In een overzichtsartikel worden de belangrijkste overeenkomsten en verschillen
tussen ME en ME-ICC (ME volgens de Internationale Consensus Criteria) samengevat.
Beide definities onderkennen
- dat ME een neurologische ziekte is,
- dat ook andere lichamelijke systemen betrokken kunnen zijn en
- dat ME géén psychogene basis heeft (niet voorkomt uit 'dysfunctionele gedachten')
Maar er zijn ook vier essentiële verschillen tussen ME (1938-1999) en ME-ICC:
- Abnormale snelle spiervermoeidheid/lang aanhoudende spierzwakte na inspanning
is hét kenmerk van ME (verplicht voor de diagnose),
maar is niet verplicht voor de diagnose ME-ICC.
- Alhoewel (potentieel) negatieve effecten van inspanning in de ME-literatuur genoemd worden,
is post-exertionele neuro-immunologische uitputting (PENE), hét kenmerk van ME-ICC
(verplicht voor de diagnose ME-ICC), niet verplicht voor de diagnose ME.
- Neurologische afwijkingen, m.n. cognitieve, sensorische en autonome disfunctie
(verplicht voor de diagnose ME), zijn niet verplicht voor de diagnose ME-ICC:
iemand kan aan de eisen voor categorie B voldoen zonder genoemde symptomen te ervaren.
- Waar twee (soorten) symptomen patiënten met ME onderscheiden,
moet iemand 8 of meer symptomen ervaren om aan de diagnose ME-ICC te voldoen.
Patiënten(vertegenwoordigers) die zich hard maken voor de Internationale Consensus Criteria (ICC),
moeten zich bewust zijn van het feit dat dat ME (1938-1990) en ME-ICC niet hetzelfde zijn:
Video presentatie:
Myalgic Encephalomyelitis or what?
The International Consensus Criteria.
Diagnostics 2019; 9(1): 1. doi: 10.3390/diagnostics9010001.
Twisk FNM.
Myalgic Encephalomyelitis (ME) is a neuromuscular disease
with two distinctive types of symptoms
(muscle fatigability or prolonged muscle weakness after minor exertion and
symptoms related to neurological disturbance,
especially of sensory, cognitive, and autonomic functions) and
variable involvement of other bodily systems.
Chronic fatigue syndrome (CFS),
introduced in 1988 and re-specified in 1994,
is defined as (unexplained) chronic fatigue
accompanied by at least four out of eight listed (ill-defined) symptoms.
Although ME and CFS are two distinct clinical entities (with partial overlap),
CFS overshadowed ME for decades.
In 2011, a panel of experts recommended abandoning the label CFS and its definition and
proposed a new definition of ME: the International Consensus Criteria for ME (ME-ICC).
In addition to post-exertional neuroimmune exhaustion (PENE), a mandatory feature,
a patient must experience
at least three symptoms related to neurological impairments;
at least three symptoms related to immune, gastro-intestinal, and genitourinary impairments; and
at least one symptom related to energy production or transportation impairments
to meet the diagnosis of ME-ICC.
A comparison between the original definition of ME and the ME-ICC
shows that there are some crucial differences between ME and ME-ICC.
Muscle fatigability, or long-lasting post-exertional muscle weakness, is the hallmark feature of ME,
while this symptom is facultative for the diagnosis under the ME-ICC.
PENE, an abstract notion
that is very different from post-exertional muscle weakness, is the hallmark feature of the ME-ICC
but is not required for the diagnosis of ME.
The diagnosis of ME requires only two type of symptoms
(post-exertional muscle weakness and neurological dysfunction),
but a patient has to experience
at least eight symptoms to meet the diagnosis according to the ME-ICC.
Autonomic, sensory, and cognitive dysfunction, mandatory for the diagnosis of ME,
are not compulsory to meet the ME-ICC subcriteria for 'neurological impairments'.
In conclusion,
the diagnostic criteria for ME and of the ME-ICC define two different patient groups.
Thus, the definitions of ME and ME-ICC are not interchangeable.
Keywords:
Myalgic Encephalomyelitis; chronic fatigue syndrome; diagnosis; symptoms; muscles; neurology
https://www.mdpi.com/2075-4418/9/1/1/htm
https://www.mdpi.com/2075-4418/9/1/1/pdf
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