We all probably mean the same when we say “diagnosis”: a cognitive process during which, through a scientific method, using his knowledge and experience, analyzing tests results, comparing them with statistics and eventually with colleagues, a clinician reaches a conclusion on what disease his patient is suffering from.
As already pointed out, Myalgic Encephalomyelitis is a very serious and well defined illness; so, what Chronic Fatigue Syndrome is?
ME has been called for many years CFS, that is CFS and ME have been identified as the same illness. This has been a big mistake. In another post we will talk about the ME story.
Here I will use the excellent Nightingale Definition of Myalgic Encephalomyelitis by Dr. Byron Marshall Hyde MD (in English, French, Norwegian and Danish):
Consider that this definition is of 2007, before the 2011 ICC, when ME was been better defined respect to the 2002 Canadian Criteria.
I copy-paste only the beginning and I recommend you to read it all, because it is very easy to read and gives you a concrete insight on ME:
“Primary M.E. is an acute onset biphasic epidemic or endemic (sporadic) infectious disease process, where there is always a measurable and persistent diffuse vascular injury of the CNS in both the acute and chronic phases. Primary M.E. is associated with immune and other pathologies. “
I already said that we have a ME criteria available (Diagnostic Criteria for Experts: http://mechannel.wordpress.com/2012/03/08/diagnostic-criteria-3/).
In this criteria some tests are foreseen, but much is entrusted to the clinician’s preparation and experience; we need a very intelligent clinician to do a ME diagnosis using ICC criteria, a common one is not sufficient.
On the other hand, the Nightingale Definition can by applied by any normal doctor but requires a large list of expensive tests.
I see ICC Criteria and Nightingale Definition as two extremes between which we need to find a realistically applicable and internationally common protocol, that should be used for a first diagnosis and treatment.
After this first step, every patient needs to be 360º monitored during the illness evolution and eventually needs further tests of any kind, to improve and specify the initial treatment and, if possible, to find what caused his disease in order to optimize the treatment and prevent any worsening of his condition.
More informations here:
Dr. Hyde speaking in Canada (video):