Moderate myalgic encephalomyelitis or chronic fatigue syndrome

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Moderate myalgic encephalomyelitis or moderate chronic fatigue syndrome or moderate ME/CFS is a serious neurological disease, and should not be confused with either a moderate level of illness, or moderate fatigue.

Moderate ME/CFS causes a severe level of disability, and some patients report deteriorating permanently to severe ME/CFS.

NHS definition

Moderate ME/CFS

People with moderate ME/CFS have reduced mobility and are restricted in all activities of daily living, although they may have peaks and troughs in their level of symptoms and ability to do activities. They have usually stopped work or education, and need rest periods, often resting in the afternoon for 1 or 2 hours. Their sleep at night is generally poor quality and disturbed.[1]

The UK's National Health Service definition of moderate ME/CFS can be found within the 2021 NICE guidelines.[1]

International Consensus Criteria

[2]

Comparison

Mild severity: I walk...on Thursdays, Fridays. I've been quite ill (Andrew, 40s). The holiday travel exertion was too strenuous... I collapsed. (Wanda, 50s). Moderate severity: After trying to work for 14 days I became much worse (Yvonne, 30s). I tried to exercise and collapsed like a bunch of broccoli (Sue, 20s). Severe: You even get tired from speaking...from sitting (Wanda, 50s).

Fluctuating level of symptoms

Invisible illness

ME/CFS is known as an invisible illness due to the lack of obvious physical signs of illness.

Impact

Work and education

Care needs

Mobility

People

British member of parliament Brynmor John appeared to have mild to moderate ME/CFS in 1988, but with some fluctuations. His ME/CFS improved enough to enable him to return to work but he struggled with walking, including being unable to walk up the slight incline on the road he lived on. He was not reliant on a wheelchair and did not need daily care.

After his doctor advised him to exercise in order to aid his recovery from ME/CFS, Brynmor John visited the House of Commons gym one day after work, where he then collapsed and died soon after.

Notable studies

  • 2015, Fatigue in adults with post-infectious fatigue syndrome: a qualitative content analysis[3] - (Full text)
  • 2019, Physical activity patterns among children and adolescents with mild-to-moderate chronic fatigue syndrome/myalgic encephalomyelitis - (Full text)

See also

Learn more

References

  1. ↑ 1.0 1.1 NICE Guideline Development Group (October 29, 2021). "Myalgic Encephalomyelitis (or Encephalopathy)/Chronic Fatigue Syndrome:diagnosis and management. NICE guideline". National Institute for Health and Care Excellence.
  2. ↑ 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
  3. ↑ Stormorken, Eva; Jason, Leonard A.; Kirkevold, Marit. "Fatigue in adults with post-infectious fatigue syndrome: a qualitative content analysis". BMC Nursing. p. 64. doi:10.1186/s12912-015-0115-5. PMC 4662830. PMID 26617466.
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