Muscle fatigability

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Muscle fatigability in ME is a symptom in which muscles become weaker after minor exertion and a long period (3-5 days or longer) may elapse before full muscle power is restored. According to Melvin Ramsay, it is the defining feature of myalgic encephalomyelitis, without which a diagnosis of ME should not be made,[1] though this symptom is noted to improve during remission. Similar muscle effects are known to occur in other neurological diseases such as multiple sclerosis[2] and post-polio syndrome.[3]

Prevalence[edit | edit source]

Symptom recognition[edit | edit source]

  • In the Holmes criteria, unexplained generalized muscle weakness is an optional criteria for diagnosis, under the section Minor Symptom Criteria.[6]

Notable studies[edit | edit source]

Possible causes[edit | edit source]

  • Muscle biopsies have shown evidence of mitochondrial degeneration,[7] deletions of mitochondrial DNA,[8][9] and the reduction of mitochondrial activity.[10]
  • In addition, evidence of oxidative damage to muscles has been found in CFS.[11]
  • Studies have found reduced levels of serum carnitine which return to normal after recovery and correlate with symptom severity.[12]
  • Exercise has also been found to induce both early and excessive lactic acid formation in the muscles[13] with a reduced intraceullar concentrations of ATP and acceleration of glycolysis.[14]
  • Neurologist Peter Behan noted that ME patients were found to lack an important muscle enzyme called myoadenylate deaminase. An attempt has not been made to reproduce this finding in published research.[citation needed]

Potential treatments[edit | edit source]

Learn more[edit | edit source]

See also[edit | edit source]

References[edit | edit source]

  1. "Ramsay's Definition of M.E., 1986". www.cfids-me.org. Retrieved August 28, 2019.
  2. Managing MS Symptoms - Fatigue and Fatigability
  3. "The Late Effects of Polio: An Overview". www.post-polio.org. Retrieved August 28, 2019.
  4. De Becker, Pascale; McGregor, Neil; De Meirleir, Kenny (December 2001). "A definition‐based analysis of symptoms in a large cohort of patients with chronic fatigue syndrome". Journal of Internal Medicine. 250 (3): 234–240. doi:10.1046/j.1365-2796.2001.00890.x.
  5. Berne, Katrina (December 1, 1995). Running on Empty: The Complete Guide to Chronic Fatigue Syndrome (CFIDS) (2nd ed.). Hunter House. p. 59. ISBN 978-0897931915.
  6. "Holmes Definition of Chronic Fatigue Syndrome, U.S. CDC 1988". www.cfids-me.org. Retrieved August 28, 2019.
  7. Behan, W. M. H.; More, I. A. R.; Behan, P. O. (December 1991). "Mitochondrial abnormalities in the postviral fatigue syndrome". Acta Neuropathologica. 83 (1): 61–65. doi:10.1007/BF00294431. ISSN 0001-6322.
  8. Vecchiet, L.; Montanari, G.; Pizzigallo, E.; Iezzi, S.; de Bigontina, P.; Dragani, L.; Vecchiet, J.; Giamberardino, M. A. (April 19, 1996). "Sensory characterization of somatic parietal tissues in humans with chronic fatigue syndrome". Neuroscience Letters. 208 (2): 117–120. doi:10.1016/0304-3940(96)12559-3. ISSN 0304-3940. PMID 8859904.
  9. Zhang, C.; Baumer, A.; Mackay, I. R.; Linnane, A. W.; Nagley, P. (April 1995). "Unusual pattern of mitochondrial DNA deletions in skeletal muscle of an adult human with chronic fatigue syndrome". Human Molecular Genetics. 4 (4): 751–754. doi:10.1093/hmg/4.4.751. ISSN 0964-6906. PMID 7633428.
  10. Vecchiet, L.; Montanari, G.; Pizzigallo, E.; Iezzi, S.; de Bigontina, P.; Dragani, L.; Vecchiet, J.; Giamberardino, M. A. (April 19, 1996). "Sensory characterization of somatic parietal tissues in humans with chronic fatigue syndrome". Neuroscience Letters. 208 (2): 117–120. doi:10.1016/0304-3940(96)12559-3. ISSN 0304-3940. PMID 8859904.
  11. Fulle, S.; Mecocci, P.; Fanó, G.; Vecchiet, I.; Vecchini, A.; Racciotti, D.; Cherubini, A.; Pizzigallo, E.; Vecchiet, L. (December 15, 2000). "Specific oxidative alterations in vastus lateralis muscle of patients with the diagnosis of chronic fatigue syndrome". Free Radical Biology & Medicine. 29 (12): 1252–1259. doi:10.1016/s0891-5849(00)00419-6. ISSN 0891-5849. PMID 11118815.
  12. Kuratsune, H.; Yamaguti, K.; Takahashi, M.; Misaki, H.; Tagawa, S.; Kitani, T. (January 1994). "Acylcarnitine deficiency in chronic fatigue syndrome". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 18 (Suppl 1): S62–67. doi:10.1093/clinids/18.supplement_1.s62. ISSN 1058-4838. PMID 8148455.
  13. Plioplys, A. V.; Plioplys, S. (1995). "Serum levels of carnitine in chronic fatigue syndrome: clinical correlates". Neuropsychobiology. 32 (3): 132–138. doi:10.1159/000119226. ISSN 0302-282X. PMID 8544970.
  14. McCully, K. K.; Natelson, B. H.; Iotti, S.; Sisto, S.; Leigh, J. S. (May 1996). "Reduced oxidative muscle metabolism in chronic fatigue syndrome". Muscle & Nerve. 19 (5): 621–625. doi:10.1002/(SICI)1097-4598(199605)19:53.0.CO;2-Q. ISSN 0148-639X. PMID 8618560.