Highlights & Basics
- Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a severe, multisystemic, and disabling condition.
- A history of post-exertional malaise (PEM), also known as post-exertional neuroimmune exhaustion (PENE), for a minimum of 6 months is considered a defining key symptom. PEM occurs when exertion and other stressors lead to symptom exacerbations with immediate or delayed onset. Although many of the symptoms commonly reported in ME/CFS may occur in several other diseases, the presence of PEM should always prompt consideration of ME/CFS.
- Although diagnostic criteria stipulate that diagnosis in adults should not be made until after 6 months of symptoms (3 months for children) and negative medical evaluation, the 2021 UK National Institute for Health and Care Excellence (NICE) guidance discusses the negative impact of a 6-month delay in starting management. NICE therefore recommends that observation in adults be reduced to 3 months before initiating therapy.
- There are no objective diagnostic tests, verified biomarkers, curative medications, or treatments for ME/CFS. The primary goals of treatment are to manage symptoms and improve functional capacity. Initial treatment should be individualized based on the patient's most severe complaints.
- The chronic but fluctuating debilitating symptoms require substantial lifestyle changes to carefully plan each day's activities, conserve energy resources for the most important tasks, schedule rest periods to avoid individuals overtaxing themselves, and to improve the quality of sleep.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Citations
Institute of Medicine of the National Academies. Beyond myalgic encephalomyelitis/chronic fatigue syndrome: redefining an illness. Feb 2015 [internet publication].[Full Text]
National Institute for Health and Care Excellence. Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management. Oct 2021 [internet publication].[Full Text]
Nacul L, Authier FJ, Scheibenbogen C, et al. European Network on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (EUROMENE): expert consensus on the diagnosis, service provision, and care of people with ME/CFS in Europe. Medicina (Kaunas). 2021 May 19;57(5):510.[Abstract][Full Text]
International Association for Chronic Fatigue Syndrome/Myalgic Encephalomeyelitis. Chronic fatigue syndrome/myalgic encephalomeyelitis: primer for clinical practitioners. 2014 [internet publication].[Full Text]
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