MEDICAL DEFINITIONS

Whether you're new to FM and/or CFS/ME, or an experienced patient, there are always new terms and terminologies coming up. In order to find the medical information you're looking for, you'll come across medical terminology and medical information you might not understand.

This page contains over 200 definitions listed below, with many new words added monthly. The words are listed in alphabetical order. You can either select a letter from the box below, or scroll down the page to reveal the word you're looking for.

Contact us if you cannot locate a specific definition.

EEG Biofeedback or Neurofeedback, is a form of biofeedback which allows an individual to learn voluntary control of their brainwave activity. Electrodes (sensors) are placed on the surface of the scalp and are held painlessly in place with a paste. The process is non-invasive. These sensors pick up the brainwave patterns (electrical activity of the brain) and transmit them to a computer which analyzes them. Settings in the computer program are individually tailored for the client based on what brainwave patterns are desired.

An electrocardiogram (ECG or EKG, abbreviated from the German Electrocardiogram) is a graphic produced by an electrocardiograph, which records the electrical activity of the heart over time. Analysis of the various waves and normal vectors of depolarization and repolarization yields important diagnostic information.

• It is the gold standard for the diagnosis of cardiac arrhythmia's


• It guides therapy and risk stratification for patients with suspected acute myocardial infarction


• It helps detect electrolyte disturbances (e.g. hyperkalemia and hypokalemia)


• It allows for the detection of conduction abnormalities (e.g. right and left bundle branch block)


• It is used as a screening tool for ischemic heart disease during a cardiac stress test


• It is occasionally helpful with non-cardiac diseases (e.g. pulmonary embolism or hypothermia)

The electrocardiogram does not directly assess the contractility of the heart. However, it can give a rough indication of increased or decreased contractility.

Electromyography (EMG) is a medical technique for evaluating and recording physiologic properties of muscles at rest and while contracting. EMG is performed using an instrument called an electromyography, to produce a record called an electromyogram. An electromyograph detects the electrical potential generated by muscle cells when these cells contract, and also when the cells are at rest.

Developing or originating within the organisms or arising from causes within the organism.

Endometriosis is a common medical condition affecting an estimated 89 million women of reproductive age around the world. In endometriosis, the tissue that lines the uterus (the endometrium, from endo, "inside", and metra, "womb") is found to be growing outside the uterus, on or in other areas of the body. Normally, the endometrium is shed each month during the menstrual cycle; however, in endometriosis, the misplaced endometrium is usually unable to exit the body.

The endometriotic tissues still detach and bleed, but the result is far different: internal bleeding, degenerated blood and tissue shedding, inflammation of the surrounding areas, pain, and formation of scar tissue may result. In addition, depending on the location of the growths, interference with the normal function of the bowel, bladder, small intestines and other organs within the pelvic cavity can occur.

An endotracheal tube (ETT) is used in anesthesia, intensive care and emergency medicine for airway management and mechanical ventilation. It is regarded as the most reliable available method for protecting a patient's airway.

Enteroviruses live and reproduce in your intestinal tract, and humans are susceptible to more than 70 types of them. When it comes to how common they are, they're second only to "common cold" viruses.

Specific enteroviruses can cause diseases including poliomyelitis, aseptic meningitis, rhinitis and inflammatory heart disease.

Most enterovirus infections do not lead to disease. When they do make people sick, it's usually with either mild cold-like symptoms or with a flu-like illness including fever and muscle aches. Flu-like symptoms are common in people with chronic fatigue syndrome, and onset of chronic fatigue syndrome often comes after a flu-like illness.

A 2007 study on chronic fatigue syndrome showed a high predominance of enteroviruses in the gut, which could explain some symptoms. More research needs to be done to verify this link.

Because the bodies of people with chronic fatigue syndrome show signs of an activated immune system, scientists have long believed that many case are caused either by an active viral or bacterial infection, or by an infection that permanently altered the immune system before leaving the body.

Epigallocatechin gallate belongs to the family of catechins. It contains 3 phenol rings and has very strong antixoidant properties. It is the main active component if green tea leaves. Black tea leaves also contain epigallocatechin gallate but in much lower quantities. That's because black tea leaves are fermented, during which many of the cathechins are oxidized to darker coloured molecules (theaflavin and thearubigen).

Epigallocatechin gallate possess the most potent antioxidant activity of the catechins. It may provide health effects by protecting our cells from oxidative damage from free radicals. A number of chronic disease have been associated with free radical damage, including cancer, arteriosclerosis, heart diseases and accelerated aging. Epigallocatechin gallate interferes with many enzyme systems: it inhibits fast-binding and reversible fatty acid synthase, increases tyrosine phosphorylation of the insulin receptor, activation of ornithine decarboxylase.

Epigallocatechin gallate can protect the DNA in the human cells from ultraviolet and visible radiation-induced damage. Epigallocatechin gallate may be effective in promoting fat oxidation and lowering body weight.

Epilepsy is a brain disorder in which a person has repeated seizures (convulsions) over time. Seizures are episodes of disturbed brain activity that cause changes in attention or behavior.

Epilepsy occurs when permanent changes in brain tissue cause the brain to be too excitable or jumpy. The brain sends out abnormal signals. This results in repeated, unpredictable seizures. (A single seizure that does not happen again is not epilepsy.)

Epilepsy may be due to a medical condition or injury that affects the brain, or the cause may be unknown (idiopathic).

Common causes of epilepsy include:

• Stroke or transient ischemic attack (TIA)
• Dementia, such as Alzheimer's disease
• Traumatic brain injury
• Infections, including brain abscess, meningitis, encephalitis, and AIDS
• Brain problems that are present at birth (congenital brain defect)
• Brain injury that occurs during or near bith
• Metabolism disorders that a child may be born with (such as phenylketonuria)
• Brain tumor
• Abnormal blood vessels in the brain
• Other illness that damage or destroy brain tissue

Epilepsy seizures usually begin between ages 5 and 20, but they can happen at any age. There may be a family history of seizures or epilepsy.

Also called Human herpes virus 4 (HHV-4), is a virus of the herpes family (which includes Herpes simplex virus and Cytomegalovirus), and is one of the most common viruses in humans.

Most people become infected with EBV, which is often asymptomatic but commonly causes infectious mononucleosis. It is named after Michael Epstein and Yvonne Barr, who together with Bert Achong discovered the virus in 1964. Thought at one time to be associated with Chronic Fatigue Syndrome.

The science and study of the causes or origins of disease. The cause or origin of a disease or disorder as determined by medical diagnosis.

Etymology is the study of the history of words - when they entered a language, from what source, and how their form and meaning have changed over time.

To increase the severity, aggravate.

Tending to induce excitation.

Exertion is a concept describing the use of physical or perceived energy. It normally refers to a strenuous or costly effort related to physical, philosophical actions and work.

The fascia is a network of fibrous tissues below the skin that encloses muscles and separates different layers of tissues in your body.

Some researchers are investigating the possible role of fascia in fibromyalgia. A commonly co-morbid condition, myofascial pain syndrome, involves multiple trigger points in the fascia associated with regional pain.

Fatigue is a condition of tiredness and reduced capacity or motivation for exertion. Fatigue is frequently accompanied by weariness, sleepiness, or irritability.

Fatigue can be either acute or chronic. In chronic fatigue syndrome, and to a lesser degree in fibromyalgia, fatigue is chronic and can be highly debilitating.

While the most predominant symptoms of fibromyalgia include widespread pain and persistent fatigue, the resulting cognitive impairment of this condition may be its most maddening.

Commonly referred to as fibro-fog, this symptom is a conglomeration of cognitive challenges. Fibro-fog is understood to be a physical symptom of fibromyalgia, not a psychological one. While research on fibro-fog is scarce, experts agree that it is not the result of Alzheimer's disease, dementia, or other brain function deterioration condition. Of utmost importance is recognizing that fibro-fog can be managed and with the reduction of fibromyalgia's other symptoms, the cloud of fibro-fog will also fade away.

Symptoms of Fibro-Fog

Just as no two individuals experience fibromyalgia in the same way, fibro-fog also has a varying range of indications, including:

• Mental confusion
• Fuzzy thinking
• Short-term memory loss
• Inability to concentrate or pay attention
• Language lapses

Fibro-Fog Causes

The same lack of information as to fibromyalgia's origin also surrounds fibro-fog. While a variety of causes have been proposed, including depression, decreased oxygen flow to the brain, certain medications, poor nutrition, and changes to the Central Nervous System (CNS), most experts agree that sleep deprivation is the primary culprit of fibro-fog.

Occurring at the deepest level of the sleep cycle, individuals with fibromyalgia typically lack sufficient restorative sleep. We know that at the deeper levels of sleep, called delta wave sleep, a person's mind conducts internal housekeeping. During delta wave sleep, newly acquired information is assimilated and integrated into the brain. The inability to get sufficient delta wave sleep impairs the ability to recall information and operate at a normal level of mental efficiency.

Physical Link

Temporal lobe brain abnormalities appear to mimic the presentation of fibro-fog. According to Dr. Jay Seastrunk, a psychiatrist specializing in fibromyalgia, if the temporal lobes are mismatched, there will be trouble with memory, recall and concentration. "Cognitive dysfunction is a right temporal lobe phenomena. Multiple mood swings, trouble sleeping are all temporal lobe abnormalities. Temporal lobe is responsible for understanding what we hear, retrieving and restoring our memories even though the patient may feel they have difficulty with their memory. The problem is actually the retrieval of this information. Not being able to find the word or you forget what you are going to do, or blocking, is a left temporal lobe phenomena."

Dr. Muhammad B. Yunus, a leading chronic fatigue syndrome and fibromyalgia researcher, suggests that SPECT (single photon emission computerized tomography), PET (positron emission tomography) and BEAM (brain electrical activity mapping) scans of the brain demonstrate that fibro-fog is a physical anomaly. According to Dr. Yunus, "Cerebral blood flow imaging by SPECT, PET and BEAM have been reported to be abnormal in a large majority of patients with CFS (Chronic Fatigue Syndrome), showing a pattern different from normal controls and those with depression. Results of SPECT, PET or BEAM studies specifically in fibromyalgia have not been reported, but a good number of patients with CFS who had these tests carried out with abnormal results also had fibromyalgia."

When considering both Dr. Seastrunk and Dr. Yunus' contributions, it is clear that fibro-fog is represented by physically visible brain variances.

Managing Fibro-Fog

Since fibro-fog is believed to be directly related to non-restorative sleep, putting all of one's resources into getting good, quality sleep is crucial. In addition to seeking professional assistance (and possible physician-prescribed sleep medications), the following suggestions may be conducive to getting a quality night's sleep:

• Adhering to a regular sleep routine – going to sleep and waking at the same time each day
• Providing a relaxing atmosphere prior to and during sleep
• Limiting caffeine and food consumption near bedtime
• Listening to white noise prior to and during sleep
• Sleeping on a high quality mattress
• For pain reduction, using pillows in bed to cushion any sore spots
• Using natural sleep aids (always consult your physician)

In addition to focusing on getting restorative sleep, The Arthritis Foundation® shares nine tips to minimize fibro-fog's impact during the day:

• Repeat yourself. Repeat things to yourself over and over again. Repetition will keep thoughts fresh in your mind.


• Write it down. Whether you write in a calendar, in a notebook or on sticky notes, if you're afraid you won't remember something, putting pen to paper can help.


• Pick your best time. If there is something you need to do that requires concentration and memory, such as balancing your checkbook or following a recipe, pick your best time to do it. Many people with fibromyalgia say they perform best early in the day.


• Get treated. Depression, pain and sleep deprivation can influence your ability to concentrate and remember. Getting your medical problems treated may indirectly help your memory.


• Engage yourself. Reading a book, seeing a play, or working a complex crossword or jigsaw puzzle can stimulate your brain and your memory.


• Stay active. Physical activity, in moderation, can increase your energy and help lift your fibro-fog. Speak to your doctor or physical therapist about an exercise program that is right for you.


• Explain yourself. Explain your memory difficulties to family members and close friends. Memory problems often result from stress. Getting a little understanding from the ones you love may help.


• Keep it quiet. A radio blasting from the next room, a TV competing for your attention, or background conversation can distract your attention from the task at hand. If possible, move to a quiet place and minimize distractions when you are trying to remember.


• Go slowly. Sometimes memory problems can result from trying to do too much in too short a period of time. Break up tasks, and don't take on more than you can handle at once. Stress and fatigue will only make the situation worse.

Fibro-Fog Hope

As one of fibromyalgia's most frustrating components, there is hope for fibro-fog sufferers. Understanding the following about fibro-fog will allay many accompanying fears:

• You are not alone in suffering with fibro-fog
• fibro-fog is not a psychological condition
• fibro-fog is likely a result of non-restorative sleep disturbances
• Improving sleep can reduce fibro-fog
• There are many ways to reduce fibro-fog's prominence in your life

The best news of all is that many individuals report that being committed to managing their fibromyalgia (by integrating western medicine, alternative medicine and lifestyle changes), has resulted in their fibro-fog fading away.

References:

FM is a poorly-understood chronic pain syndrome characterized by:

• Widespread Musculoskeletal Pain
• Non restorative Sleep
• Fatigue
• Psychological Distress
• Specific Regions of Localized Tenderness

People with FM may also have other symptoms such as:

• Morning stiffness
• Tingling or numbness in hands and feet
• Headaches, including migraines
• Irritable bowel syndrome
• Problems with thinking and memory (sometimes called "fibro-fog")
• Painful menstrual periods and other pain syndromes

While the etiology of FM is unclear, accumulating data suggest that disordered central pain processing likely plays a role in the pathogenesis of symptoms. Although various pharmacological treatments have been studied and espoused for treating FM, no single drug or group of drugs has proved to be particularly useful in treating FM patients as a whole, and only one drug to date has earned U.S. Food and Drug Administration (FDA)approval for treating the syndrome in the United States.

The earliest onset of FM can occur in childhood, however most people believe their pain originated in their early 20's and 30's. Although genetic research is just beginning, there is already evidence that FM runs in some families leading researchers to believe it may be hereditary. Although men and women are both affected by FM, women make up the majority of those affected. The reason is unknown.

While FM is one of the most common diseases affecting the muscles, its cause is currently unknown. The painful tissues involved are not accompanied by tissue inflammation. Therefore, despite potentially disabling body pain, patients with FM do not develop body damage or deformity. FM also does not cause damage to internal body organs. Therefore, FM is different from many other rheumatic conditions (such as rheumatoid arthritis, systemic lupus, and polymyositis). In those diseases, tissue inflammation is the major cause of pain, stiffness and tenderness of the joints, tendons and muscles, and it can lead to joint deformity and damage to the internal organs or muscles.

A flare-up is a time when symptoms are more intense. Many people with fibromyalgia and chronic fatigue syndrome experience periodic flare-ups separated by remissions, when symptoms recede.

With work, many people with fibromyalgia and chronic fatigue syndrome can identify what triggers or intensifies their flare-ups and can use that information to lessen their symptoms. Sometimes, flare-ups are linked to a woman's menstrual cycle, especially in fibromyalgia.

GABA is a neurotransmitter. One of its primary functions is to calm brain activity. GABA is also involved in sleep, muscle function, relaxation, and anxiety regulation.

GABA is derived from the neurotransmitter glutamate, which increases brain activity. Some research suggests that abnormal levels of GABA or glutamate may play a role in fibromyalgia and chronic fatigue syndrome.

The gastrointestinal tract (GI tract), also called the digestive tract, the alimentary canal, or the entrails, is the system of organs within multi cellular animals that takes in food, digests it to extract energy and nutrients, and expels the remaining waste. The major functions of the GI tract are ingestion, digestion, absorption, and excretion.

The GI tract differs substantially from animal to animal. Some animals have multi-chambered stomachs, while some animals' stomachs contain a single chamber. In a normal human adult male, the GI tract is approximately 6.5 meters (20 feet) long and consists of the upper and lower GI tracts. The tract may also be divided into foregut, midgut, and hindgut, reflecting the embryological origin of each segment of the tract.

A genetic predisposition is a genetic effect which influences the phenotype of an organism but which can be modified by the environmental conditions. Genetic testing is able to identify individuals who are genetically predisposed to certain health problems.

Generalized anxiety disorder (or GAD) is characterized by excessive, exaggerated anxiety and worry about everyday life events with no obvious reasons for worry. People with symptoms of generalized anxiety disorder tend to always expect disaster and can't stop worrying about health, money, family, work, or school. In people with GAD, the worry often is unrealistic or out of proportion for the situation. Daily life becomes a constant state of worry, fear, and dread. Eventually, the anxiety so dominates the person's thinking that it interferes with daily functioning, including work, school, social activities, and relationships.

What Are the Symptoms of GAD?

GAD affects the way a person thinks, but the anxiety can lead to physical symptoms, as well. Symptoms of GAD can include:

• Excessive, ongoing worry and tension
• An unrealistic view of problems
• Restlessness or a feeling of being "edgy"
• Irritability
• Muscle tension
• Headaches
• Sweating
• Difficulty concentrating
• Nausea
• The need to go to the bathroom frequently
• Tiredness
• Trouble falling or staying asleep
• Trembling
• Being easily startled

In addition, people with GAD often have other anxiety disorders (such as panic disorder, obsessive-compulsive disorder, and phobias), suffer from depression, and/or abuse drugs or alcohol.

What Causes GAD?

The exact cause of GAD is not fully known, but a number of factors -- including genetics, brain chemistry and environmental stresses -- appear to contribute to its development.

Genetics

Some research suggests that family history plays a part in increasing the likelihood that a person will develop GAD. This means that the tendency to develop GAD may be passed on in families.

Brain Chemistry

GAD has been associated with abnormal levels of certain neurotransmitters in the brain. Neurotransmitters are special chemical messengers that help move information from nerve cell to nerve cell. If the neurotransmitters are out of balance, messages cannot get through the brain properly. This can alter the way the brain reacts in certain situations, leading to anxiety.

Environmental Factors

Trauma and stressful events, such as abuse, the death of a loved one, divorce, changing jobs or schools, may lead to GAD. GAD also may become worse during periods of stress. The use of and withdrawal from addictive substances, including alcohol, caffeine, and nicotine, can also worsen anxiety.

How Common Is GAD?

About 4 million adult Americans suffer from GAD during the course of a year. It most often begins in childhood or adolescence, but can begin in adulthood. It is more common in women than in men.

How Is GAD Diagnosed?

If symptoms of GAD are present, the doctor will begin an evaluation by asking questions about your medical history and performing a physical examination. Although there are no laboratory tests to specifically diagnose anxiety disorders, the doctor may use various tests to look for physical illness as the cause of the symptoms.

The doctor bases his or her diagnosis of GAD on reports of the intensity and duration of symptoms -- including any problems with functioning caused by the symptoms. The doctor then determines if the symptoms and degree of dysfunction indicate a specific anxiety disorder. GAD is diagnosed if symptoms are present for more days than not during a period of at least six months. The symptoms also must interfere with daily living, such as causing you to miss work or school.

How Is GAD Treated?

If no physical illness is found, you may be referred to a psychiatrist or psychologist, mental health professionals who are specially trained to diagnose and treat mental illnesses like GAD. Treatment for GAD most often includes a combination of medication and cognitive-behavioral therapy.

Medication

Drugs are available to treat GAD and may be especially helpful for people whose anxiety is interfering with daily functioning. The medications most often used to treat GAD in the short-term are from a class of drugs called benzodiazepines. These medications are sometimes referred to as "tranquilizers," because they leave you feeling calm and relaxed. They work by decreasing the physical symptoms of GAD, such as muscle tension and restlessness. Common benzodiazepines include Xanax, Librium, Valium and Ativan. Antidepressants, such as Paxil, Effexor, Prozac, Lexapro, and Zoloft, are also being used to treat GAD. These antidepressants may take a few weeks to start working but they're more appropriate for long-term treatment of GAD.

Cognitive Behavioral Therapy

People suffering from anxiety disorders often participate in this type of therapy, in which you learn to recognize and change thought patterns and behaviors that lead to anxious feelings. This type of therapy helps limit distorted thinking by looking at worries more realistically.

In addition, relaxation techniques, such as deep breathing and biofeedback, may help to control the muscle tension that often accompanies GAD.

Are There Side Effects of GAD Treatment?

Dependency on anti-anxiety medications (benzodiazepines) is a potential complication of treatment. Side effects of antidepressants vary by specific drug and the person taking them. Common side effects can include sleepiness, weight gain, and sexual problems.

What Is the Outlook for People With GAD?

Although many people with GAD cannot be cured and symptoms can return from time to time, most people gain substantial relief from their symptoms with proper treatment.

Can GAD Be Prevented?

Anxiety disorders like GAD cannot be prevented. However, there are some things that you can do to control or lessen symptoms, including:

• Stop or reduce your consumption of products that contain caffeine, such as coffee, tea, cola and chocolate.
• Ask your doctor or pharmacist before taking any over-the-counter medicines or herbal remedies. Many contain chemicals that can increase anxiety symptoms.
• Exercise daily and eat a healthy, balanced diet.
• Seek counseling and support after a traumatic or disturbing experience.
• Practice stress management techniques like yoga or meditation.

Glia are cells that are found throughout the brain and also play a role in other parts of the central nervous system. They have a complex relationship to neurons, supporting them with nourishment, serving immune functions, and performing other essential tasks.

Glia do not conduct electrical signals like neurons do, but researchers are beginning to uncover ways in which glia communicate with other cells and make it possible for neurons to function.

Different types of glia include:

• Microglia
• Schwann cells
• Astrocytes
• Oligodendrocytes

Some fibromyalgia research indicates that problems with glia may play a role in the condition, including disturbances in communication between glia and neurons, sustained activation of spinal cord glia, and abnormally shaped Schwann cells in the skin.

Researchers are continuing to investigate glial cells' role in the central sensitization and lowered pain threshold that are key features of fibromyalgia.

Glial research may help with treatments as well -- low-dose naltrexone, a drug that's showing promise as a fibromyalgia treatment in clinical trials, is believed to inhibit microglia activity in the central nervous system.

Glutamate is a neurotransmitter normally involved in learning and memory. It also is an excitatory neurotransmitter, which means it stimulates areas in the brain or other parts of the nervous system. In some cases, it can be an excitotoxin that appears to cause nerve-cell death in a variety of neurodegenerative disorders including Alzheimer's and amyotrophic lateral sclerosis (known as ALS or Lou Gherig's disease).

Research shows that people with fibromyalgia have abnormally high levels of glutamate in the area of the brain called the insula, which is highly involved in pain and emotion. The insula also is involved in the senses, anxiety, motor skills, cravings, eating disorders and addiction.

As an amino acid, glutamate is in monosodium glutamate (MSG), which is used in pharmaceuticals and as a food additive. When consumed, research shows MSG can stimulate pain receptors in the spinal cord.

Granulocytes are a category of white blood cells characterized by the presence of granules in their cytoplasm. They are also called polymorphonuclear leukocytes (PMN or PML) because of the varying shapes of the nucleus, which is usually lobed into three segments.

Granuloma's are small nodules that are seen in a variety of diseases such as Crohn's disease, tuberculosis, sarcoidosis, and berylliosis.

The greater trochanter of the femur is a large, irregular, quadrilateral eminence, situated at the junction of the neck with the upper part of the body.

It is directed a little lateralward and backward, and, in the adult, is about 1 cm. lower than the head. Part of the skeletal system. It has two surfaces and four borders.

Growth hormone is a 191-amino acid, single chain polypeptide hormone which is synthesized, stored and secreted by the somatotroph cells within the lateral wings of the anterior pituitary gland, which stimulates growth and cell reproduction in humans and other animals.

Hashimoto's thyroiditis or chronic lymphocytic thyroiditis is an autoimmune disease in which the thyroid gland is gradually destroyed by a variety of cell and antibody mediated immune processes. It was the first disease to be recognised as an autoimmune disease. It was first described by the Japanese specialist Dr. Hakaru Hashimoto in Germany in 1912.

Hashimoto's thyroiditis very often results in hypothyroidism with bouts of hyperthyroidism. Physiologically, antibodies against thyroid peroxidase and/or thyroglobulin cause gradual destruction of follicles in the thyroid gland. Accordingly, the disease can be detected clinically by looking for these antibodies in the blood. It is also characterized by invasion of the thyroid tissue by leukocytes, mainly T-lymphocytes. It is associated with non-Hodgkin lymphoma.

Symptoms of Hashimoto's thyroiditis include weight gain, depression, mania, sensitivity to heat and cold , paresthesia, fatigue, panic attacks, bradycardia, tachycardia, high cholesterol, reactive hypoglycemia, constipation, migraines, muscle weakness, cramps, memory loss, infertility and hair loss.

Hashimoto's thyroiditis is often misdiagnosed as depression, cyclothymia, PMS, and, less frequently, as bipolar disorder or as an anxiety disorder. Testing for thyroid-stimulating hormone (TSH) and anti-thyroid antibodies can resolve any diagnostic difficulty.

Hashimoto's when presenting as mania is known as Prasad's syndrome after Ashok Prasad, the psychiatrist who first described it.

A pain in the head with the pain being above the eyes or the ears, behind the head (occipital), or in the back of the upper neck. Headache, like chest pain or back ache, has many causes.

Hepatitis is inflammation of the liver. The clinical signs, prognosis, and treatment depend on the cause.

Types of hepatitis:

• Hepatitis A
• Hepatitis B
• Hepatitis C
• Hepatitis B with D
• Hepatitis E
• Hepatitis F (discredited)
• Hepatitis G

Herpes simplex virus 1 and 2 (HSV-1 and HSV-2) are two strains of the herpes virus family, Herpes viridae, which cause infections in humans. HSV-1 and 2 are also referred to as Human Herpes Virus 1 and 2 (HHV-1 and HHV-2).

After an initial, or primary, infection, HSV establishes latency, during which the virus is present in the cell bodies of nerves which innervate the area of original outbreak. During reactivation, the virus is produced in the cell and transported outwardly via the nerve cell's axon to the skin. The ability of HSV to become latent leads to the chronic nature of Herpes infection; after the initial infection subsides, Herpes symptoms may periodically recur in the form of outbreaks of herpetic sores near the site of original infection.

Herpes infections are marked by painful, watery blisters in the skin or mucous membranes (such as the mouth or lips) or on the genitals. The blisters resemble those seen in chickenpox - an infection caused by a third member of the alpha-Herpes viridae subfamily, Varicella Zoster Virus (VZV), also known as Human Herpes Virus 3 (HHV-3). Lesions heal with a crudescent scab, the hallmark of herpetic disease. Herpes is contagious if the carrier is producing and releasing ("shedding") virus. This is particularly likely during an outbreak, although individuals may shed virus between outbreaks. Although no cure is yet available, treatments exist which reduce the likelihood of viral shedding. An HSV infection on the lips is commonly known as a "cold sore" or "fever blister" and should not to be confused with a canker sore; canker sores are not caused by the HSV virus.

Holism is the idea that all the properties of a given system (biological, chemical, social, economic, mental, linguistic, etc.) cannot be determined or explained by the sum of its component parts alone. Instead, the system as a whole determines in an important way how the parts behave.

Homeopathy is a system of alternative medicine that aims to treat "like with like." Despite being widely discredited in scientific circles homeopathy has grown in popularity in recent years.

Homeopathic remedies are extremely diluted agents. The first remedies used by homeopaths were made from substances such as arsenic that, in undiluted doses, would have produced similar symptoms in the healthy. The substances on which other, more recent, remedies are based such as lac humanum (human milk), lac delphinum (dolphin milk) and adamas (diamond), are not known to produce symptoms from the undiluted form.

Homeostasis is the property of an open system, especially living organisms, to regulate its internal environment to maintain a stable, constant condition, by means of multiple dynamic equilibrium adjustments, controlled by interrelated regulation mechanisms.

A hormone is a chemical messenger from one cell (or group of cells) to another. The function of hormones is to serve as a signal to the target cells. The action of hormones is determined by the pattern of secretion and the signal transduction of the receiving tissue.

Hydrotherapy, formerly called hydropathy involves the use of water for pain-relief and treating illness. The term hydrotherapy itself is synonymous with the term water cure as it was originally marketed by practitioners and promoters in the 1800's.

The recuperative and healing properties of hydrotherapy are based on its mechanical and/or thermal effects. It exploits the body's reaction to hot and cold stimuli, to the protracted application of heat, to pressure exerted by the water and to the sensation it gives. The nerves carry impulses felt at the skin deeper into the body, where they are instrumental in stimulating the immune system, influencing the production of stress hormones, invigorating the circulation and digestion, encouraging blood flow, and lessening pain sensitivity.

Generally, heat quiets and soothes the body, slowing down the activity of internal organs. Cold, in contrast, stimulates and invigorates, increasing internal activity. If you are experiencing tense muscles and anxiety from your stress, a hot shower or bath is in order. If you are feeling tired and stressed out, you might want to try taking a warm shower or bath followed by a short, invigorating cold shower to help stimulate your body and mind.

When you submerge yourself in a bath, a pool, or a whirlpool, you experience a kind of weightlessness. Your body is relieved from the constant pull of gravity. Water also has a hydrostatic effect. It has a massage-like feeling as the water gently kneads your body. Water, in motion, stimulates touch receptors on the skin, boosting blood circulation and releasing tight muscles.

Hyperalgesia is an increased sensitivity to pain, which may be caused by damage to nociceptors or peripheral nerves. Temporary increased sensitivity to pain also occurs as part of sickness behavior, the evolved response to infection.

Hyperalgesia can be experienced in focal, discrete areas, or as a more diffuse, body-wide form. Conditioning studies have established that it is possible to experience a learned hyperalgesia of the latter, diffuse form. The focal form is typically associated with injury, and is divided into two subtypes:

• Primary hyperalgesia describes pain sensitivity that occurs directly in the damaged tissues


• Secondary hyperalgesia describes pain sensitivity that occurs in surrounding undamaged tissues

Opioid-induced hyperalgesia may develop as a result of long-term opioid use in the treatment of chronic pain. Various studies of humans and animals have demonstrated that primary or secondary hyperalgesia can develop in response to both chronic and acute exposure to opioids. This side effect can be severe enough to warrant discontinuation of opioid treatment.

Primary hyperhidrosis is the condition characterized by abnormally increased perspiration, in excess of that required for regulation of body temperature. Some patients afflicted with the condition experience a distinct reduction in the quality of life. Sufferers feel at a loss of control because perspiration takes place independent of temperature and emotional state.

However, anxiety can exacerbate the situation for many sufferers. A common complaint of patients is that they get nervous because they sweat, then sweat more because they are nervous. Other factors can play a role; certain foods & drinks, nicotine, caffeine, and smells can trigger a response.

Hyperparathyroidism is overactivity of the parathyroid glands resulting in excess production of parathyroid hormone (PTH). The parathyroid hormone regulates calcium and phosphate levels and helps to maintain these levels. Excessive PTH secretion may be due to problems in the glands themselves, in which case it is referred to as primary hyperparathryroidism and which leads to hypercalcemia (raised calcium levels).

It may also occur in response to low calcium levels, as encountered in various situations such as vitamin D deficiency or chronic kidney disease; this is referred to as secondary hyperparathyroidism. In all cases, the raised PTH levels are harmful to bone, and treatment is often needed. Recent evidence suggests that Vitamin D deficiency/insufficiency plays a role in the development of hyperparathyroidism. Lithium is associated with an increased incidence of hyperparathyroidism.

Hypochondria refers to an excessive preoccupation or worry about having a serious illness. Often, hypochondria persists even after a physician has evaluated a person and reassured him/her that his/her concerns about symptoms do not have an underlying medical basis or, if there is a medical illness, the concerns are far in excess of what is appropriate for the level of disease.

Many people with unexplained illnesses, such as Fibromyalgia and Chronic Fatigue Syndrome, are accused of being hypochondriacs, simply because the medical profession is unable to properly diagnose these illnesses.

Hypocretin's, are the common names given to a pair of highly excitatory neuropeptide hormones that were simultaneously discovered by two groups of researchers in rat brains.

Low blood sugar (glucose). When symptoms of hypoglycemia occur together with a documented blood glucose under 45 mg/dl, and the symptoms promptly resolve with the administration of glucose, the diagnosis of hypoglycemia can be made with some certainty. Hypoglycemia is only significant when it is associated with symptoms.

An electrolyte disturbance (disturbance of the salts in the blood) in which the sodium concentration in the plasma is too low (in this case, below 135 mmol/L).

Severe or rapidly progressing hyponatremia can result in swelling of the brain (cerebral edema), and the symptoms of hyponatremia are mainly neurological. Hyponatremia is most often a complication of other medical illnesses in which either fluids rich in sodium are lost (for example because of diarrhea or vomiting), or excess water accumulates in the body at a higher rate than it can be excreted (for example in polydipsia or syndrome of inappropriate antidiuretic hormone, SIADH).

The hypothalamic-pituitary-adrenal axis is a complex set of interactions between the hypothalamus (a part of the brain), the pituitary gland (also part of the brain) and the adrenal or suprarenal glands (at the top of each kidney.) The HPA axis helps regulate things such as your temperature, digestion, immune system, mood, sexuality and energy usage. It's also a major part of the system that controls your reaction to stress, trauma and injury.

Research links fibromyalgia and chronic fatigue syndrome with abnormalities in genes involved in the HPA axis. (Primarily the hypothalamus in fibromyalgia and primarily the adrenals in chronic fatigue syndrome.)

The HPA axis also is involved in anxiety disorder, bipolar disorder, post-traumatic stress disorder, clinical depression, burnout and irritable bowel syndrome.

The hypothalamus, also known as the "master gland," links the nervous system to the endocrine system via the pituitary gland. The hypothalamus is located below the thalamus, just above the brain stem.

Hypothyroidism is the disease state in humans and animals caused by insufficient production of thyroid hormone by the thyroid gland.

Hypoxemia is an abnormal deficiency in the concentration of oxygen in arterial blood. A frequent error is made when the term is used to describe poor tissue diffusion as in hypoxia. It is possible to have a low oxygen content (eg due to anemia) but a high concentration of oxygen in arterial blood so incorrect use can lead to confusion.

Protected against infection. The Latin immunis means free, exempt.

A complex system that is responsible for distinguishing us from everything foreign to us, and for protecting us against infections and foreign substances. The immune system works to seek and kill invaders.

A broad branch of biomedical science that covers the study of all aspects of the immune system in all organisms. It deals with, among other things, the physiological functioning of the immune system in states of both health and disease; malfunctions of the immune system in immunological disorders (autoimmune diseases, hyper sensitivities (increased sensitivity), immune deficiency).

Urinary incontinence is the involuntary excretion of urine from one's body. It is often temporary, and it almost always results from an underlying medical condition.

The growth of a parasitic organism within the body. (A parasitic organism is one that lives on or in another organism and draws its nourishment there from.) A person with an infection has another organism (a "germ") growing within him, drawing its nourishment from the person.

Insulin is a polypeptide hormone that regulates carbohydrate metabolism. Apart from being the primary agent in carbohydrate homeostasis, it has effects on fat metabolism and it changes the liver's activity in storing or releasing glucose and in processing blood lipids, and in other tissues such as fat and muscle. The amount of insulin in circulation has extremely widespread effects throughout the body.

Between the phalanges, or fingers.

Interstitial Cystitis is a urinary bladder disease of unknown cause characterized by urinary frequency (as often as every 10 minutes), urgency, pressure and/or pain in the bladder and/or pelvis.

Pain typically increases as the bladder fills and reduces after voiding however some patients report pain with urination, often in the urethra. Patients may also experience nocturia, pelvic floor dysfunction and tension (thus making it difficult to start their urine stream), pain with sexual intercourse, discomfort and difficulty driving, traveling or working. Research has determined that the quality of life of IC patients is equivalent to end stage renal failure.

Situated in, occurring in, or administered by entry into a blood vessel.

Irritable bowel syndrome is a disorder characterized most commonly by cramping, abdominal pain, bloating, constipation, and diarrhea. IBS causes a great deal of discomfort and distress, but it does not permanently harm the intestines and does not lead to a serious disease, such as cancer. Most people can control their symptoms with diet, stress management, and prescribed medications. For some people, however, IBS can be disabling. They may be unable to work, attend social events, or even travel short distances.

As many as 20 percent of the adult population, or one in five Americans, (4-70% of FM patients), have symptoms of IBS, making it one of the most common disorders diagnosed by doctors. It occurs more often in women than in men, and it begins before the age of 35 in about 50 percent of people.

Abdominal pain, bloating, and discomfort are the main symptoms of IBS. However, symptoms can vary from person to person. Some people have constipation, which means hard, difficult-to-pass, or infrequent bowel movements. Often these people report straining and cramping when trying to have a bowel movement but cannot eliminate any stool, or they are able to eliminate only a small amount. If they are able to have a bowel movement, there may be mucus in it, which is a fluid that moistens and protect passages in the digestive system. Some people with IBS experience diarrhea, which is frequent, loose, watery, stools. People with diarrhea frequently feel an urgent and uncontrollable need to have a bowel movement. Other people with IBS alternate between constipation and diarrhea. Sometimes people find that their symptoms subside for a few months and then return, while others report a constant worsening of symptoms over time.

Researchers have yet to discover any specific cause for IBS. One theory is that people who suffer from IBS have a colon (large bowel) that is particularly sensitive and reactive to certain foods and stress. The immune system, which fights infection, may also be involved.

• Normal motility, or movement, may not be present in a colon of a person who has IBS. It can be spasmodic or can even stop working temporarily. Spasms are sudden strong muscle contractions that come and go.


• The lining of the colon called the epithelium, which is affected by the immune and nervous systems, regulates the flow of fluids in and out of the colon. In IBS, the epithelium appears to work properly. However, when the contents inside the colon move too quickly, the colon looses its ability to absorb fluids. The result is too much fluid in the stool. In other people, the movement inside the colon is too slow, which causes extra fluid to be absorbed. As a result, a person develops constipation.


• A person's colon may respond strongly to stimuli such as certain foods or stress that would not bother most people.

Recent research has reported that serotonin is linked with normal gastrointestinal (GI) functioning. Serotonin is a neurotransmitter, or chemical, that delivers messages from one part of your body to another. Ninety-five percent of the serotonin in your body is located in the GI tract, and the other 5 percent is found in the brain. Cells that line the inside of the bowel work as transporters and carry the serotonin out of the GI tract. People with IBS, however, have diminished receptor activity, causing abnormal levels of serotonin to exist in the GI tract. As a result, people with IBS experience problems with bowel movement, motility, and sensation-having more sensitive pain receptors in their GI tract.

A joint is the area where two bones are attached for the purpose of motion of body parts. It is usually formed of fibrous connective tissue and cartilage.

Ketoacidosis is a type of metabolic acidosis which is caused by high concentrations of keto acids, formed by the deamination of amino acids.

Lability refers to something that is constantly undergoing change or something that is likely to undergo change.

In medicine, the term "labile" means susceptible to alteration or destruction. For example, a heat-labile protein is one that can be changed or destroyed at high temperatures. The opposite of labile in this context is "stable."

Latent means that something is dormant and may become active in the future, as in a latent fault.

That is, potentially existing but not presently evident; also commonly used to describe a medical condition that is present but not active or causing symptoms.

The lateral epicondyle of the humerus is a small, tuberculated eminence, curved a little forward, and giving attachment to the radial collateral ligament of the elbow-joint, and to a tendon common to the origin of the Supinator and some of the Extensor muscles.

Chronic Myelogenous Leukemia (CML) is a form of chronic leukemia characterized by increased and unregulated clonal production of predominantly myeloid cells in the bone marrow.

CML is a myeloproliferative disease associated with a characteristic chromosomal translocation called the Philadelphia chromosome.

Historically, it has been treated with chemotherapy, interferon and bone marrow transplantation, although targeted therapies introduced at the beginning of the 21st century have radically changed the management of CML.

Levothyroxine, also known as L-thyroxine, or synthetic T4 is a synthetic form of thyroxine (thyroid hormone). The natural hormone is chemically in the L-form, as is the pharmaceutical agent. Dextrothyroxine (D-thyroxine) briefly saw research as an anti cholesterol agent but was pulled due to cardiac side-effects.

Fibrous tissue that connects bones (or two different parts of a single bone). They are sometimes called "articular ligaments", "fibrous ligaments", or "true ligaments".

Liothyronine sodium, also known as T3 is a thyroid hormone drug used to treat hypothyroidism. It is a major component of the medication Cytomel.

A lipoma is a growth of fat cells in a thin, fibrous capsule usually found just below the skin. Lipomas are found most often on the torso, neck, upper thighs, upper arms, and armpits, but they can occur almost anywhere in the body. One or more lipomas may be present at the same time. Lipomas are the most common noncancerous soft tissue growth.

The cause of lipomas is not completely understood, but the tendency to develop them is inherited. A minor injury may trigger the growth. Being overweight does not cause lipomas.

Lipomas usually:

• Are small [0.4 in. (1 cm) to 1.2 in. (3 cm)] and felt just under the skin.
• Are movable and have a soft, rubbery consistency.
• Do not cause pain.
• Remain the same size over years or grow very slowly.

Often the most bothersome symptom is the location or increased size that makes the lipoma noticeable by others.

A lipoma can usually be diagnosed by its appearance alone, but your health professional may want to remove it to make sure the growth is noncancerous.

Lipomas do not generally require treatment. Because lipomas are not cancerous growths and cannot become cancerous, they do not need to be removed. There is no known treatment to prevent lipomas or affect their growth.

A lipoma may be surgically removed if symptoms develop, such as if the lipoma:

• Becomes painful or tender.
• Becomes infected or inflamed repeatedly.
• Drains foul-smelling discharge.
• Interferes with movement or function.
• Increases in size.
• Becomes unsightly or bothersome.

Most lipomas can be removed in the doctor's office or outpatient surgery center. The doctor injects a local anesthetic around the lipoma, makes an incision in the skin, removes the growth, and closes the incision with stitches (sutures). If the lipoma is in an area of the body that cannot be easily reached through a simple incision in the skin, the lipoma may need to be removed in the operating room under general anesthesia.

Lipomas occur in all age groups but most often appear in middle age. Single lipomas occur with equal frequency in men and women. Multiple lipomas occur more frequently in men.

• Lipoma - Topic Overview, WebMD, Accessed April 21, 2012.

A recent German study examined the cytokine protein profiles of 40 patients with chronic widespread pain, 26 of whom had fibromyalgia. The study found that the patients with chronic widespread pain had significantly lower levels of two types of cytokines, IL-4 and IL-10 than individuals who do not, suggesting a link between low levels of cytokine proteins and fibromyalgia syndrome.

Cytokines are a type of protein that are key to the normal functioning of the immune system, as they serve as messengers that order the body’s immune cells to activate, grow and die. Cytokine cells also help white blood cells ward off infection, a process that results in inflammation.

Systemic lupus erythematosus is a chronic, inflammatory autoimmune disorder. It may affect the skin, joints, kidneys, and other organs.

Normally, the immune system controls the body's defenses against infection. In SLE and other autoimmune diseases, these defenses are turned against the body and rogue immune cells attack tissues.

Antibodies may be produced that can react against the body's blood cells, organs, and tissues. These lead immune cells to attack the affected systems, producing a chronic (long-term) disease.

• Coping with Common Lupus Symptoms and Treatments

Lyme disease, which is also known as Lyme borreliosis, is an infection transmitted by the bite of deer ticks carrying the spirochete (spiral-shaped bacterium) Borrelia burgdorferi.

The disease was named for Lyme, Connecticut, the town where it was first diagnosed in 1975 after a puzzling outbreak of juvenile arthritis. The organism that causes the disease was identified in 1982 and named for its discoverer, Willy Burgdorfer.

Malaise is a feeling of general discomfort or uneasiness, an "out of sorts" feeling, often the first indication of an infection or other disease.

Malaise has been referred to as "the creeping crud" (especially in reference to the malaise caused by communicable diseases such as influenza and the common cold). This usage may have originated in folk medicine, but it is adopted from the French word meaning "discomfort", "feeling faint", "feeling sick".

Magnet therapy, magnetic therapy, or magnotherapy is an alternative medicine practice involving the use of static magnetic fields. Practitioners claim that subjecting certain parts of the body to magnetostatic fields produced by permanent magnets has beneficial health effects.

Magnet therapy is considered pseudoscientific due to both physical and biological implausibility, as well as a lack of any established effect on health or healing. Although hemoglobin, the blood protein that carries oxygen, is weakly diamagnetic and is repulsed by magnetic fields, the magnets used in magnetic therapy are many orders of magnitude too weak to have any measurable effect on blood flow.

Massage therapy is a hands-on treatment that is becoming more and more popular, both with fibromyalgia patients and other pain sufferers. In massage therapy, your muscles and soft tissues are manipulated in order to relieve stress, reduce pain, and increase flexibility. Usually done with the hands, there are a variety of different techniques used to give a massage. Common techniques involve stroking, kneading, and palpating the muscles. Sometimes, a special instrument or device is used to help relieve tension in tight muscles. Hot and cold therapies are also used during massages in order to increase blood flow and relax muscles.

Massage therapy can really reduce the pain, stiffness, and tender points caused by fibromyalgia. But how does it manage to do this? Well, no one is 100% sure on how massage actually reduces pain, but it may have something to do with the central nervous system. It is theorized that massage therapy actually enhances the production of certain pain blockers, including endorphins, serotonin, and norepinephrine. These hormones work to counteract pain signals conducted by the brain, and this would explain why massage offers such dramatic pain relief.

Massage therapy is actually one of the most beneficial treatments for fibromyalgia pain and fatigue. In fact, in a survey completed by fibromyalgia sufferers, massage therapy was rated the best fibromyalgia treatment option by an overwhelming margin. Massage therapy benefits include:

• increased blood circulation to the muscles, allowing for faster muscle repair
• increased flexibility
• increased range of motion
• decreased stress and depression
• reduced pain
• reduced stiffness
• improved sleep patterns

In a 1996 study, fibromyalgia sufferers reported a 38% decrease in pain symptoms after receiving just ten, 30 minute massage sessions. They also reported a significant decrease in their sleep difficulties: they began sleeping for longer periods at a time and were disturbed less by sleep disorders.

A hormone derived from serotonin. The two hormones help regulate your sleep-wake cycle.

When you're in dark conditions, your brain raises melatonin levels so you can sleep. Bright conditions, on the other hand, decrease melatonin release and increase serotonin production. Many people with insomnia take melatonin supplements to help them sleep.

It's suspected that, because serotonin levels are often low in people with fibromyalgia and chronic fatigue syndrome, the brain may not be able to produce enough melatonin. The low levels may throw off the body clock and can make it difficult to sleep or wake in the morning.

Methocarbamol is a central muscle relaxant for skeletal muscles, used to treat spasms. Robaxin® is a trade name for methocarbamol. It is structurally related to guaifenesin.

Migraine headaches are caused by constrictions of your blood vessels and arteries, and are also known as vascular headaches. Due to stress, fatigue, or illness, the blood vessels in your head and neck begin to constrict and then dilate, causing severe pain, nausea, dizziness, and eye pain.

A migraine headache can also move around your head, shifting from side to side. The common migraine is usually preceded by episodes of anxiety, depression, and fatigue. The less common type of migraine is the "classic" migraine, and is always immediately preceded by visual symptoms including double vision, blurry vision, flashing dots, bright lights, or distorted vision. These visual symptoms are often called the migraine aura.

Sufferers of the "classic" migraine may experience these symptoms for 15 to 60 minutes immediately before a migraine. Migraine symptoms typically last about 4 hours, though they can plague you for as long as a week. Migraines can develop also into chronic headaches.

• Migraines and Headaches
• Migraines in Fibromyalgia and CFS/ME

In cell biology, a mitochondrion (plural mitochondria) is a membrane-enclosed organelle, found in most eukaryotic cells. Mitochondria are sometimes described as "cellular power plants," because they convert NADH and NADPH into energy in the form of ATP via the process of oxidative phosphorylation.

A mitogen is a chemical, usually some form of a protein, that encourages a cell to commence cell division, triggering mitosis. Mitogens trigger signal transduction pathways in which mitogen-activated protein kinase is involved, leading to mitosis.

Mitral valve prolapse is a heart valve condition marked by the displacement of an abnormally thickened mitral valve leaflet into the left atrium during systole.

In its non classic form, MVP carries a low risk of complications. In severe cases of classic MVP, complications include mitral regurgitation, infective endocarditis, and, in rare circumstances, cardiac arrest usually resulting in sudden death.

Micro vascular disease is a disease of any small blood vessels in the body. This sometimes occurs when a person has had diabetes for a long time. The walls of the vessels become abnormally thick but weak, and therefore they bleed, leak protein, and slow the flow of blood through the body. Then some cells, for example in the retina (diabetic retinopathy) or kidney (diabetic nephropathy), may not get enough blood and may be damaged. Nerves are also damaged and may lead to loss of function (diabetic neuropathy).

Of all the antidepressant drugs, monamine oxidase inhibitors are used less often than any others due to the serious risk of interactions they pose. They are still regarded, however, as extremely useful for atypical cases of depression that do not respond to other, milder forms of treatment. They are also effective in helping cigarette smokers to kick their habit.

These drugs protect monoamine neurotransmitters from breaking down. They work on levels of serotonin, melatonin, adrenaline, noradrenaline, phenylethylamine, and dopamine. In addition to interacting with other prescription medications, monamine oxidase inhibitors cause high blood pressure and can damage the liver.

MAOI's Include:

• Isocarboxazid (Marplan®)
• Moclobemide (Aurorix®, Manerix®, Moclodura®)
• Phenelzine (Nardil®)
• Tranylcypromine (Parnate®)
• Selegiline (Eldepryl®)
• Nialamide

A disease seen most commonly in adolescents and young adults, characterized by fever, sore throat, muscle soreness, and fatigue. White patches on the tonsils or in the back of the throat may also be seen, (resembling strep throat).

Mononucleosis (Mono) is usually caused by the Epstein-Barr virus (EBV), which infects B cells (B-lymphocytes), producing a reactive lymphocytosis and atypical T cells (T-lymphocytes) known as Downey bodies.

The virus is typically transmitted from asymptomatic individuals through blood or saliva (hence "the kissing disease"), or by sharing a drink, or sharing eating utensils. The disease is far less contagious than is commonly thought.

There are two main types of mononuclear leukocytes: monocytes and lymphocytes. They normally account for about 35% of all white blood cells. With infectious mononucleosis, this can rise to 50-70%. Also, the total white blood count may increase to 10000-20000 per cubic millimeter.

Morton's Neuroma is a pain condition that affects your feet and toes. If you are suffering from Morton's Neuroma, a growth of tissue has developed over one of the nerves running from your feet into your toes. This growth can cause inflammation and pain whenever you use your foot.

A type of benign tumor, Morton's Neuroma typically develops in the space between the third and fourth toes, although it can also form between the second and third toes. When you walk, the bones and ligaments in the top of your foot press down on this growth, causing pressure and pain.

Unfortunately, the cause of Morton's Neuroma remains unknown to researchers. It is likely that a variety of factors may play a role in the development of this condition, including the presence of chronic pain conditions like fibromyalgia.

Multiple Chemical Sensitivity; in broad terms it means an unusually severe sensitivity or allergy-like reaction to many different kinds of pollutants including solvents, VOC's (Volatile Organic Compounds), perfumes, petrol, diesel, smoke, "chemicals" in general and often encompasses problems with regard to pollen, house dust mites, and pet fur & dander.

Multiple chemical sensitivity unlike true allergies - where the underlying mechanisms of the problem are relatively well understood widely accepted, is generally regarded as "idiopathic" - meaning that it has no known mechanism of causation & it's processes are not fully understood.

The problem here is made more difficult still, due to the variable nature of Multiple Chemical Sensitivity from one patient to the next & this often makes treatment with conventional medicine & practices ineffective or inappropriate; for most sufferers with Multiple Chemical Sensitivity, the avoidance of pollutants/toxicants is the key.

Multiple sclerosis is an inflammatory disease of the central nervous system. The disease results in injury to the myelin sheath (the fatty matter that covers the axons of the nerve cells), the oligodendrocytes (the cells that produce myelin) and, to a lesser extent, the axons and nerve cells themselves.

The symptoms of multiple sclerosis vary, depending in part on the location of plaques (areas of thick scar tissue) within the central nervous system. Common symptoms include weakness and fatigue, sensory disturbances in the limbs, bladder or bowel dysfunction, problems with sexual function, and ataxia (loss of coordination).

Although the disease may not be cured or prevented at this time, treatments are available to reduce severity and delay progression.

Muscle is the tissue of the body which primarily functions as a source of power. There are three types of muscle in the body. The muscle responsible for moving extremities and external areas of the body is called the "skeletal muscle." Heart muscle is called "cardiac muscle." Muscle that is in the walls of arteries and bowel is called "smooth muscle."

Muscle Relaxers are not really a class of drugs, but rather a group of different drugs that each has an overall sedative effect on the body. These drugs do not act directly on the muscles, rather they act centrally (in the brain) and are more of a total body relaxant.

Typically, Muscle Relaxants are prescribed early in a course of back pain, on a short-term basis, to relieve low back pain associated with muscle spasms. There are several types of muscle relaxant medications that are commonly used to treat low back pain.

Muscle Relaxers are also used for relief of spasticity in neuromuscular diseases, such as multiple sclerosis, as well as for spinal cord injury, stroke and musculoskeletal conditions. They may also be used for pain relief in minor strain injuries and control of the muscle symptoms of tetanus.

Muscle Relaxants are divided into only two groups, Benzodiazepines and Methocarbamol. The centrally acting group, benzodiazepines, appears to act on the central nervous system, and contains 10 drugs which are chemically different.

Musculoskeletal disorders (MSD's) can affect the body's muscles, joints, tendons, ligaments and nerves. Most-work related MSD's develop over time and are caused either by the work itself or by the employees' working environment. They can also result from fractures sustained in an accident. Typically, MSD's affect the back, neck, shoulders and upper limbs; less often they affect the lower limbs.

Health problems range from discomfort, minor aches and pains, to more serious medical conditions requiring time off work and even medical treatment. In more chronic cases, treatment and recovery are often unsatisfactory, the result could be permanent disability and loss of employment.

The acronym ME/CFS refers to Myalgic Encephalomyelitis and Chronic Fatigue Syndrome, according to the Canadian Case Definition.

The patient community has felt That the term chronic fatigue syndrome trivializes the seriousness of this illness, as the illness is typified by many severe symptoms in addition to fatigue, and fatigue is generally regarded as a common symptom experienced by many otherwise healthy individuals in the general population.

The term Myalgic Encephalomyelitis had been used prior To the use of the term chronic fatigue syndrome (Acheson, 1959). Some individuals Have preferred to use the term Myalgic Encephalomyelitis rather than Myalgic Encephalomyelitis, as the former term does not suggest brain inflammation.

Myalgic means 'muscle aches or pains'. Encephalomyelitis means 'inflammation of the brain and spinal cord', and is characterized by prolonged fatigue associated with a wide range of accompanying symptoms.

Myasthenia gravis is a neuromuscular disorder characterized by variable weakness of voluntary muscles, which often improves with rest and worsens with activity. The condition is caused by an abnormal immune response.

Symptoms

• Muscle weakness, including:
• Swallowing difficulty, frequent gagging, or choking
• Paralysis
• Muscles that function best after rest
• Drooping head
• Difficulty climbing stairs
• Difficulty lifting objects
• Need to use hands to rise from sitting positions
• Difficulty talking
• Difficulty chewing
• Vision problems:
• Double vision
• Difficulty maintaining steady gaze
• Eyelid drooping

Additional symptoms that may be associated with this disease:

• Hoarseness or changing voice
• Fatigue
• Facial paralysis
• Drooling
• Breathing difficulty

Treatment

There is no known cure for myasthenia gravis. However, treatment may result in prolonged periods of remission.

Lifestyle adjustments may enable continuation of many activities. Activity should be planned to allow scheduled rest periods. An eye patch may be recommended if double vision is bothersome. Stress and excessive heat exposure should be avoided because they can worsen symptoms.

Some medications, such as neostigmine or pyridostigmine, improve the communication between the nerve and the muscle. Prednisone and other medications that suppress the immune response (such as azathioprine, cyclosporine, or mycophenolate mofetil) may be used if symptoms are severe and there is inadequate response to other medications.

Plasmapheresis, a technique in which blood plasma containing antibodies against the body is removed from the body and replaced with fluids (donated antibody-free plasma or other intravenous fluids), may reduce symptoms for up to 4 - 6 weeks and is often used to optimize conditions before surgery.

When other treatments do not improve systems, patients may receive intravenous immunoglobulin.

Surgical removal of the thymus (thymectomy) may result in permanent remission or less need for medicines.

Patients with eye problems may try lens prisms to improve vision. Surgery may also be performed on the eye muscles.

Several medications may make symptoms worse and should be avoided. Therefore, it is always important to check with your doctor about the safety of a medication before taking it.

Crisis situations, where muscle weakness involves the breathing muscles, may occur. These attacks seldom last longer than a few weeks. Hospitalization and assistance with breathing may be required during these attacks. Often plasmapheresis is used to help end the crisis.

Mycoplasma fermentans is considered to be a commensal in the human mucosal tissues and has often been found in saliva and oropharyngeal of 45% of healthy adults. Also, M. fermentans organisms have been isolated from the human urogenital tract and are suspected of invading host tissues from a site of mucosal colonization.

Although mycoplasma's are recognized primarily as extra cellular parasites or pathogens of mucosal surfaces, recent evidence suggests that certain species may invade the host cells.

The molecular and cellular bases for the invasion of M. fermentans from mucosal cells to the bloodstream and its colonization of blood remain unknown.

Also, it remains unclear whether M. fermentans infection of white blood cells is transient, intermittent or persistent. It is not clear how these stages influence any disease progression. The invasion of host blood cells by M. fermentans is due to inhibition of phagocytosis by a variety of mechanisms, including antiphagocytic proteins such as protease's, phospholipases and by oxygen radicals produced by mycoplasma's.

Myositis is inflammation of your skeletal muscles, which are also called the voluntary muscles. These are the muscles you consciously control that help you move your body. An injury, infection or autoimmune disease can cause myositis.

The diseases dermatomyositis and polymyositis both involve myositis. Polymyositis causes muscle weakness, usually in the muscles closest to the trunk of your body. Dermatomyositis causes muscle weakness, plus a skin rash. Both diseases are usually treated with prednisone, a steroid medicine, and sometimes other medicines.

Narcolepsy is a chronic central nervous system (CNS) disorder of unknown etiology that is characterized by excessive daytime sleepiness (EDS), hypnogogic hallucinations, cataplexy, sleep paralysis, and disrupted nocturnal sleep. Mistakenly considered a rare disorder, it is now estimated that one in every one to two thousand Americans may be afflicted with this disease, a prevalence approximating that of multiple sclerosis.

The symptoms of this disorder adversely impact the psychological and social functioning of those afflicted, and is especially debilitating because the disease onset occurs most often in the second and third decade of life, a time of increasing responsibility at school and work. The diagnosis and treatment are often delayed because the complaint of fatigue and sleepiness is often not taken seriously. It is often attributed to events surrounding the psychosocial milieu of the individual, even though the complaint of excessive daytime sleepiness always has an organic, nonfunctional explanation when an organized clinical evaluation is attempted. Both the primary care physician and the specialist play a pivotal role in screening and making appropriate referrals for narcolepsy and other disorders of excessive sleepiness. A high index of suspicion will lead to earlier diagnosis and treatment of this disabling disorder.

Recognizing Symptoms of Narcolepsy

Excessive Daytime Sleepiness (EDS): EDS is common with estimates in the general population ranging from one to five percent. Sleepiness has a circadian tendency with peaks of sleepiness in midafternoon and early morning. In normals, if the sleep need is satisfied, the tendency to doze during periods of idleness or boring situations is greatly reduced. Sleepiness indicates a sleep disorder when it persists and cannot be resolved by increasing amounts of sleep. Patients with the complaint of fatigue and sleepiness should be asked about their bedtime, wake up time, and napping behavior to determine if sleep deprivation is the cause. Patients will often explain their sleepiness using social or occupational demands to explain or justify this symptom. The astute clinician will ignore these trivial explanations and come to his own conclusion regarding the patient's sleep wake behavior.

Cataplexy: Cataplexy results when the atonia of REM sleep intrudes into wakefulness. It occurs in about two thirds of patients with narcolepsy and the severity of the symptom is quite variable. The symptom is very important because it is pathognomic for narcolepsy. Cataplectic attacks are triggered by emotion such as laughter, excitement, and anger. Attacks of cataplexy may be partial or complete. Limited attacks affect the face or neck muscles and are characterized by drooping eyelids, sagging jaw, or an inclined head. Speech may be slurred or stuttering. More complete episodes may result in a buckling of the knees and a fall. During a cataplectic episode the narcoleptic is fully aware of their surroundings but cannot move. The duration of the episode, whether partial or complete, may vary from a few seconds to thirty minutes. Cataplexy may occur only a few times in a lifetime with very strong emotion or may be totally disabling with multiple attacks in a given day. Cataplexy may not occur for the first time until months to years after the onset of EDS.

Sleep Paralysis: Approximately sixty percent of individuals with narcolepsy report the experience of sleep paralysis. The frequency of episodes varies from a few lifetime events to daily episodes. The episodes are frequently accompanied by vivid dreams. Sleep paralysis may be hypnopompic or hypnogogic. During an episode the patients find themselves unable to move their extremities or to speak, respiratory distress is rare as phrenic nerve function is preserved.

Hypnogogic Hallucinations: Vivid dreams described as hallucinations occur at the onset of nocturnal sleep, but may also occur during daytime naps or inadvertent sleep episodes. Approximately seventy percent of narcoleptics experience these hallucinations, which occasionally occur in association with sleep paralysis.

Fragmented Night Sleep: Although patients with narcolepsy fall asleep quite easily, they paradoxically often experience insomnia. At least sixty percent of patients with narcolepsy report severe disruption of nocturnal sleep. Many of the patients will present with an insomnia complaint and delay the diagnosis of narcolepsy if it is not considered in the differential diagnosis.

Other Manifestations: Approximately fifty percent of narcoleptic patients experience automatic behavior with retrograde amnesia. 8 Automatic behavior occurs when sleep has partially overtaken the brain, but the body continues to perform familiar tasks without conscious awareness of doing them. These episodes are sometimes confused with partial complex seizures. Periodic leg movements during nocturnal sleep occur with a higher incidence in narcoleptics than in the general population.

Treatment

In narcolepsy the goal of treatment is to provide symptom control and specifically to relieve the most troubling symptoms, EDS and cataplexy. EDS is primarily treated with stimulants or wake promoting agents. The commonly prescribed stimulant agents include amphetamine, methylphenidate, and pemoline. These are CNS stimulants that increase alertness and assist the patient to remain awake. These agents are associated with some undesirable side effects, which include insomnia, hypertension, palpitations and irritability. Tolerance to long-term stimulant therapy may occur necessitating an increase in dosage to achieve the same control. Methylphenidate is the most widely used stimulant. The dose required for effective treatment varies widely from patient to patient. The usual range of methylphenidate dosage is 30-60 mg per day in the adult. Reports of severe liver toxicity due to pemoline have limited its usefulness. Modafinil is a novel wake promoting agent recently approved by the Food and Drug Administration (FDA) for the treatment of narcolepsy. 15 It has been shown to reduce daytime sleepiness with few side effects. Because of its improved safety profile and Schedule IV labeling, many experienced clinicians utilize the drug modafinil as the drug of first choice in the treatment of EDS of narcolepsy.

Stimulants and modafinil are not effective in the treatment of symptoms associated with abnormal REM sleep, hypnogogic hallucinations, sleep paralysis and cataplexy. These symptoms respond to tricyclic antidepressants that include imipramine, protriptyline, clomipramine and selective seratonin re-uptake inhibitors (fluoxetine, sertraline and fluvoxamine). These agents appear to act by suppressing REM sleep. Although the doses generally used to treat cataplexy are lower than those required to treat depression, side effects, particularly with the tricyclic group, are common. These include dry mouth, constipation, tachycardia, urinary retention and impotence.

Sodium oxybate or gammahydroxybutyrate (GHB) is an endogenous compound found in many tissues of the body that appears to be very effective for the treatment of cataplexy. 16 This compound is currently being considered for approval by the FDA. Data from clinical trials suggests that this drug consolidates sleep and increases slow wave sleep time, resulting in suppression of the auxiliary symptoms of narcolepsy and improving daytime sleepiness. Sodium oxybate is given at bedtime and repeated four hours later. It has been shown to be well tolerated and it is believed by this clinician to be the most effective agent for the treatment of cataplexy.

A narcotic is a drug derived from opium, or a synthetic compound, that has powerful pain-killing effects. Narcotics also are associated with significant alteration of mood and behavior, and they're potentially addictive. With prolonged use, many people develop a tolerance for them, meaning they need more of the drug to get the same benefit.

Examples of narcotics include:

• Vicodin (contains hydrocodone)
• OxyContin, Percocet (contain oxycodone)
• Duragesic (fentanyl)

A type of cell in the immune system that destroys tumor cells or cells that are infected with some types of organisms. NK cells play a "front line" role in controlling infection by keeping it under control until the body can mount a full immune response.

Research suggests that some people with chronic fatigue syndrome have decreased function of NK cells, which is one piece of evidence supporting one chronic fatigue syndrome theory that attributes symptoms to chronic immune system activation possibly triggered by infection.

Naturopathic medicine (also known as naturopathy) is a school of medical philosophy and practice that seeks to improve health and treat disease chiefly by assisting the body's innate capacity to recover from illness and injury.

Naturopathic practice may include a broad array of different modalities, including manual therapy, hydrotherapy, herbalism, acupuncture, counseling, environmental medicine, aroma therapy, nutritional counseling, homeopathy, and so on.

Practitioners tend to emphasis a holistic approach to patient care. Naturopathy has its origins in the United States, but is today practiced in many countries around the world in one form or another, where it is subject to different standards of regulation and levels of acceptance.

Naturopathic practitioners prefer not to use invasive surgery, or most synthetic drugs, preferring "natural" remedies, (i.e. relatively unprocessed or whole medications), such as herbs and foods.

Licensed physicians from accredited schools are trained to use diagnostic tests such as imaging and blood tests before deciding upon the full course of treatment. Naturopathic Practitioners also employ the use of prescription medications and surgery when necessary and refer out to other medical practitioners.

Neoplasia is abnormal, disorganized growth in a tissue or organ, usually forming a distinct mass. Such a growth is called a neoplasm, also known as a tumor.

It is important to note that the term "neoplasm" is not synonymous with cancer, since neoplasms can be either benign or malignant. Leiomyoma (fibroids of the uterus) and melanocytic nevi (moles) are the most common types of neoplasms - both are benign.

Neuroendocrine cells are a specialized group of nerve cells (neurons) that produce hormones. These hormones may be amines, neuropeptide's, or specialized amino acids. They package the hormones in vesicles and send these packages via long processes (axons) to blood vessels.

When stimulated (by hormones from the blood stream or other neurons) the neuroendocrine cells secrete the hormones into the blood stream. The hormones then travel to their target cells and may stimulate, inhibit or maintain function of these cells. The target cells may feed back information to these neurons that regulates further secretion.

Specialized groups of neuroendocrine cells can be found at the base of the third ventricle in the brain (in a region called the hypothalamus). This area controls most anterior pituitary cells and thereby regulates functions in the entire body, like responses to stress, cold, sleep, and the reproductive system.

The neurons send processes to a region connecting to the pituitary stalk and the hormones (called releasing or inhibiting hormones) are released into the blood stream. They are carried by portal vessels to the pituitary cells where they may stimulate, inhibit, or maintain the function of a particular cell type.

A neurochemical is an organic molecule that participates in neural activity.

A branch of medicine dealing with disorders of the nervous system. Physicians specializing in the field of neurology are called neurologists and are trained to diagnose, treat, and manage patients with neurological disorders.

Your brain is made up of billions of cells called neurons that communicate with each other to control everything that goes on in your body. Communication between neurons relies on chemicals called neurotransmitters, which create and control signals. Every time you feel an itch, hear a noise, or experience an emotion, neurotransmitters are responsible. In addition, they tell your heart to beat, your lungs to breathe, and your stomach to produce digestive enzymes.

Each bodily function and emotion is linked to the operations of specific neurotransmitters. When your levels of a particular neurotransmitter are too high or too low, things can start to malfunction. FMS and ME/CFS have been associated with irregular levels of several neurotransmitters, including:

• Serotonin (the sleep cycle, pain processing, body temperature, appetite, sex drive, mood)
• Norepinephrine ("fight or flight" response, alertness, memory)
• Dopamine (mental focus, movement disorders, motivation)

A lot of treatment research has focused on how to regulate these neurotransmitters in order to alleviate the symptoms of FMS and ME/CFS. So far, experts don't know why neurotransmitter levels are abnormal in these conditions, but we do know they're responsible for a host of symptoms.

Technical term used to describe the disease of substance dependence, an interruption of the brains neuron activity.

Part of the U.S. Food and Drug Administration drug approval process.

The purpose of the NDA is to determine:

• whether a drug is safe and effective for its proposed use
• whether benefits of the drug outweigh the risks
• what information the drug's labeling should include
• that manufacturing methods are adequate to maintain the drug's quality, strength and purity

Nociceptors are specialized nerve endings that respond to pain or other unpleasant sensations and transmit information about those sensations to the central nervous system.

For reasons that aren't fully understood, nociceptors can become chronically activated and send persistent pain signals that can make you feel itching, burning, tingling or knife-stabbing pain. The level of pain depends on the level of irritation at the nociceptor.

Many researchers believe that the pain associated with fibromyalgia and chronic fatigue syndrome comes from this kind of chronic nociceptive activity, which is part of central sensitization.

Norepinephrine is a hormone and a neurotransmitter. As a hormone, it's secreted by the adrenal gland and works with epinephrine (adrenaline) to give you sudden bursts of energy in response to stress (the "fight or flight" mechanism.) As a neurotransmitter, it sends signals between nerves.

Studies show that norepinephrine levels are low in people with fibromyalgia and chronic fatigue syndrome. Medications that inhibit the reuptake (reabsorption) of norepinephrine and serotonin (SNRIs) are effective at treating symptoms in many people with the conditions.

Non-steroidal anti-inflammatory drugs, NSAID's, are drugs with analgesic antipyretic and anti-inflammatory effects - they reduce pain, fever and inflammation. The term "non-steroidal" is used to distinguish these drugs from steroid, which (among a broad range of other effects) have a similar eicosanoid-depressing, anti-inflammatory action. The most prominent members of this group of drugs are:

• Aspirin
• Ibuprofen

Acetaminophen has little anti-inflammatory activity, and is strictly speaking not an NSAID.

Part of the popularity of NSAID's is that, unlike opiods, they do not produce sedation or respiratory depression and have a very low addiction rate. NSAID's, however, are not without their own problems. The two main adverse drug reactions associated with NSAID's relate to gastrointestinal (GI) effects and renal effects of the agents.

RISKS:

• If you are taking a COX-2 inhibitor such as: Celebrex® or celecoxib you should not use a traditional NSAID (prescription or over-the-counter).


• GI Problems: Nausea/Vomiting, Dyspepsia, stomach ulceration/bleeding, Diarrhea


• Risk of ulceration increases with duration of therapy, and with higher doses.


• NSAID's are also associated with a relatively high incidence of renal adverse drug reactions.