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):
- post-exertional malaise,
- neurologische abnormaliteiten (geheugen- en koncentratieproblemen etc.) en
- autonome dysfunctie (orthostatische intolerantie etc.)
Symptomen die altijd aanwezig zijn (volgens de "oude" ME-kriteria):
- pijn,
- endocriene afwijkingen,
- immunologische symptomen (koortsgevoel, geziowllen lymfeklieren etc.)
- 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:
ME-viral,
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
ME-other,
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
include
pain,
endocrine manifestations,
immune manifestations, and
sleep dysfunction.
Myalgic Encephalomyelitis Case Definitions
Automatic Control of Physiological State and Function. 2012; 1.
doi:10.4303/acpsf/K110601.
Leonard A. Jason, Dylan Damrongvachiraphan, Jessica Hunnell, Lindsey Bartgis, Abigail Brown, Meredyth Evans, and Molly Brown
Abstract
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.
Keywords
myalgic encephalomyelitis; case definitions
http://www.ashdin.com/journals/ACPSF/K110601.pdf
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