|
Symptoms
|
% Effected
|
|
Fatigue, often accompanied by non-restorative sleep, generally worsened by exertion
|
50-90%
|
|
Nausea
|
60-90%
|
|
Irritable bowel syndrome (diarrhea, nausea, gas, abdominal pain)
|
50-90%
|
|
Chronic sore throat
|
50-90%
|
|
Fevers, chills, sweats, feeling hot often
|
60-95%
|
|
Muscle and/or joint pain, neck pain
|
65-95%
|
|
Bladder/prostate problems, frequent urination
|
20-95%
|
|
Low blood pressure
|
86%
|
|
Recurrent illness and infections
|
70-85%
|
|
Malaise
|
80%
|
|
Heat/cold intolerance
|
75-80%
|
|
Painful and/or swollen lymph nodes
|
50-80%
|
|
Systemic yeast/fungal infections
|
30-80%
|
|
Fungal infection of skin and nails
|
71%
|
|
Weight gain
|
50-70%
|
|
Increased/severe PMS (Premenstrual Syndrome)
|
70%
|
|
Swelling, fluid retention
|
55-70%
|
|
Shortness of breath
|
30-70%
|
|
Subnormal body temperature
|
65%
|
|
Severe allergies
|
40-60%
|
|
Sensitivities to medicines, inhalants, odors, and foods
|
25-65%
|
|
Difficulty swallowing
|
55-60%
|
|
Heart palpitations
|
40-60%
|
|
Sinus pain
|
56%
|
|
Rash or flushing of face
|
35-45%
|
|
Chest pain
|
40%
|
|
Hair loss
|
20-35%
|
|
Eye pain
|
30%
|
|
Pressure at the base of the skull
|
30%
|
|
Weight loss
|
20-30%
|
|
Tendency to bruise easily
|
25%
|
|
Vomiting
|
20%
|
|
Other CFS/ME Physical Symptoms
|
Endometriosis
|
|
Dryness of mouth, eyes
|
|
Pressure sensation behind eyes
|
|
Frequent canker sores
|
|
Periodontal disease, pain in teeth, loose teeth
|
|
Cough
|
|
TMJ syndrome
|
|
Mitral valve prolapse
|
|
Carpal tunnel syndrome
|
|
Serious cardiac rhythm disturbances
|
|
Pyriform muscle syndrome, causing sciatica
|
|
Impotence
|
|
Thyroid inflammation
|
|
Hypoglycemia
or hypoglycemia like symptoms
|
|
Swelling of nasal passages
|
|
Micro vascular disease
|
|
Cardiomyopathy
|
|
Tachycardia
|
| Neurological/Central Nervous System Symptoms
|
|
Symptoms
|
% Effected
|
|
Confusion, inability to think clearly
|
75-100%
|
|
Concentration/attention deficit
|
70-100%
|
|
Sleep disorder/disturbance (insomnia, un restorative sleep, unusual nightmares)
|
65-100%
|
|
Muscle weakness
|
85-95%
|
|
Headache
|
75-95%
|
|
Memory problems (especially short-term memory)
|
80-90%
|
|
Photosensitivity
|
65-90%
|
|
Disequilibrium, spatial disorientation, dizziness, vertigo
|
60-90%
|
|
Spaceyness, light-headedness
|
75-85%
|
|
Muscle twitching, involuntary movements
|
55-80%
|
|
Aphasia and/or dyscalculia
|
75-80%
|
|
Alcohol intolerance
|
45-75%
|
|
Seizure-like episodes
|
70%
|
|
Coordination problems/clumsiness
|
60%
|
|
Paresthesias
(numbness, tingling or other odd sensations in face and/or extremities)
|
25-60%
|
|
Visual disturbance (scratchiness, blurring of vision, "floaters")
|
45-55%
|
|
Episodic hyperventilation
|
40-45%
|
|
Fainting or blackouts
|
40%
|
|
Strange taste in mouth (bitter, metallic)
|
25%
|
|
Temporary paralysis after sleeping
|
20%
|
|
Earache
|
20%
|
|
Other CFS/ME Symptoms Reported
|
|
Decreased sex drive
|
|
Hallucinations (sensory perception experienced in the absence of an external stimulus)
|
|
Alteration of taste, smell, hearing
|
|
Tinnitus
|
|
|
|
Neurological Channelopathies
The symptoms of CFS/ME patients display some similarities to those found in
neurological channelopathies. One of the symptoms CFS/ME has in common with ion
channel disorders is its fluctuating nature. All known
channelopathies of
the excitable tissues result in episodic episodes of fatigue. As in CFS/ME some cause
symptoms that indicate both peripheral and central disruption. Neurological
channelopathies (hypoakalemic periodic paralysis, episodic ataxia) are often
characterized by sudden attacks of fatigue, weakness, cramping or even paralysis. As
in CFS/ME many channelopathies can be induced by physical activity and/or stress.
While there has been much discussion regarding the need for longitudinal studies to
capture the fluctuations present in CFS/ME Many question how episodic CFS/ME is.
Their experience is that it is no more episodic than would probably be expected in a
chronic disorder; that is, there are better or worse days but few days with truly
dramatic shifts in well-being.
CFS/ME patients share with epileptics a predisposition to several autonomic related
symptoms such as frequent near syncope (fainting) and low blood pressure, particularly
during TILT table testing. A great deal of evidence since 1999 indicates many CFS/ME
patients display abnormalities during TILT table testing or during standing.
CFS/ME patients share with migraine sufferers such symptoms as headache, confusion,
increased sensitivity to lights, sounds and smells as well as exacerbated responses
to serotonin. Symptom exacerbation during menstruation and muscle pain, disequilibrium
and unusual sweating are often seen in both diseases. White brain matter abnormalities
and reduced cerebral blood flows are also seen in both diseases and stress, alcohol
and caffeine can exacerbate symptoms in both diseases. Transient or chronic fatigue is
also common in migraine.
Finally, there is evidence of a channelopathy in CFS/ME. Some indirect evidence of
ion channel disruption is provided by
Chaudhuri et al's
finding of increased resting energy expenditure (REE) in CFS/ME patients. Since about 25%
of the energy expended during resting goes to maintaining ion gradients in the cell,
the authors speculate the increased REE seen in CFS/ME could be due to compensation for
faulty ion channel functioning. CFS/ME patients also appear to be particularly susceptible
to some substances (alcohol, anesthesia, some cholesterol lowering drugs) known to
effect either membrane integrity (alcohol) and/or ion function (anesthethetics).
Indeed fatigue is a common symptom of a new anti-epileptic drug, dezinamide, targeting
sodium channels. Results from a thallium scan of the cardiac muscle in CFS/ME patients
suggest a potassium ion channel dysfunction that may be responsible for the
cardiomyopathy reported by Lerner and now advocated by Cheney. Chaudhuri and Behan
believe a potassium channelopathy is mostly likely to occur in CFS/ME.
Potential causes of channel dysfunction - The natural history of CFS/ME suggests that
an early pathogenic or toxic insult often occurs. Several viruses, including HIV and
the picornaviruses are able to alter ion channel flow. Herpes viruses have also been
linked, interestingly enough given their history in CFS/ME, to altered ion
channel functioning. Ciguatoxin, a neuronal sodium channel disrupter, produces many
symptoms, including fatigue, similar to those that occur in CFS/ME.
Studies indicate
a substantial number of CFS/ME patients have extremely high levels of the ciguatera
epitope. Toxic insults from organophosphate's, lead, insecticides, pesticides can also
alter ion channel activity.
|
|
|
| Emotional/Psychological Symptoms
|
|
Symptoms
|
% Effected
|
|
Anxiety
|
70-90%
|
|
Mood swings, excessive irritability, overreaction
|
70-90%
|
|
Depression
|
65-90%
|
|
Personality change
|
55-75%
|
|
Panic attacks
|
30-40%
|
|
|
|
Sources:
- Abhijit Chaudhuri, Peter O. Behan, Chronic fatigue syndrome is an acquired
neurological channelopathy, University Department of Neurology, Institute
of Neurological Sciences, Southern General Hospital, 1345 Govan Road, Glasgow G51 4TF, UK.
- Epidemiological study of an epidemic diagnosed as poliomyelitis occurring among
the personnel of Los Angeles County General Hospital during the summer of 1934.
Gilliam AG Public Health Bulletin, US Treasury Department No.240, 1938.
- An investigation into an unusual disease in epidemic and sporadic form in general
practice in Cumberland in 1955 and subsequent years. Wallis AL. University of
Edinburgh Doctoral Thesis 1957.
- The Clinical Syndrome Variously Called Benign Myalgic Encephalomyelitis, Iceland
Disease and Epidemic Neuromyasthenia. ED Acheson. Am J Med 1959:569 595.
- Diseases of the Nervous System. Lord Brain. Sixth Edition. Oxford University Press
1962.
- Epidemic Neuromyasthenia 1934 1977.. current approaches. Ed: WH Lyle and RN
Chamberlain. Postgraduate Medical Journal 1978:54:637:705 774 pub: Blackwell
Scientific Publications, Oxford.
- Myalgic Encephalomyelitis: A Baffling Syndrome with a Tragic Aftermath. A. Melvin
Ramsay pub: The ME Association, November 1981.
- Presentation to the Scottish Parliament on 4th April 2001 by Dr A. Chaudhuri,
Senior Clinical Lecturer in Neurology, University of Glasgow.
- Introduction to Research and Clinical Conference. Daniel L Peterson. Journal of CFS
1995: 1:3 4:123 125 (Previously presented at the AACFS International Research and
Clinical Conference on CFS held at Fort Lauderdale, Florida, 7th1Oth October 1994,
co sponsored by the National Institutes of Health and the Centres for Disease Control).
- The Quality of Life of Patients with Chronic Fatigue Syndrome. JS Anderson, CE
Ferrans J Nervous and Mental Diseases 1997:185:6:359 367.
- Quality of Life in Chronic Fatigue Syndrome. R Schweitzer et al Soc Sci Med
1995:41:10: 1367 1372.
- Interferon induced proteins are elevated in blood samples of patients with
chemically or virally induced chronic fatigue syndrome. Vojdani A, Lapp CW.
Immunopharmacol Immunotoxicol 1999:21: (2):175 202.
- Estimating rates of Chronic Fatigue Syndrome from a community based sample.
Jason LA et al American Journal of Community Psychology 1995:21557 568.
- Prevalence of Chronic Fatigue Syndrome in an Australian Population. Lloyd AR
et al Medical Journal of Australia 1990:153:522 528.
- Chronic Fatigue Syndrome. Report of a Joint Working Group of the Royal Colleges
of Physicians, Psychiatrists and General Practitioners (CR 54) pub. RCP London 1996.
- The Organic Basis of ME / CFS. EG Dowsett, DM Jones. Information and Statistics
presented to the Chief Medical Officer in person at a meeting on 11th March 1998.
- Review by JF Mowbray, Emeritus Professor of Immunopathology, Imperial College
School of Medicine, London: Enteroviral and Toxin Mediated Myalgic Encephalomyelitis /
Chronic Fatigue Syndrome and other Organ Pathologies. John Richardson. The Haworth
Press Inc. New York, 2001.
- Enteroviral and Toxin Mediated Myalgic Encephalomyelitis / Chronic Fatigue
Syndrome and Other Organ Pathologies. John Richardson The Haworth Press Inc, New York
2001.
- Clinical Observations of Central Nervous System Dysfunction in Post infectious
Acute Onset ME / CFS. B Hyde A Jain. In. The Clinical and Scientific Basis of
Myalgic Encephalomyelitis Chronic Fatigue Syndrome. ed: BM Hyde, J Goldstein,
P Levine pub: The Nightingale Research Foundation, Ottawa, Canada, 1992.
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fatigue syndrome: a comprehensive approach to its definition and study. International
Chronic Fatigue Syndrome Study Group. Ann Intern Med 1994;121:953-9. PMID 7978722.
- Holmes GP, Kaplan JE, Gantz NM, Komaroff AL, Schonberger LB, Straus SE, Jones JF,
Dubois RE, Cunningham-Rundles C, Pahwa S, et al. Chronic fatigue syndrome: a working
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