Myalgic Encephalomyelitis or What? The International Consensus Criteria.
1ME-de-Patiënten Foundation, Zonnedauw 15, 1906 HB Limmen, The Netherlands. frank.twisk@hetnet.nl.
Diagnostics (Basel, Switzerland)
|December 23, 2018
Summary
Myalgic encephalomyelitis (ME) and the International Consensus Criteria for ME (ME-ICC) represent distinct patient groups. Diagnostic criteria differ significantly, particularly regarding post-exertional malaise and symptom requirements.
Area of Science:
- Neurology
- Immunology
- Clinical Medicine
Background:
- Myalgic encephalomyelitis (ME) is a complex neuromuscular disease characterized by muscle fatigability and neurological disturbances.
- Chronic Fatigue Syndrome (CFS) criteria, established in 1988 and revised in 1994, have historically overshadowed ME.
- The International Consensus Criteria for ME (ME-ICC), proposed in 2011, aimed to redefine ME diagnosis.
Purpose of the Study:
- To compare the diagnostic criteria of Myalgic Encephalomyelitis (ME) with the International Consensus Criteria for ME (ME-ICC).
- To highlight the critical differences in symptomology and diagnostic requirements between ME and ME-ICC.
- To clarify that ME and ME-ICC do not define interchangeable patient groups.
Main Methods:
- Comparative analysis of the original ME diagnostic features.
- Detailed examination of the ME-ICC criteria, including mandatory and subcriteria requirements.
- Direct comparison of hallmark symptoms and overall symptom burden between ME and ME-ICC definitions.
Main Results:
- Muscle fatigability is a hallmark of ME but only facultative in ME-ICC.
- Post-exertional neuroimmune exhaustion (PENE) is central to ME-ICC but not required for ME diagnosis.
- ME diagnosis requires two symptom types, while ME-ICC necessitates at least eight symptoms across multiple systems.
Conclusions:
- The diagnostic criteria for ME and ME-ICC are fundamentally different.
- ME-ICC criteria do not fully encompass the diagnostic requirements for ME, particularly concerning muscle fatigability and neurological dysfunction.
- The definitions of ME and ME-ICC are not interchangeable and identify distinct patient populations.
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