Post-exertional symptom exacerbation
Post-exertional symptom exacerbation or PESE is a significant increase in ME/CFS symptoms caused by over-exertion, which begins either immediately or may be delayed by hours or days. PESE involves a mix of symptoms, for example exhaustion, acute flu-like symptoms, pain and worsening of other ME/CFS symptoms.
Definitions[edit | edit source]
Post-exertional symptom exacerbation is defined in a number of different ways:
- The International Consensus Criteria (2011) refer to PESE as one of several required symptoms of post-exertional neuroimmune exhaustion (PENE), defined as "post-exertional exhaustion may occur immediately after activity or be delayed by hours or days."
- The UK's NICE ME/CFS diagnostic criteria 2021 (NG206) refer to it as an alternative name for post-exertional malaise (PEM).
Prevalence[edit | edit source]
When listed as a separate diagnostic criteria, post-exertional symptom exacerbation is a mandatory symptom that is required for ME/CFS to be diagnosed.
Symptom recognition[edit | edit source]
Notable studies[edit | edit source]
Possible causes[edit | edit source]
See also[edit | edit source]
Learn more[edit | edit source]
References[edit | edit source]
- 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
- "Myalgic Encephalomyelitis (or Encephalopathy)/Chronic Fatigue Syndrome:1.5 Assessment and care and support planning by an ME/CFS specialist team. NICE guideline [NG206] Diagnosis". National Institute for Health and Care Excellence. January 30, 2022.
post-exertional neuroimmune exhaustion (PENE) - An alternative term for post-exertional malaise (PEM), used by people who find that the word 'malaise' fails to capture the serious nature of the condition. Used in the Institute of Medicine (IOM) report.
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.