (60.3% of the CFS group) fulfilled the Holmes criteria. The Holmes definition was found to be better than the Fukuda at differentiated CFS patients from the patients with Chronic Fatigue without CFS. ==See also== * [[Rare and uncommon symptoms]] * [[DePaul Symptom Questionnaire]] * [[Short Form 36-Item Health Survey|SF-36 Health Survey]] * [[CDC 2005 Symptom Inventory for CFS]] * [[Chronic fatigue syndrome|Chronic Fatigue Syndrome]] ** [[Fukuda criteria|CFS Fukuda criteria]] * [[Myalgic encephalomyelitis|Myalgic Encephalomyelitis]] ** [[Holmes criteria]] ** [[Canadian Consensus Criteria]] ** [[International Consensus Criteria|International Consensus Criteria]] * [[Systemic Exertion Intolerance Disease]] ==Learn more== * [http://www.investinme.org/Article-020%20What%20is%20ME%20What%20is%20CFS.shtml What is M.E?] - Invest in M.E. Reseach ==References== {{reflist}} [[Category:Signs and symptoms]]
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