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ME or not ME?



door Jason en kollega's








Jason en kollega's van de DePaul University hebben de verschillende ME-kriteria

met elkaar vergeleken en geanalyseerd wat de overeenkomsten zijn.


Op basis van die overeenkomsten komen zij tot nieuwe konsensuskriteria voor ME:


Symptomen die altijd aanwezig zijn (volgens de "oude" ME-kriteria):

  1. post-exertional malaise,
  2. neurologische abnormaliteiten (geheugen- en koncentratieproblemen etc.) en
  3. autonome dysfunctie (orthostatische intolerantie etc.)

Symptomen die altijd aanwezig zijn (volgens de "oude" ME-kriteria):

  1. pijn,
  2. endocriene afwijkingen,
  3. immunologische symptomen (koortsgevoel, geziowllen lymfeklieren etc.)
  4. slaapstoornissen.

De ME-consensus-kriteria van Jason en zijn kollega's zijn, zo blijkt uit hun analyse,

strenger dan die van de onlangs gepubliceerde internationale consensus-kriteria.


Het goede nieuws is dat deze studie een duidelijk onderscheid maakt

tussen ME (hét kenmerk: post-exertional malaise) en CVS (hoofdkenmerk: "vermoeidheid").


Het minder goede nieuws is dat we geconfronteerd worden met nieuwe nieuwe kriteria...




In summary,

the current review of ME case definitions focuses on

the major features of the illness,

and suggests that

ME has an acute onset

that can be categorized into three categories:


in which ME is precipitated by a virus;

ME-infectious non-viral,

in which ME is precipitated by a non-viral infection

such as a tick bite resulting in Lyme disease; and


in which ME is precipitated by trauma or chemical exposure.


The major symptom categories of ME include:

post-exertional malaise, and

neurological and

autonomic manifestations.


Postexertional malaise can be described as

prolonged restoration of muscle power

following either mental or physical exertion

with recovery often taking 2–24 hours or longer.


Neurological manifestations,

which include short-term memory loss, loss of powers of concentration,

cognitive dysfunction, increased irritability, confusion, perceptual difficulties,

as well as evidence of

central nervous system and/or brain injury.


Autonomic mdysfunction,

which can incorporate

neutrally mediated hypotension, postural orthostatic tachycardia,

delayed postural hypotension, palpitations with or without cardiac arrhythmias,

dizziness, feeling unsteady on one’s feet, disturbed balance, cold extremities,

hypersensitivity to climate change, cardiac irregularity, Raynaud’s phenomenon,

circulating blood volume decrease, and shortness of breath.


Secondary features of ME



endocrine manifestations,

immune manifestations, and

sleep dysfunction.




Myalgic Encephalomyelitis Case Definitions

Automatic Control of Physiological State and Function. 2012; 1.


Leonard A. Jason, Dylan Damrongvachiraphan, Jessica Hunnell, Lindsey Bartgis, Abigail Brown, Meredyth Evans, and Molly Brown






This article reviews a Myalgic Encephalomyelitis (ME) case definition

based on criteria offered over the past five decades.


The current paper looks to review case definitions for ME based on

In general, these theorists have argued that

ME is now defined differently than chronic fatigue syndrome

because ME involves

an acute onset, post-exertional malaise and neurocognitive problems,

and fatigue is not a major criteria.


We will compare these theorists to

the recently published International Consensus Criteria for Myalgic Encephalomyelitis.


We will also attempt to consolidate aspects of different current definitions

in order to suggest possible core features of ME.


This article will also recommend the importance of

providing explicit, objective criteria on specific key symptoms.


In addition, structured interview schedules along with specific medical tests are recommended to assure this illness is assessed in a consistent way across settings.


It is hoped these developments will lead to

increased reliability of the ME case definition,

as well as

more frequent use of these criteria by investigators.




myalgic encephalomyelitis; case definitions