What is Myalgic Encephalomyelitis ?

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by John Duncan and Maryann Spurgin.

 

A Brief Historical Introduction.

 

In the first half of the twentieth century, Myalgic Encephalomyelitis outbreaks appeared to be associated with polio outbreaks, but with the eradication of polio the meaning of this connection has not been given attention [6-8].The name “Myalgic Encephalomyelitis” comes from a 1955 outbreak of the disease at the Royal Free Hospital in London [2] described by A. Melvin Ramsay and others. For the chronic phase of the disease, (II) Ramsay described a triad of distinguishing hallmarks: muscle fatigability after trivial exertion, circulatory impairment, and cerebral dysfunction [3]. The name was proposed by Sir Donald Acheson, later the UK’s Chief Medical Officer.

In the 1980’s an outbreak occurred at the resort town of Incline Village, Nevada. Although eventually the CDC was convinced to investigate, instead of recognition of this outbreak as Myalgic Encephalomyelitis, the ultimate result was the creation of a new syndrome construct, “Chronic Fatigue Syndrome,” with a new definition: the Holmes Definition [9]. Mistakenly, the new definition privileged rarely seen symptoms and made essential symptoms such as intolerance to sensory or cognitive stimulation and the hallmark 24-48 hour delayed post-exertional worsening of all symptoms optional.

 

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