What is Myalgic Encephalomyelitis? and What is "Chronic Fatigue Syndrome" (Currently "erroneously" labelled "ME/CFS"?) - PART 1 - WORK IN PROGRESS

The background on "Epidemic" Myalgic Encephalomyelitis (also known as "Enteroviral Encephalomyelitis") (M.E.) and Chronic Fatigue Syndrome (CFS)

If a patient or a family member has tried to search the internet for an understanding of Myalgic Encephalomyelitis (M.E.), or so-called "Chronic Fatigue Syndrome" (CFS, currently being labeled "ME/CFS"), they will have been overwhelmed by the multitude of technical descriptions and the numerous overlapping medical conditions. 

There have been many attempts to define CFS, some of them described in our 1992 book 'The Clinical and Scientific Basis of M.E. and CFS'.

M.E. and ME/CFS represent a complex, multi-system group of afflictions, adversely affecting the brain, heart, neuro-endocrine, immune and circulatory systems in our bodies, but, crucially, M.E. is a distinct illness, while both CFS and ME/CFS are umbrella terms for a group of symptoms common to many illnesses and conditions. 

This has led to M.E. symptoms being confused with the symptoms for neurasthenia, multiple chemical sensitivities, fibromyalgia, chronic mononucleosis, and much more.

Unfortunately, the majority of physicians in the UK, Europe and North America, not to mention the rest of the world, have a poor and sometimes distorted idea of what "MYALGIC ENCEPHALOMYELITIS (M.E.)" represents.

Myalgic Encephalomyelitis (also known as Enteroviral Encephalomyelitis / Enteroviral Meningo-Encephalomyelitis) M.E. - MEPedia

One of the several fallacies is that "M.E." is just another name for "CHRONIC FATIGUE SYNDROME (CFS)". 

IT IS NOT AND NEVER HAS BEEN.

"Epidemic Myalgic Encephalomyelitis" (also known as Enteroviral Encephalomyelitis / Enteroviral Meningo-Encephalomyelitis) M.E. - MEPedia

The Background on Myalgic Encephalomyelitis


Myalgic Encephalomyelitis beginning in 1905, with a swedish epidemic, and subsequently named Superior Polioencephalitis - Medin Type, meaning effecting the midbrain, pons, medulla and cerebellum of most infected patients. The infection can reach up through the thalamus and hypothalamus and effects the superior (cerebral) brain functions by Polio Expert Dr. Ivar Wickman. In 1934 an outbreak of an illness described as Atypical Poliomyelitis, within a 1938 Epidemiological Study Report and Public Health Bulletin by Dr. Alexander Gilliam, struct Los Angeles County General Hospital in California, USA. An experimental Polio vaccine was given to the staff at the hospital preceding this outbreak. The illness was initially confused with Poliomyelitis, but it was eventually differentiated and became known as "Epidemic Neuromyasthenia", meaning Neurological Muscle Weakness, in 1957 within two seperate case reports by Dr. Alexis Shelokov and Dr. David Poskanzer within The New England Journal of Medicine. The term "Benign Myalgic Encephalomyelitis" was first coined in The Lancet, within a 1956 editorial by Sir Donald Acheson *anonymously* to describe a similar 1955 outbreak, which occured at the Royal Free Hospital in London, UK. The details of each outbreak vary, but in general, patients experienced a variety of symptoms, including malaise, tender lymph nodes, sore throat, pain, and "signs of encephalomyelitis". Although the cause of the condition could not be determined, it appeared to be infectious, and the term "Benign Myalgic Encephalomyelitis" eventually was chosen to reflect "the absent mortality, the severe muscular pains, the evidence of parenchymal damage to the central nervous system, and the presumed inflammatory nature of the disorder".

List of Myalgic Encephalomyelitis (also known as Enteroviral Encephalomyelitis) and "Original" Chronic Fatigue Syndrome (also known as Enteroviral Encephalitis) Outbreaks - MEPedia

There have been dozens of documented outbreaks of Myalgic Encephalomyelitis (also known as "Enteroviral Encephalomyelitis") and "original" Chronic Fatigue Syndrome (also known as "Enteroviral Encephalitis") since the 1930's. The true number of clusters and outbreaks is likely vastly higher. Many of these outbreaks occurred in institutions like hospitals and schools, and frequently coincided with outbreaks of poliomyelitis.

1934 Los Angeles County General Hospital Atypical Poliomyelitis Outbreak - MEPedia

The 1934 Los Angeles County General Hospital epidemic is the first known recorded cluster outbreak resulting in what is now known as Myalgic Encephalomyelitis.

Between May 1934 and December 15, 1935, one hundred ninety-eight (198) employees of Los Angeles County Hospital came down with an acute onset neurological illness. This accounted for 4.5% of hospital personnel becoming ill including about 10.7% of the nurses and 5.4% of the physicians.

As a poliomyelitis epidemic was occurring in California at this time, the first impression from the medical community was that the illness was polio, especially since the the illness presented with similarities including febrile onset and flaccid weakness.

1948-49 Akureyri Outbreak (also known as Iceland Disease) - MEPedia


Akureyri Disease (also called Iceland disease) is used for an outbreak of fatigue symptoms in Iceland. The outbreak of a disease simulating poliomyelitis took place in the town of Akureyri in Northern Iceland in the winter of 1948-1949. The center of the epidemic was in the main secondary boarding school. The predominant symptoms were tiredness and exhaustion. Since the outbreak of the disease the sufferers were often thought to suffer from psychiatric disorder such as hysteria

The disease was first diagnosed as poliomyelitis and the first case was reported on September 25, 1948 in Akureyri. During the third and fourth week of November it became evident that this epidemic was different from epidemics of poliomyelitis. The epidemic lasted for more than 3 months and the total number of reported cases was 488.

In a study of children in Iceland vaccinated against polio in 1956, Sigurdsson, et. al found significant differences in antibody response to vaccination depending on where the children lived. Children in Egilsstadir had only a slight antibody rise to type 2 and type 3 poliovirus, while children in Thorshofn, which had recently had an outbreak of Epidemic Myalgic Encephalomyelitis (also known as "Enteroviral Encephalomyelitis"), had a much stronger antibody response to the polio vaccine. Sigurdsson postulated that this might be explained by "the existence of basic immunity acquired through a related infection."

It was after this outbreak that the term Icelandic Disease, an early name for Myalgic Encephalomyelitis, was coined.

Is "MYALGIC ENCEPHALOMYELITIS" a form of POLIO

Understanding M.E. is relatively simple. However, understanding M.E. was much simpler sixty years ago. Prior to 1955, if the patient fell ill with M.E. their illness would have been called: Missed Polio.

Missed polio was a diagnosis given prior to 1955, when the patients fell ill during a Poliomyelitis epidemic and were left disabled, weak, often in pain and with cognitive difficulties

The term Myalgic Encephalomyelitis was a name developed to describe the disabling chronic injury sustained by the nurses and physicians of the Royal Free Hospital in London, England in 1955.

1955 Royal Free Hospital Outbreak of Epidemic Myalgic Encephalomyelitis (also known as Enteroviral Encephalomyelitis) - MEPedia

The Royal Free Hospital outbreak was a cluster outbreak of myalgic encephalomyelitis at the Royal Free Hospital in London.

In 1955, between July and November, 292 members of the medical, nursing, auxiliary medical, ancillary, and administrative staff fell ill, of which 255 were admitted to the hospital. The disease name myalgic encephalomyelitis was first coined to describe the illness in an editorial in The Lancet, in 1956.

This epidemic was part of the combined epidemic of paralytic and missed poliomyelitis which struck across England and London that year. 

This was also the same year that the first major successful paralytic polio immunization, the incredibly effective Jonah Salk immunization, began to be distributed in the United States of America.

The Salk immunization solved the problem of flaccid paralysis and death caused by the three known polioviruses but in 1955 Salk and colleagues didn't realize there were some hundred other dangerous enteroviruses which existed but had not yet been discovered.

Enterovirus - MEPedia

These missing links to the puzzle of acute and chronic enterovirus illness were not included in these Salk and later Sabin polio immunizations. Unknown to them, some of these other dangerous enteroviruses also caused flaccid paralysis and several caused what they referred to as missed polio, what we know since the 1950's as Myalgic Encephalomyelitis

M.E. is a biphasic epidemic and sporadic enteroviral infectious disease. Up to 1955 and the introduction of Jonas Salk’s polio immunization M.E. tended to occur in the same location and at the same time as polio epidemics. In epidemic form, both Polio and M.E. tend to peak in the north temperate hemisphere during the period of July to November, with a last small blip around Christmas when families tend to get together.


Many of these other disease causing enteroviruses are very similar in genetic structure to the then known polio-enteroviruses. Many differ, one from the other, by less than 5% of their genomic (genetic blueprint) structure. 

There are at least six or more enteroviruses causing paralytic or flaccid paralysis and I assume that one day they will all be included in the polio immunization. These non-polio enteroviruses appear to be on the rise.

"Encephalomyelitis" resembling Benign Myalgic Encephalomyelitis - S.N.B. Innes (The Lancet, 1970)

Abstract

Four cases of encephalomyelitis resembling benign myalgic encephalomyelitis are reported. A Coxsackie B2 virus was isolated from the cerebrospinal fluid in one case and an echovirus type 3 virus from the faeces and the cerebrospinal fluid in another. Serological tests indicated Coxsackie B2 and Coxsackie B5 infection in the other two cases.

Where known, the shortest incubation period is 3-5 days, (short incubation allows epidemic spread)

01. A few: e.g. Paralytic Polio and M.E. are biphasic with early minor symptoms; followed by severe chronic illness,

02. As in polio, the majority of those infected don’t fall ill but tend to become immune for life. 

03. Some are infected, show no signs of illness but become carriers, infecting other people, some fall ill for a few days or weeks and then recover. 

04. Some fall ill, improve, and get better only to have recurrent chronic illness, sometimes years later. 

05. Some fall ill and remain chronically ill and disabled, and among adults, often for life, some die and according to Dr. Ivar Wickman, some patients are identified as other illnesses including:

01. Landry’s Paralysis (both "descending" "Miller Fisher Syndrome" and "ascending" Guillain-Barré Syndrome)

02. Chronic Pain Syndromes (Fibromyalgia, "Secondary" Complex Regional Pain Syndrome) and... 

03. Patients with Cognitive Difficulties.

Defining Neuromuscular Symptom

Post-Exertional Muscle Fatigability followed by Motor Weakness - MEPedia

Muscle Fatigability ("Muscle Fatigue") in M.E. is a symptom in which muscles become weaker (also known as "Motor Weakness") after minor exertion and a long period (3-5 days or longer) may elapse before full muscle power is restored. 


According to Dr. Melvin Ramsay, it is the defining feature of Myalgic Encephalomyelitis, without which a diagnosis of M.E. should not be made, though this symptom is noted to improve during remission.

Similar muscle effects are known to occur in other neurological diseases such as Multiple Sclerosis (M.S.) and Post-Polio Syndrome.

In addition to Myalgic Encephalomyelitis, an extensive list of enteroviral provoked diseases, disorders, syndromes and symptoms, includes:

01. Anterior Poliomyelitis - Motor Neuronopathy - Anterior Horn Syndrome; leading to Asymmetrical "Flaccid Paralysis"


03. Acute Flaccid Myelitis (AFM) - New Polio - Motor Neuronopathy - caused by "Non-Polio Enteroviruses", maybe we should call them "Polio-like Enteroviruses" considering the name is a "misnomer"

04. Poliomyelitis-like Syndrome - Motor Neuronopathy - Anterior Horn Syndrome; leading to Asymmetrical "Flaccid Paralysis", Areflexia and "Neurogenic Muscle Atrophy"

05. Aspetic Meningitis

06. Fever

07. Headaches

08. Stiff Neck

09. PhotophobiaNystagmusLoss of Accommodation



10. ConfusionDeliriumAltered Mental Status (AMS) and altered level/state of consciousness

11. Encephalitis - Limbic, Meningo or Rhombencephalitis, Cerebellar Ataxia and Cerebellar Syndrome and Disequilibrium (Overlaps the vague symptom constellation-based checklist of "Chronic Fatigue Syndromes - 1994 Fukuda CFS, 2003 CCC and 2015 SEID" criterias but which are also "EXCLUDED" from them, under statements like "CONSIDER ANOTHER DIAGNOSIS" from IOM's SEID algorithm (also known as "ME/CFS" erroneously, invented by individuals, WHO ARE "NOT" EXPERTS in INFECTIOUS DISEASES, CLEARLY?). So how about that for "MEDICAL GASLIGHTING")


12. ProprioceptionRomberg Test

13. DizzinessVertigoBalance Problems


14. Brainstem Dysfunction triggers Autonomic Instability which can cause Tachycardia (High Heart Rate), Hypertension (High Heart Rate), Hyperhidrosis (Excessive Sweating)
 and can also cause Noncardiogenic (Neurogenic) Pulmonary EdemaHypoxemia

15. Brainstem/Midbrain : Internuclear Ophthalmoplegia

16. Tinnitus (Ringing In Ears), Ménière’s DiseaseHyperacusisSensorineural Hearing Loss (SNHL)Hearing Loss

17. Transient Derealization Disorder

18. Increased Intracranial Pressure (ICP)Blurred Vision

19. Eye Pain (Retro-Orbital Eye Ball Pain with Meningeal Irritation with Headache and Increased Intracranial Pressure (ICP) or with Trigeminal Nerve (Cranial Nerve V) inflammation

20. Fatigue

21. Hyper Somnolence (Drowsiness)Hypersomnia, and Insomnia

22. Short Term Memory LossBrain FogDyslexiaDyscalculiaProsopagnosia (Face Blindness)Executive Dysfunction

23. Syncope (Fainting)

24. Aphasia (Expressive, Receptive and Anomic)

25. Mood SwingsAdjustment Disorder with depressed mood, Frustration

26. Muscle Weakness (Motor Weakness) or Muscle Atrophy (Neurogenic Atrophy) are the unifing hallmarks of PolioEnteroviral Encephalomyelitis (also known as Myalgic Encephalomyelitis), Poliomyelitis-like SyndromeAcute Flaccid Myelitis (AFM) or Guillain-Barré Syndrome (especially Axonal forms)

27. ParesthesiaHyperesthesia

28. Seizure, Post-Viral Epilepsy

29. Hypothalamic Dysfunction and Tertiary Adrenal Insufficiency (Adrenal Dysfunction)

30. Cranial Nerve Palsies (e.g. Accucem Palsy Diplopia (Double Vision), Strabismus (Eye Misalignment)Ptosis (Droopy Eyelid)Bulbar Palsy (DysphagiaDysarthria (Slurred Speech), Voice Disorders and Dysphonia (Hoarseness)), "Peripheral" Facial Palsy etc...) / "descending" Guillain-Barré Syndrome (GBS) - Miller Fisher Syndrome (MFS)



"Peripheral" Facial Palsy

31. Myoclonic Jerks (Muscle Twitch), Fasciculations, Muscle Spasms

32. Tremors, Shakings, SpastcityHyperreflexiaClonusMovement Disorders and Dystonia

33. Dysautonomia / Postural orthostatic Tachycardia Syndrome (PoTS) / Low Blood Volume (Hypovolemia) | Reduced Cardic Output - Especially "Thermoregulation and Circulation"



35. Neuromuscular Disorder

36. Motor Disorder (also known as a "Motor Neuron Disorder") 

37. Gastroenteritis, Gastritis, Colitis and Terminal Ileitis - Diarrhoea & Vomiting and Abdominal Pain, Irritable Bowel Syndrome, (IBS)Visceral HypersensitivityUnintended Weight Loss due to infection, Nausea, Non-IgE Mediated Food (Cow Milk) Allergy - Food Protein-Induced Allergic Proctocolitis (FPIAP), Mesenteric Lymphadenitis and a Chronic Non-Cytolytic Enterovirus Gastrointestinal, or Central Nervous System Infection - "FATIGUE and (IRES-Capped Cellular mRNA, Mitochondrial Dysfunction - Reduced Cellular Metabolism) ---> POST-EXERTIONAL MALAISE (PEM)"

Myalgic encephalomyelitis—a persistent enteroviral infection? - Elizabeth Dowsett (Postgraduate Medical Journal, Oxford Academic, 1st July 1990)






38. Gastroparesis, Intestinal Dysmotility, Constipation, Paralytic Ileus 


39. Hepatitis 

40. Disturbance of Micturition : Frequent UrinationUrinary IncontinenceUrinary Retention

41. Mast Cell Activation Syndrome (MCAS)

42. Crohn's Disease

43. Herpangina, Tongue Ulcers and Hand, Foot and Mouth Disease (HFMD)

44. Haemorrhagic Conjunctivitis (also known as Apollo Disease)

45. Rhinitis, Laryngitis, Tracheitis, Croup (Laryngotracheobronchitis), Bronchitis, Bronchiolitis, Pleurisy, Pneumonia 


46. Pericarditis, Myocarditis or Perimyocarditis

47. Diastolic DysfunctionDiastolic Heart FailureLeft Ventricular Diastolic Dysfunction (LVDD)

48. Dilated Cardiomyopathy

49. Systolic Heart Failure

50. Epidemic Pleurodynia (Bornhom Disease) (also known as "Epidemic Myalgia")

51. Labyrinthitis (also known as "Epidemic Vertigo")

52. Muscle Fibers: Acute Viral Myositis (Polymyositis-like Syndrome - Myalgia) and Myopathy, Post-Exertional Myalgia and Rhabdomyolysis

53. Arthralgia (Joint Pain)Viral Arthritis

54. Costochondritis, Tietze Syndrome 

55. Vestibular Migraines, Tension Headaches

56. Larger Fiber Peripheral Neuropathies: "ascending flaccid paralysis" Guillain-Barré Syndrome (GBS) - Acute Inflammatory Demyelinating Polyradiculoneuropathy (AIDP), Acute Motor Axonal Neuropathy (AMAN) and Acute Motor Sensory Axonal Neuropathy (AMSAN), Polyradiculoneuritis, Sensorimotor Axonal Polyneuropathy, Axonal Polyneuropathy and Motor Axonal Neuropathy (Secondary to Anterior Horn Syndrome)

57. Small Fiber Polyneuropathies : Small Fiber Autonomic & Sensory Neuropathy, Small Fiber Sensory Neuropathy and Small Fiber Autonomic Neuropathy

58. Brachial Plexus Neuritis (Neuralgic Amyotrophy) (also known Parsonage-Turner Syndrome), Spinal and Cervical Radiculitis 

59. Pain Syndromes : Fibromyalgia, (Secondary) Complex Regional Pain Syndrome (CRPS)Myofascial Pain Syndrome

60. Hypokalemia (Hypokalemic Periodic Paralysis (hypoPP

61. Pancreatitis and Type 1 Diabetes (T1DM)


62. Primary Thyroid Failure (Hypothyroidism - Hashimoto's Disease)

63. Pernicious Anemia and B12 Deficiency 

64. Folate Deficiency (Vitamin B9 Deficiency)

65. Autoimmune Hemolytic Anemia (AHA)

66. Connective Tissue DiseasesMixed Connective Tissue Disease (MCTD)Ehlers Danlos Syndromes (hEDS)

67. Mitral Valve Prolapse

68. Raynaud's Phenomenon (Secondary)

69. Dermatomyositis

70. Sjögren’s Syndrome (Sicca Syndrome)

71. Palindromic Rheumatism (Arthritis)

72. Spinal Degenerate Disease and Spinal Pain : Radiculopathy Pain Syndromes, KyphosisLordosis (Swayback)ScoliosisDegenerative Disk DiseaseSpinal ArthritisSpondylolysisSacroiliitisSacroiliac Joint Dysfunction

73. Endothelial Dysfunction

74. Vitamin D Deficiency and Osteoarthritis 

75. TendonitisBursitisPlantar Fasciitis

76. Joint Instability : Joint Hypermobility SyndromePatellar InstabilityPatellar SubluxationSoft Tissue Injury

77. Bladder Pain Syndrome (Interstitial Cystitis), Dyspareunia and Endometritis

78. Epididymitis, Orchitis, Salpingitis (fallopian tube inflammation) and Prostatitis 

79. Pneumonia, Neonatal Sepsis and Necrotizing Enterocolitis (NEC) and SIDS in Neonatals 

80. Leukopenia (Low White Blood Cell Count), Lymphopenia, Bone Marrow Failure

81. Acute Infectious Lymphocytosis (AIL) in children and Atypical Lymphocytosis and Leukocytosis (High White Blood Cell Count) with Encephalitis/Meninigitis

82. Infectious Mononucleosis-like Syndrome (Fever, Pharyngitis, Lymphadenopathy, Fatigue, Atypical Lymphocytosis) - M.E. was confused with "Glandular Fever" at the Royal Free Hospital Outbreak in 1955.

EBV was not isolated until 1964. Glandular Fever(Mono)-like Syndrome was already being used in popular usage before the discovery of the Epstein Barr Virus (EBV) in 1964, to reflect a common symptom constellation, and presentation, that typically occured together with infectious disease. 

Myalgic Encephalomyelitis (M.E.)

Dr. Paul Cheney explains that when patients with severe M.E. stand up, they are essentially "on the edge of organ failure." This is due to a dramatic drop in cardiac output: from a normal 7 liters per minute down to around 3.7 liters per minute - a 50% reduction. According to Cheney, every disabled M.E. patient is in a state of heart failure, and the level of disability directly matches the degree of this cardiac dysfunction.

Research findings also show that M.E. involves mitochondrial metabolic dysfunction, similar to what is seen in mitochondrial encephalomyopathy. Because of this, Cheney strongly warns against aerobic exercise for M.E. patients. He emphasizes that even progressive aerobic activity can worsen the condition:

“If you have a defect in mitochondrial function and you push the mitochondria by exercise, you kill the DNA.” (Williams 2004)

What Is Known About M.E.? 

M.E. is a complex, multi-system disease that affects nearly every part of the body. It is recognized as:

1. An infectious disease with acute (biphasic) onset, sometimes epidemic, more often endemic

2. An autoimmune illness (with similarities to lupus)

3. A neurological infection that affects both adults and children

4. A condition that causes major cognitive impairment and dysfunction

5. A persistent viral illness, linked to enteroviruses (the same family causing Polio and Post-Polio Syndrome)

6. A vascular disease that injures the central nervous system (the brain)

7. A central nervous system disease (with similarities to Multiple Sclerosis)

8. A diffuse (acquired) brain injury

9. A systemic illness that impacts multiple organs, particularly the heart (e.g. Diastolic DysfunctionPericarditis, Myocarditis, Perimyocarditis and Dilated Cardiomyopathy)

10. A vascular disorder (e.g. Endothelial Dysfunction)

11. A cardiovascular disease

12. A form of cardiac insufficiency (e.g. Reduced Cardiac Output)

13. A mitochondrial disorder (e.g. Mitrochondrial Dysfunction and Encephalomyopathy)

14. A metabolic disorder

15. A musculoskeletal disorder (e.g. Neuromuscular Disorder)

16. A neuroendocrine disease

17. A seizure disorder (e.g. Post-viral Epilepsy)

18. A sleep disorder

19. A gastrointestinal disorder

20. A respiratory disorder

21. An allergic disorder (e.g. Mast Cell Activation Disorder)

22. A pain disorder

23. A life-changing, disabling disease

24. A chronic or lifelong illness with high disability levels

25. An unstable condition, with severity that can change from hour to hour, day to day, or month to month

26. A potentially progressive or even fatal illness

This summary is not a complete list of all research findings. However, what is clear is that M.E. impacts nearly every cell and system in the body, making it a profoundly disabling and multi-system illness.

Additional Findings

Research shows that Myalgic Encephalomyelitis (M.E.) is also associated with a number of genetic abnormalities. These are acquired changes (not inherited) that affect how cells function.

The position of Nightingale Research Foundation is that the IOM does NOT describe or define M.E., and that the ICC, while far superior to the IOM, is still not specific enough. In creating the Nightingale Definition, we have studied decades of clinical evidence, and followed up on the work of Dr. Melvin Ramsay (case descriptions published 1986 and 1988), Dr. Elizabeth Dowsett, Dr. John Richardson, and others who closely studied M.E. patients and M.E. outbreaks over several decades.

Dr. John Richardson - Myalgic Encephalomyelitis : Guidelines for Doctors (2002)

M.E. has a clearly defined disease process, while CFS by definition has always been a syndrome. In light of this state of affairs, the Nightingale Research Foundation created it's 2006 and 2007 Definitions of M.E. and updated it in 2016

2016 Nightingale Research Foundation Definition is a "clinical case definition" for Myalgic Encephalomyelitis (also known as Enteroviral Encephalomyelitis) M.E. - MEPedia

















MRI Findings in Enteroviral Encephalomyelitis - Science Direct

Introduction 

The majority of enterovirus infection in pediatrics presented with hand, foot and mouth disease and oral ulcers. A few of these patients had manifestations of polio-like encephalitis, and acute flaccid paralysis.

Aim of the work 

The aim of our study was to highlight the MR imaging features of enterovirus infection of the brain and spinal cord.

Results 

MR imaging of the 25 patients revealed 5 patients with normal MRI brain examination. T2 hyperintensity within the brainstem was seen in 16 patients, while 2 patients showed cervical cord lesions and two patients with dentate nuclei lesions.

Conclusion 

Enterovirus Encephalomyelitis has characteristic lesion locations in the posterior portions of the brainstem, substantia nigra, dentate nucleus and within the anterior horns of spinal cord

Recognition of these findings in the presence of suggestive clinical presentation can help to establish the diagnosis of Enterovirus Encephalomyelitis.


Polioencephalitis - Wikipedia

Polioencephalitis is a viral infection of the brain, causing inflammation within the grey matter of the brainstem. The virus has an affinity for neuronal cell bodies and has been found to affect mostly the midbrain, pons, medulla and cerebellum of most infected patients. The infection can reach up through the thalamus and hypothalamus and possibly reach the cerebral hemispheres.

Naming and Nomenclature

ATYPICAL POLIOMYELITIS (MYALGIC ENCEPHALOMYELITIS) M.E.

01. Enteroviral Encephalomyelitis or Enteroviral Meningo-Encephalomyelitis (Upper Motor Neurons)

02. Poliomyelitis-like Syndrome with Anterior Horn Damage; leading to "Asymmetrical" Flaccid Paralysis (Lower Motor Neurons)

Polio should be placed at the front of the naming of this Neurological and Vascular Disease. It is NOT Chronic Fatigue Syndromes, or a so called "ME/CFS" "Unexplained Fatigue" State Critera, whether the 2003 Canadian Consenus Criteria or Institute of Medicine (IOM) / National Academy of Medicine (NAM) 2015 Systemic Exertion Intolerance Disease Criteria (SEID) (Erroneously labeled as "ME/CFS" by the "misinformed" CDC and NICE), and M.E. is actually EXCLUDED from these criterias. The SEID criteria is another Chronic Fatigue Syndrome, re-definition. So one would assume it's meant for "missed" "Chronic Fatigue Syndromes" and "NOT" for "Myalgic Encephalomyelitis" (also known as "Enteroviral Encephalomyelitis") which is EXCLUDED under "Consider Another Diagnosis".


The 2011 International Consenus Criteria (ICC) is the symptom-based criteria that overlaps the closest to Myalgic Encephalomyelitis (M.E.) - It's FLAWED and OUT OF DATE and is still being defined just by a "Constellation of Symptoms", and obviously doesn't define M.E. outright. One thing it does get right, is that it focuses on CNS Brain Dysfunction, and not on FATIGUE which can be completely absent, within M.E.-induced CHRONIC DISABILITY. Post-Exertional Central Nervous System Exhaustion is a more appropriate term, rather than Post-Exertional Neuroimmune Exaustion, which has a rather unforunate acronym. The former term was endorsed by Dr. Elizabeth Dowsett, and the latter PENE acronym translates to PENIS in spanish and italian. Not really an appropriate way to describe a Brain Disorder; effecting the Central Nervous System

2011 International Consensus Criteria (ICC) - MEPedia

Myalgic Encephalomyelitis (M.E.) has similarities to Poliomyelitis, Post-Polio Syndrome, Multiple Sclerosis, Myasthenia Gravis, ADEM and is a Motor Neuron Disease



Neuromuscular Disorders - MEPedia


The 8th of August is "Myalgic Encephalomyelitis Awareness Day" (Named after Sophia Mirza's Birthday, and is also Byron Hyde's Birthday). Myalgic Encephalomyelitis is a Severe Disease. 


Contributions also from the works of Dr. Byron Hyde, Dr. Melvin Ramsay, and Dr. Elizabeth Dowsett

By Larrin Carney (M.E. Patient, Sufferer & Survivor) - Historical M.E. Investigator

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