Bansal Score Chart for ME/CFS

The Bansal Score Chart was developed in 2008, by Dr. Amolak Bansal of the UK, in order to improve the diagnostic certainty for primary and secondary care physicians.

Bansal Score Chart

Delayed prolonged PEM after Physical, Mental & Emotional excess	3
Non-restorative sleep with difficulty initiating and maintaining sleep	2
Impaired concentration that is reduced further by external stimuli	1
Reduced short term memory with word finding difficulty	1
New headaches (>2/mth & different in character from previous headaches)	1
Sore throat with cervical tenderness/recurrent flu-like episodes	1
Arthralgia affecting several joints (with stiffness >1 hr but no swelling)	1
Myalgia affecting multiple groups and exacerbated by mild exertion	1
Postural instability (NMH/POTS) - feeling unstable on standing/sitting	1
Hypersensitivity to sounds and lights (smells as well with nausea)	1

Need 8 or more from 13 points to confirm CFS/ME with an absolute requirement for some form of PEM.
Delayed (>12 hours) prolonged (24hrs+) PEM gives 3 points while an immediate PEM (<3 hours) of >24 hours gives 2 points. Immediate PEM (<3Hours) lasting <24 hours gives 1 point.
The fatigue, neurocognitive problems, myalgia, arthalgia, hypersensitivity issues must be significant and cause disability for >50% of the time.
Non-restorative sleep with difficulty initiating and maintaining this at night time and present >5+ nights per week gives 2 points. | The non-restorative nature of the sleep disturbance must persist with hypnotics.
Non-restorative sleep without difficulty initiating and or staying asleep gives 1 point.
Sore throat and flu like sensations must be present 1+ week.
Neurocognitive dysfunction with impaired concentration and memory problems aggravated by overload from excessive visual and auditory stimuli.
Great care when patients have a significant anxiety and/or depression. However, depression and anxiety can complicate CFS and vice versa. | |
In our research studies all subjects have 10 or more points and we exclude those with significant depression and anxiety. The HADS is partly helpful.
Hypersensitivity to medications is particularly frequent and especially to SSRIs, SNRI’s, TCA,s etc.
Alcohol intolerance is also frequent and tolerance of 4 units or more in a single sitting encourages a revaluation of the diagnosis. Fewer than 10% our patients continue regular alcohol ingestion. | |
From a clinical perspective, additional points that may help in suggesting the diagnosis in borderline cases include cold peripheries, alcohol intolerance, drug hypersensitivity, altered pupil reflexes and sighing respiration (3+ = 1 point)

See ME/CFS.

post-exertional malaise (PEM) - A notable exacerbation of symptoms brought on by small physical or cognitive exertions. PEM may be referred to as a "crash" or "collapse" and can last for days or weeks. Symptoms can include cognitive impairments, muscle pain, trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, and others.

See post-exertional malaise.