The Clinical and Scientific Basis of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

The Clinical and Scientific Basis of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, published as The Nightingale Research Foundation Review of The Clinical and Scientific Basis of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, as a classic book about myalgic encephalomyelitis by Dr Byron Hyde and other international experts.

The Clinical and Scientific Basis of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

Editors	Byron Hyde
Authors	Jay Goldstein, Paul Levine
Country	Canada, United States
Language	English
Subject	Medical reference, medical research
Genre	Medical
Publisher	Nightingale Research Foundation
Publication date	1992
Media type	print & digital
Pages	724
ISBN	978-0969566205, 0-9695662-0-4
Website	https://www.nightingale.ca/publications

The Clinical and Scientific Basis of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome is a large reference book edited by Byron Hyde, Jay Goldstein, and Paul Levine. The book contains the proceedings from the first international symposium for clinicians and researchers in ME/CFS, held in Cambridge, England in April 1990. The symposium was organized by Dr. Byron Hyde of the Nightingale Research Foundation and Dr. John Richardson of the Newcastle Research Group. One of the honorary chairpeople of the symposium, Dr. Melvin Ramsay, who was instrumental in encouraging the idea of the symposium, passed away a few weeks before the symposium was to be held. His prepared remarks were included in the book. From the forward to the book:

We have attempted to obtain material in every area of M.E./CFS knowledge, but we have not always been successful. Some information is under copyright and could not be released. Some promised material just never arrived. Scientific knowledge of M.E./CFS is growing so rapidly that we were not always able to keep up with all of the explosive changes in information. To compensate for some of the omissions, Nightingale staff have written review chapters only when an appropriate contributor was not available or the chapter was delayed. These review chapters represent Nightingale's opinions and are not necessarily those of the clinicians and researchers mentioned. Furthermore, in a few cases, we have requested and obtained permission from certain prestigious journals to reproduce works of historical significance. Due to the sheer length of some of the original manuscripts, it was necessary for us to reproduce some of the authors' work in abstract form.

A PDF of the book is freely available to download from the Nightingale Research Foundation website.

Publisher's synopsis

(This synopsis was provided by the publisher for promotional purposes. For book reviews, please see Links section below.)

Eighty of the world's leading M.E./CFS authorities have contributed their knowledge to produce a 750-page encyclopedia on the disease process that may be one of the biggest single causes of chronic illness in the world today. Known in the United States as Chronic Fatigue Syndrome and in Great Britain both as Myalgic Encephalomyelitis and Post-Viral Fatigue Syndrome, M.E./CFS has provoked a chronic disabling illness in an estimated 1,000,000 persons in North America and Europe.

This book provides, in one superb 75-chapter source, an up-to-date, comprehensive account of current knowledge concerning the history, epidemiology, children with M.E., investigation, virology, immunology, muscle pathology, host response, food intolerance, brain mapping, neurophysiology, neuropsychology, psychiatry, sleep dysfunction, fibromyalgia syndrome, treatment and management.

This is an essential reference book for medical, government and public library reference rooms. This text is a unique vehicle for researchers, physicians and other health education and government officials, and is easily understandable by the general public interested in M.E./CFS.

Contents

• i. Magnetic Resonance Imaging (MRI)
• ii. Dedication: Dr. John Richardson
• iv-viii. Brain Imaging Illustrations
• ix. Foreword
• x. Preface: Unravelling the Enigma
• xiv. In Appreciation

Section 1: A Road Map to M.E. / CFS / PVFS / CFIDS

• Chapter 1: The Disease of a Thousand Names
• Chapter 2: The Definitions of M.E./CFS, A Review
• Chapter 3: A Description of Patients, Borys Chabursky, Byron Hyde, M.D., Anil Jain, M.D.
• Chapter 4: General Information, Post Infectious, Acute Onset M.E./CFS, Byron Hyde, M.D., Sheila Bastien, Ph.D, Anil Jain, M.D.
• Chapter 5: Clinical Observations of CNS Dysfunction in Post-Infectious, Acute Onset M.E./CFS, Byron Hyde, M.D., Anil Jain, M.D.
• Chapter 6: M.E./CFS: The Physical Signs of Disease, Byron Hyde, M.D., Anil Jain, M.D.

Section 2: Opening Remarks of the Honorary Chairmen

• Chapter 7: Myalgic Encephalomyelitis, Then and Now, An Epidemiological Introduction, A. Melvin Ramsay, M.B., Betty Dowsett, M.B.
• Chapter 8: M.E., The Epidemiological and Clinical Observations of a Rural Practitioner, John Richardson, M.B., B.S.

Section 3: Opening Remarks of some of the Chairmen

• Chapter 9: The Myalgic Encephalomyelitis Syndrome, John Murdoch, M.D., Ph.D: New Zealand
• Chapter 10: "Spasmophilia" and/or "Myalgic Encephalomyelitis", Henri Rubinstein, M.D.: France
• Chapter 11: Tapanui Flu (A quest for a diagnosis), Peter Snow, M.B., ChB, FRNZCSP: New Zealand

Chairman J.E. Banatvala, MA., M.D., MRCP, FRCPath: England

Chairman Alan Smith, M.D.: South Africa

Section 4: An Historical Review of M.E./CFS Like Disease

• Chapter 12: Myalgic Encephalomyelitis (Chronic Fatigue Syndrome): An Historical Perspective, Byron Hyde, M.D.

Section 5: The Twentieth Century History of M.E./CFS

• Chapter 13: The 1934 Los Angeles County Hospital Epidemic, A.G. Gilliam, M.D., reviewed by Byron Hyde, M.D.
• Chapter 14: The Clinical Syndrome Variously Called Benign Myalgic Encephalomyelitis, Iceland Disease and Epidemic Neuromyasthenia, E.D. Acheson, D.M., MRCP
• Chapter 15: Epidemic Neuromyasthenia - Clinical Syndrome?, Donald A. Henderson, M.D., MPH and Alexis Shelokov, M.D.
• Chapter 16: A Bibliography of M.E./CFS Epidemics, Public Domain

Section 6: The Epidemiology and Methodology of M.E./CFS

• Chapter 17: Epidemiolgic and Immunologic Findings in Clusters of Chronic Fatigue Syndrome, Seymour Grufferman, M.D., Dr. PH
• Chapter 18: Epidemiologic Aspects of CFS/M.E., Paul H. Levine, M.D.

Section 7: Children and Students with M.E./CFS

• Chapter 19: Children with M.E./CFIDS: Overview and Review of the Literature, David S. Bell, M.D., FAAP

Section 8: General Review

• Chapter 20: A Multidisciplinary Approach to Investigating and Treating Patients with Chronic Fatigue, Richard H.T. Edwards, Ph.D., FRCP
• Chapter 21: A Review of M.E. / CFIDS / PVFS in America, Anthony Komaroff, M.D.
• Chapter 22: Post-Viral Fatigue Syndrome Research in Glasgow, A Review, Nightingale Research Foundation

Section 9: Evaluating the M.E./CFS Patient

• Chapter 23: How do I Diagnose a Patient with Chronic Fatigue Syndrome?, Jay Goldstein, M.D.
• Chapter 24: The Evaluation of Adults with Chronic Fatigue: A Review of Laboratory and Psychological Findings, Dedra Buchwald, M.D.
• Chapter 25: Chronic Fatigue of Nasal Origin: Possible Confusion with Chronic Fatigue Syndrome, Alexander Chester III, M.D., FACP

Section 10: The Infectious Origins of M.E./CFS

• Chapter 26: Possible Role for Epstein-Barr Virus (EBV) in the Chronic Fatigue Syndrome (CFS), James Jones, M.D.
• Chapter 27: Detection of Viral Related Sequences in CFS Patients Using the Polymerase Chain Reaction, W. John Martin, M.D., Ph.D

Subsection A: The Enteroviral Theories

• Chapter 28: Myalgic Encephalomyelitis (M.E.) - A Persistent Enteroviral Infection?, E.G. Dowsett, M.B., A.M. Ramsay, M.B. et al
• Chapter 29: Virology Laboratory Diagnosis of Chronic Fatigue Syndrome, Bernadette McLaughlin, M.D.
• Chapter 30: The Immunosuppressive Effects of Group B Coxsackievirus Infections, Mauro Bendinelli, M.D., Ph.D., Donatella Matteuci, BS
• Chapter 31: Evidence of Chronic Enterovirus Infection in M.E., James F. Mowbray, FRCP
• Chapter 32: Chronic Enterovirus Infection in Patients with PVFS, Galal Yousef, M.D. et al

Subsection B: The Retroviral Theories

• Chapter 33: A Retrovirus Aetiology for CFS?, Michael J. Holmes, M.D.
• Chapter 34: Viral Infection in CFS Patients, W. John Martin, M.D., Ph.D
• Chapter 35: The Search for a Retrovirus in CFS/CFIDS, Elaine DeFreitas, Ph.D, Hiroshi Terunuma, M.D., Ph.D.
• Chapter 36: The Search for a Retrovirus in M.E./CFS, A Review, Byron Hyde, M.D.

Section 11: The Skeletal Muscle As Target

• Chapter 37: Molecular Virology of Muscle Disease: Persistent Virus Infection of Muscle in Patients with Postviral Fatigue Syndrome, Leonard C. Archard, PhD, Louise Cunningham, Ph.D.
• Chapter 38: Neuromuscular Abnormalities in Patients with CFS, Carolyn L. Warner, M.D. et al
• Chapter 39: An Account of 100 Muscle Biopsies in Epidemic M.E., David Doyle, M.D.
• Chapter 40: Whole Body and Muscle Protein Synthesis in Myalgic Encephalomyelitis, David Halliday, M.D., P.J. Pacy, M.D.
• Chapter 41: Exercise Testing in Patients with Chronic Fatigue Syndrome, David McCluskey, M.D., M. Riley, M.D.

Section 12: The Heart As Target

• Chapter 42: Cardiac and Cardiovascular Aspects of M.E./CFS, A Review, Byron Hyde, M.D., Anil Jain, M.D.

Section 13: Neurology

• Chapter 43: The Differential Diagnosis Between Multiple Sclerosis and Chronic Fatigue Postviral Syndrome, Charles M. Poser, M.D.
• Chapter 44: Neurological Features of M.E., Russell J.M. Lane, M.D.
• Chapter 45: CFS: Limbic Encephalopathy in a Dysfunctional Neuroimmune Network, Jay Goldstein, M.D.

Section 14: M.E./CFS and the Peripheral Nervous System

• Chapter 46: An Historical Review of the Electromyographic Features of Post-Infectious M.E./CFS, Byron Hyde, M.D., Alberto Marinacci, M.D. and Karl Von Hagen, M.D.
• Chapter 47: Evidence for Organic Disturbance in the Post Viral Fatigue Syndrome: Neurophysiological Studies, Goran A. Jamal, M.D., Ph.D.

Section 15: M.E./CFS and Central Nervous System Injury

• Chapter 48: Magnetic Resonance in the Diagnosis of M.E./CFS, A Review, Byron Hyde, M.D., Royce Biddle, M.D., Thomas McNamara, M.D.
• Chapter 49: Study of Cerebral Perfusion by NeuroSPECT in Patients with CFS, Ismael Mena, M.D., Javier Villanueva-Meyer, M.D.
• Chapter 50: Multi-modality Sensory and Auditory Cognitive Event-Related Potentials in M.E. and M.S., Deepak Prasher, M.D., and Leslie Findley, M.D.

Section 16: Neuropsychological Changes in M.E./CFS

• Chapter 51: Patterns of Neuropsychological Abnormalities and Cognitive Impairment in Adults and Children, Sheila Bastien, Ph.D
• Chapter 52: The MMPI as an Aid to CFS Diagnosis, Linda Iger, Ph.D
• Chapter 53: Is There a CFS Dementia?, Curt A. Sandman, Ph.D
• Chapter 54: Physical and Psychosocial Functioning in Chronic Fatigue Syndrome, Diane L. Cookfair, Ph.D et al

Section 17: Psychiatry in M.E./CFS

• Chapter 55: Depression / Somatization Explanations for the Chronic Fatigue Syndrome: A Critical Review, Donald G. Dutton, Ph.D
• Chapter 56: The Psychiatric Status of Patients with the Chronic Fatigue Syndrome, Ian Hickie, M.D. et al

Section 18: Food Intolerance in M.E./CFS

• Chapter 57: The Role of Food Intolerance in CFS, Robert Loblay, M.D., Ph.D., Anne R. Swain, Ph.D

Section 19: Immunology

• Chapter 58: Immunological Abnormalities in Patients with CFS, Andrew Lloyd, M.D. et al
• Chapter 59: Recent Developments in Immunological Aspects of CFS, Sudhir Gupta, M.D., Ph.D.
• Chapter 60: Host Factors Affecting the Course and Outcome of Viral Disease, Roger M. Loria, Ph.D. (See also Chapter 74: The Role of Thymic Infections, Nathan Trainin, M.D. and Chapter 28: M.E. - A Persistent Enteroviral Infection, Betty Dowsett, M.D.)
• Chapter 61: Abnormalities of Natural Killer (NK) Cell Numbers and Function in Patients with Chronic Fatigue Immune Dysfunction Syndrome (CFIDS), Hugh Pross, M.D., Ph.D, FRCPC

Section 20: Blood Cell Changes

• Chapter 62: Opioid-Mediated Monocyte Dysfunction in the CFS, Jesus Prieto, M.D. et al
• Chapter 63: Paired, Age, Sex and Ethnically Matched Studies of Peripheral Blood Leucocyte Profiles in Early CFS, Michael Holmes, M.D. et al
• Chapter 64: Working Towards a Diagnostic Aid in CFS: Analysis of Peripheral Blood Leucocyte Profiles by Radial Plot, John Cross, Ph.D et al
• Chapter 65: The Role of Nondiscocytic Erythrocytes in the Pathogenesis of M.E./CFS, Len O. Simpson, Ph.D.
• Chapter 66: Differentiation Between M.S. and M.E., E.J. Field, M.D., FRCP

Section 21: New Investigation Techniques

• Chapter 67: Biochemical Defects in the 2-5A Synthetase/RNAse L Pathway Associated with CFS with Encephalopathy, Robert J. Suhadolnik, Ph.D et al
• Chapter 68: Evidence for T-Cell Activation by Soluble IL-2-R and T8-R in the Chronic Fatigue Syndrome, Paul R. Cheney, M.D., Ph.D (See also Chapter 64: Working Towards..., John Cross, Ph.D)

Section 22: Treatment

• Chapter 69: Intravenous Immunoglobulin Therapy in Patients with CFS, Andrew Lloyd, M.D. et al
• Chapter 70: Essential Fatty Acid Therapy for M.E., Michael D. Winther, M.D.
• Chapter 71: Clinical Improvements Obtained with Ampligen in Patients with Severe CFS and Associated Encephalopathy, Daniel L. Peterson, M.D. et al
• Chapter 72: Immunological Therapy with Transfer Factor, Andrew Lloyd, M.D. et al
• Chapter 73: The Florence Nightingale Disease: A Multisystem Experiment of Nature: A 50 Patient Five Year Analysis, H. Hugh Fudenberg, M.D.
• Chapter 74: The Role of Thymic Hormones in Viral Infections, Nathan Trainin, M.D. et al (See also Chapter 23: How I Diagnose..., Jay Goldstein, M.D.)

Section 23: Fibrositis / Fibromyalgia

• Chapter 75: Fibrositis / Fibromyalgia Syndrome, I. Jon Russell, M.D., Ph.D

Section 24: Conclusions

• Summary
• Addendum I - Jay A. Goldstein, M.D.
• Addendum II - Linda Iger, Ph.D
• Addendum III - Harvey Moldofsky, M.D.
• Addendum IV - David C. Poskanzer, M.D., M.P.H.
• Addendum V - Alfredo A. Sadun, M.D., Ph.D, Pravin U. Dugel, M.D.
• Addendum VI - Bjorn Sigurdsson, M.D., Ph.D

Citation

Hyde, Byron, ed. (1992). The Nightingale Research Foundation Review of The Clinical and Scientific Basis of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Jay Goldstein, Paul Levine. Ottawa, Ontario, Canada: Nightingale Research Foundation. ISBN 978-0969566205.

Links

• The Nightingale Research Foundation (publisher)
• The Clinical and Scientific Basis of M.E./CFS - Free eBook from publisher
• The Clinical and Scientific Basis of M.E./CFS - Amazon (US)
• The Clinical and Scientific Basis of M.E./CFS - Amazon (UK)
• The Clinical and Scientific Basis of M.E./CFS - Goodreads

See also

• Nightingale Research Foundation

References

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myalgic encephalomyelitis (M.E.) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.

myalgic encephalomyelitis (M.E.) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.

myalgic encephalomyelitis (M.E.) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.

See chronic fatigue syndrome.

central nervous system (CNS) - One of the two parts of the human nervous system, the other part being the peripheral nervous system. The central nervous system consists of the brain and spinal cord, while the peripheral nervous system consists of nerves that travel from the central nervous system into the various organs and tissues of the body.

Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS) - Chronic Fatigue and Immune Dysfunction Syndrome is another term for Chronic Fatigue Syndrome, but one which emphasizes the immunological aspects of the disease. Popular in the 1990s, this term has apparently fallen into disuse.

See Chronic Fatigue and Immune Dysfunction Syndrome.

chronic fatigue (CF) - Persistent and abnormal fatigue is a symptom, not an illness. It may be caused by depression, multiple sclerosis, fibromyalgia, chronic fatigue syndrome or many other illnesses. The term "chronic fatigue" should never be confused with the disease chronic fatigue syndrome.

enterovirus A genus of RNA viruses which typically enter the body through the respiratory or gastrointestinal systems and sometimes spread to the central nervous system or other parts of the body, causing neurological, cardiac, and other damage. Since the first reports of myalgic encephalomyelitis (ME), enteroviruses have been suspected as a cause of ME. Enteroviruses have also been implicated as the cause of Type I diabetes, congestive heart failure, and other conditions. Enteroviruses include poliovirus, coxsackieviruses, and many others. New enteroviruses and new strains of existing enteroviruses are continuously being discovered. (Learn more: viralzone.expasy.org)

enterovirus A genus of RNA viruses which typically enter the body through the respiratory or gastrointestinal systems and sometimes spread to the central nervous system or other parts of the body, causing neurological, cardiac, and other damage. Since the first reports of myalgic encephalomyelitis (ME), enteroviruses have been suspected as a cause of ME. Enteroviruses have also been implicated as the cause of Type I diabetes, congestive heart failure, and other conditions. Enteroviruses include poliovirus, coxsackieviruses, and many others. New enteroviruses and new strains of existing enteroviruses are continuously being discovered. (Learn more: viralzone.expasy.org)

central nervous system (CNS) - One of the two parts of the human nervous system, the other part being the peripheral nervous system. The central nervous system consists of the brain and spinal cord, while the peripheral nervous system consists of nerves that travel from the central nervous system into the various organs and tissues of the body.

cerebral 1. of or relating to the brain or the intellect 2. of, relating to, affecting, or being the cerebrum.

cognition Thought processes, including attention, reasoning, and memory.

somatic symptom disorder A psychiatric term to describe an alleged condition whereby a person's thoughts somehow cause physical symptoms. The actual existence of such a condition is highly controversial, due to a lack of scientific evidence. It is related to other psychiatric terms, such as "psychosomatic", "neurasthenia", and "hysteria". Older terms include "somatization", "somatoform disorder", and "conversion disorder". Such terms refer to a scientifically-unsupported theory that claims that a wide range of physical symptoms can be created by the human mind, a theory which has been criticized as "mind over matter" parapsychology, a pseudoscience.

Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS) - Chronic Fatigue and Immune Dysfunction Syndrome is another term for Chronic Fatigue Syndrome, but one which emphasizes the immunological aspects of the disease. Popular in the 1990s, this term has apparently fallen into disuse.

antibodies Antibody/immunoglobulin refers to any of a large number of specific proteins produced by B cells that act against an antigen in an immune response.