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Myalgic Encephalomyelitis (ME)

**Myalgic Encephalomyelitis** (abbreviated **ME**) is a chronic, inflammatory, primarily neurological disease that is multisystemic, affecting the central nervous system (CNS), immune system, cardiovascular system, endocrinological system, and muscloskeletal system. ME can cause a wide variety of symptoms, including changes in sensory tolerance, visual problems, exertional muscle weakness, difficulties with coordination and speech, severe fatigability, cognitive impairment, problems with balance, subnormal or poor body temperature control, and pain. ME will cause a degree of impaired mobility and disability in all cases. The degree of impairment and complexity depends on the degree of diffuse brain injury and end organ involvement.

Myalgic Encephalomyelitis affects the brain and spinal cord which control the body and allow thought and sensory processing, causing dysautonomia, impaired thinking, and loss of internal homeostasis, the process whereby the body maintains a consistent internal environment in response to external stressors. Cellular metabolism and communication is disrupted, causing inefficiency in all biological processes. This includes the cellular mitochondria which process fuel to make energy, resulting in a deficiency of adenosine-triphosphate ATP with a chronic, severe, measurable loss of sustainable strength on exertion. A hallmark of ME is intolerance to previously trivial effort and deterioration through persistent or repeated exertion.

Current theory suggests ME results from a persistent viral infection and/or attacks by an individual’s immune system on the nervous system, musculoskeletal system, and blood vessels. It has been classified by the World Health Organisation as an organic brain disease since 1969. There is a controversial view that ME is not a chronic infectious or autoimmune disease, but rather a psychosocial illness triggered by infection or stress. Usually proponents of this school disdain the term ME, claiming it to be inaccurate. Although more than 50 years of research and clinical observation informs knowledge of ME pathology, its exact cause remains unknown and more research is required, particularly for treatment. ME patients are barred from donating blood or organs in the United Kingdom while symptoms persist.

Myalgic encephalomyelitis is a relapse-remitting disease with new symptoms occurring either in discrete relapses (or “crashes”) or slowly accruing over time. Between relapses, symptoms may resolve completely with sufficient rest, but permanent neurologic problems often persist, especially as the disease advances. ME currently does not have a cure, though some treatments such as antivirals are being trialed, which may at least slow the appearance of new symptoms.

ME affects all ages, with peak incidence typically between 20 and 40 years, and is more common in women than in men.

Contents

* 1 Terminology
* 2 Signs and symptoms
* 3 Diagnosis
* 3.1 Differential Diagnosis
* 4 Disease course and clinical subtypes
* 5 Factors triggering a relapse
* 7 Pathophysiology
* 8 Causes
* 8.1 Environmental
* 9 Treatment
* 10 Prognosis
* 11 Epidemiology
* 12 History
* 12.1 The Formative Years
* 12.2 WHO Classification and Disgrace
* 12.3 CDC Intervention
* 12.4 Villified but Vindicated
* 12.5 ME Redux
* 13 References
* 13.1 External links
* 13.2 Organizations