List of symptoms in ME CFS: Difference between revisions
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==Canadian consensus criteria (CCC) symptom list == | ==Canadian consensus criteria (CCC) symptom list == | ||
The [[Canadian Consensus Criteria]] (CCC), an ME/CFS criteria, includes a list of recognized signs and symptoms in the appendix. Only some of these symptoms within the categories below are needed to be diagnosed under the [[Canadian Consensus Criteria#Definition|Canadian Consensus Criteria diagnostic criteria]]. Pediatric cases have the same symptoms. | The [[Canadian Consensus Criteria]] (CCC), an ME/CFS criteria, includes a list of recognized signs and symptoms in the appendix. Only some of these symptoms within the categories below are needed to be diagnosed under the [[Canadian Consensus Criteria#Definition|Canadian Consensus Criteria diagnostic criteria]]. Pediatric cases have the same symptoms; please note the information for the "Pediatric" heading under "Systemic Exertion Intolerance Disease (SEID) symptom list" above. | ||
=== Cognitive === | === Cognitive === | ||
{{:List of symptoms in ME CFS/Canadian/Cognitive}}<div style="clear: both"></div><hr /> | {{:List of symptoms in ME CFS/Canadian/Cognitive}}<div style="clear: both"></div><hr /> |
Revision as of 21:07, February 2, 2019
This article needs cleanup to meet MEpedia's guidelines. The reason given is: International Consensus Criteria Pediatric symptoms missing (January 2019) |
This article is a stub. The talk page may contain suggestions. |
Except for introduction information and SEID criteria symptoms, this page draws symptoms from subpages. |
The list of symptoms in ME CFS can be extensive and most patients will not have every symptom possible
A minimum list of core symptoms of chronic fatigue; post-exertional malaise; unrefreshing sleep; cognitive impairment; and/or orthostatic intolerance can diagnose a person with Systemic Exertion Intolerance Disease (SEID), an ME/CFS definition. Other symptoms can be present but a diagnosis of the SEID criterion ME/CFS means there are not enough symptoms to diagnose under the Canadian Consensus Criteria (CCC) or the International Consensus Criteria (ICC). The CCC is another ME/CFS definition but includes the core symptoms and neurological, gastrointestinal, immune system symptoms, pain, and other symptoms to meet its diagnostic criteria. The ICC is for diagnosing the neurological disease myalgic encephalomyelitis (ME) which was defined by the World Health Organization (WHO) in 1969.[1] It includes the core symptoms and has more neurological, gastrointestinal, and immune system symptoms, and other symptoms than the CCC.
Systemic Exertion Intolerance Disease (SEID) symptom list[edit | edit source]
These are the minimum of core symptoms necessary to be diagnosed with SEID, an ME/CFS criteria. Patients can have more symptoms[2] and they are outlined in the Institute of Medicine report.
These core symptoms are also part of the CCC and ICC criteria below. ME/CFS and ME patients will always have these core symptoms and the SEID diagnostic criteria can be used to diagnose these patients also. However, the SEID diagnostic criteria cannot speak to the number of symptoms and their severity all ME/CFS and ME patients experience. The IOM report authors who created the SEID diagnostic criteria did include other symptoms in chapters 4 and 5.[3]
Core symptoms[edit | edit source]
- chronic fatigue and
- post-exertional malaise (PEM) and
and at least one of the following:
or
Pediatric[edit | edit source]
Pediatric cases have the same symptoms.[6] However, the CDC notes some differences: OI (dizziness and lightheadedness) is experienced more often making their other ME/CFS symptoms worse. Sleep problems may be harder to detect; they will experience insomnia, daytime sleepiness, and intense and vidid dreaming. Children and adolescents do not usually have muscle and joint pain but headaches and stomach pain are more common.[7] Dr. David Bell agrees the symptoms for children can be different noting abdominal pain is more common and in teens there can be facial flushing. Although children do not describe having PEM, a hallmark symptom used in diagnosing ME/CFS, they can experience a relapse from exertion, perhaps from just taking the school bus, having to spend prolonged periods in bed.[8]
Children, particularly adolescents, will more likely have an acute illness like the flu or mononucleosis as their onset.[9]
Canadian consensus criteria (CCC) symptom list[edit | edit source]
The Canadian Consensus Criteria (CCC), an ME/CFS criteria, includes a list of recognized signs and symptoms in the appendix. Only some of these symptoms within the categories below are needed to be diagnosed under the Canadian Consensus Criteria diagnostic criteria. Pediatric cases have the same symptoms; please note the information for the "Pediatric" heading under "Systemic Exertion Intolerance Disease (SEID) symptom list" above.
Cognitive[edit | edit source]
- difficulties processing information
- concentration problems
- confusion
- difficulties with word retrieval
- word mix-ups
- short-term memory difficulties
- slowness in cognitive processes
Motor (movement) and balance[edit | edit source]
- poor balance, ataxia & tandem gait
- clumsiness & tendency to drop things
- difficulty in tandem gait
- atypical numbness or tingling
Sleep disruption[edit | edit source]
- sleep disturbance - hypersomnia or insomnia
Visual and auditory[edit | edit source]
- photophobia
- visual changes or eye pain
- double, blurred or wavy vision
- dry or itchy eyes
- tinnitus - buzzing or ringing in ears
- hyperacusis & cocktail party phenomena
Neuropsychological[edit | edit source]
- emotional flattening or personality change
- loss of adaptability
- anxiety &/or panic attacks
- reactive depression
- worsening of symptoms with stress
Immune system[edit | edit source]
- recurrent sore throat
- recurrent flu-like symptoms
Reproductive[edit | edit source]
- loss of sexual libido or impotence
Respiratory (breathing)[edit | edit source]
- exertional dyspnea (short of breath)
- persistent cough & wheezing
Urinary[edit | edit source]
Circulatory[edit | edit source]
- neurally mediated hypotension
- postural orthostatic tachycardia syndrome (POTS)
- delayed orthostatic hypotension
- dizziness/light-headedness
- heart palpitations
- fluid retention
- extreme pallor
- bruising
Digestive[edit | edit source]
- lump in throat
Neuroendocrine[edit | edit source]
- loss of thermostatic stability - low body temperature or diurnal fluctuations
- hot flushes
- excessive sweating or night sweats
- feelings of feverishness
- feelings of cold extremities
- heat/cold intolerance
- anorexia or abnormal appetite
- marked weight loss or gain
- hair loss
Musculoskeletal[edit | edit source]
- pain in muscles (myalgia)
- muscle cramps, particularly in legs
- chest pain and pressure
- pain in multiple joints (arthalgia)
- TMJ
Neurological (nervous system)[edit | edit source]
- persistent fatigue
Sensory[edit | edit source]
- hyper-responsiveness to noxious stimuli
- feeling of burning or swelling
- loss of cognitive map
- Altered sense of taste and/or smell[10]
International consensus criteria (ICC) symptom list[edit | edit source]
The International Consensus Criteria (ICC) will diagnose myalgic encephalomyelitis (ME). See the International Consensus Criteria diagnostic criteria for diagnostic guidance. Not every symptom listed is necessary to diagnose ME but having symptoms within categories is necessary.
Post-exertional Neuroimmune Exhaustion (PENE)[edit | edit source]
Previously known as Post-exertional malaise. 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.
Neurological[edit | edit source]
Neurocognitive Impairments
Difficulty processing information: slowed thought, impaired concentration, e.g. confusion, disorientation, cognitive overload, difficulty with making decisions, slowed speech, acquired or exertional dyslexia
Short-term memory loss: e.g. difficulty remembering what one wanted to say, what one was saying, retrieving words, recalling information, poor working memory Pain
Headaches: e.g. chronic, generalized headaches often involve aching of the eyes, behind the eyes or back of the head that may be associated with cervical muscle tension; migraine; tension headaches
Significant pain can be experienced in muscles, muscle-tendon junctions, joints, abdomen or chest. It is non-inflammatory in nature and often migrates. e.g. generalized hyperalgesia, widespread pain (may meet fibromyalgia criteria), myofascial or radiating pain Sleep disturbances
- Disturbed sleep patterns: e.g. insomnia, prolonged sleep including naps, sleeping most of the day and being awake most of the night, frequent awakenings, awaking much earlier than before illness onset, vivid dreams/nightmares.
- Unrefreshed sleep: e.g. awaken feeling exhausted regardless of duration of sleep, day-time sleepiness.
Neurosensory, Perceptual and Motor Disturbances
Neurosensory and perceptual: e.g. inability to focus vision, sensitivity to light, noise, vibration, odor sensitivities, taste and touch; impaired depth perception.
Motor: e.g. muscle weakness, twitching, poor coordination, feeling unsteady on feet, ataxia.
Immune, Gastro-intestinal and Genitourinary[edit | edit source]
- Flu-like symptoms may be recurrent or chronic and typically activate or worsen with exertion: e.g. sore throat, sinusitis, cervical and/or axillary lymph nodes may enlarge or be tender on palpitation.
- Gastro-intestinal tract: e.g. nausea, abdominal pain, bloating, irritable bowel syndrome (IBS).
- Genitourinary: e.g. urinary urgency or frequency, nocturia.
- Sensitivities to food, medications, odors or chemicals.
Energy Metabolism/Ion Transportation[edit | edit source]
- Cardiovascular e.g. inability to tolerate an upright position - orthostatic intolerance (OI), neurally mediated hypotension (NMH), postural orthostatic tachycardia syndrome (POTS), heart palpitations with or without cardiac arrhythmias, light-headedness/dizziness.
- Respiratory e.g. air hunger, laboured breathing, fatigue of chest wall muscles.
- Loss of thermostatic stability: e.g. subnormal body temperature, marked diurnal fluctuation; sweating episodes, recurrent feelings of feverishness with or without low grade fever, cold extremities.
- Intolerance of extremes of tempurature.
Children's symptoms[edit | edit source]
Symptoms may progress more slowly in children than in teenagers or adults. In addition to post-exertional neuroimmune exhaustion, the most prominent symptoms tend to be neurological: headaches, cognitive impairments, and sleep disturbances.
- Headaches: Severe or chronic headaches are often debilitating. Migraine may be accompanied by a rapid drop in temperature, shaking, vomiting, diarrhoea and severe weakness.
- Neurocognitive Impairments: Difficulty focusing eyes and reading are common. Children may become dyslexic, which may only be evident when fatigued. Slow processing of information makes it difficult to follow auditory instructions or take notes. All cognitive impairments worsen with physical or mental exertion. Young people will not be able to maintain a full school program.
- Pain may seem erratic and migrate quickly. Joint hypermobility is common.
See also[edit | edit source]
Learn more[edit | edit source]
- IOM report - Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
References[edit | edit source]
- ↑ History of chronic fatigue syndrome - International Classifications
- ↑ "5". Read "Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness" at NAP.edu. nap.edu: National Academy of Medicine. 2015. p. 141.
- ↑ "4 and 5". Read "Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness" at NAP.edu. nap.edu: National Academy of Medicine. 2015.
- ↑ "Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness - Diagnostic Algorithm". nationalacademies.org. 2015. Cite has empty unknown parameter:
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(help) - ↑ "Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome - Redefining an Illness" (PDF). nationacademies.org. 2015. Cite has empty unknown parameter:
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(help) - ↑ "6". Read "Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness" at NAP.edu. nap.edu: National Academies of Medicine. 2015. p. 181.
- ↑ "Symptoms and Diagnosis of ME/CFS in Children | Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) | CDC". www.cdc.gov. January 18, 2019. Retrieved January 29, 2019.
- ↑ "ME/CFS in Children - by David S. Bell, MD | Open Medicine Foundation". Open Medicine Foundation. June 25, 2016. Retrieved August 11, 2018.
- ↑ "Symptoms and Diagnosis of ME/CFS in Children | Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) | CDC". www.cdc.gov. January 18, 2019. Retrieved January 29, 2019.
- ↑ Carruthers, Bruce M.; Jain, Anil Kumar; De Meirleir, Kenny L.; Peterson, Daniel L.; Klimas, Nancy G.; Lerner, A. Martin; Bested, Alison C.; Flor-Henry, Pierre; Joshi, Pradip; Powles, A C Peter; Sherkey, Jeffrey A.; van de Sande, Marjorie I. (2003), "Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols" (PDF), Journal of Chronic Fatigue Syndrome, 11 (2): 7-115, doi:10.1300/J092v11n01_02
- ↑ Carruthers, Bruce M.; van de Sande, Marjorie I.; De Meirleir, Kenny L.; Klimas, Nancy G.; Broderick, Gordon; Mitchell, Terry; Staines, Donald; Powles, A. C. Peter; Speight, Nigel; Vallings, Rosamund; Bateman, Lucinda; Baumgarten-Austrheim, Barbara; Bell, David; Carlo-Stella, Nicoletta; Chia, John; Darragh, Austin; Jo, Daehyun; Lewis, Donald; Light, Alan; Marshall-Gradisnik, Sonya; Mena, Ismael; Mikovits, Judy; Miwa, Kunihisa; Murovska, Modra; Pall, Martin; Stevens, Staci (August 22, 2011). "Myalgic encephalomyelitis: International Consensus Criteria". Journal of Internal Medicine. 270 (4): 327–338. doi:10.1111/j.1365-2796.2011.02428.x. ISSN 0954-6820. PMC 3427890. PMID 21777306.
- ↑ 12.0 12.1 Carruthers, BM; van de Sande, MI; De Meirleir, KL; Klimas, NG; Broderick, G; Mitchell, T; Staines, D; Powles, ACP; Speight, N; Vallings, R; Bateman, L; Bell, DS; Carlo-Stella, N; Chia, J; Darragh, A; Gerken, A; Jo, D; Lewis, DP; Light, AR; Light, KC; Marshall-Gradisnik, S; McLaren-Howard, J; Mena, I; Miwa, K; Murovska, M; Stevens, SR (2012), Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners (PDF), ISBN 978-0-9739335-3-6