Journal of IiME Volume 1 Issue 1 INFORMATION ON ME/CFS (continued) A leading professor of clinical immunology in the UK has published papers confirming that these are patients with multiple sensitivities, and that their symptoms are not all in the mind. ANAESTHESIA PROBLEMS IN ME/CFS It is well-established that patients with ME/CFS and others with neuromuscular dysfunction can have problems with anaesthesia: depolarising muscle relaxants have a known risk of causing potassium release from muscle, which can lead to cardiac arrest, and it respiratory failure. VASCULAR PROBLEMS IN ME/CFS References to vascular problems in ME/CFS have been in the medical literature from 1938. Such problems include vasomotor instability; impaired blood flow in the micro-circulation consistent with inflammatory processes; vasculopathy including Raynaud’s disease; cutaneous vasculitis; vasculitis of the liver and cerebral hypoperfusion due to vasculitis. CARDIAC PROBLEMS IN ME/CFS Documented problems include myocarditis; chronic pericarditis; paroxysmal attacks of chest pain, with the intensity of myocardial infarction; palpitations, with sinus tachycardia being particularly troublesome; flattening and inversion of T waves; a lower stroke volume and cardiac output (indicating a defect LUNG / RESPIRATORY PROBLEMS IN ME/CFS There is evidence of shortness of breath in ME/CFS patients (due in part to fatigue of the voluntary muscles of respiration); evidence shows that ME/CFS patients have a significant decrease in vital capacity (VC). The incidence of bronchial hyper-responsiveness is remarkably high. Compared with controls, ME/CFS patients showed a significant reduction in all lung function parameters studied. GUT DYSFUNCTION IN ME/CFS Irritable bowel syndrome (IBS) is a widespread and common problem in ME/CFS; reference to it throughout various sections of the reference papers. BRAIN IMAGING (NUCLEAR MEDICINE) IN ME/CFS The literature contains objective evidence of brain impairment in the majority of patients which is compatible with a chronic viral encephalitis. Patients have a particular pattern of hypoperfusion of the brainstem. Brain perfusion impairment in ME/CFS provides objective evidence of central nervous system dysfunction. COGNITIVE DYSFUNCTION IN ME/CFS Neuropsychological testing reveals a pattern of cognitive impairment which is compatible with an organic brain lesion. Tests on ME/CFS patients revealed a performance which was sevenfold worse than that found in either the controls or in depressed patients. Results indicate that the memory deficit in ME/CFS is more severe than has been assumed by the CDC criteria. A pattern has emerged of brain behaviour which supports neurological compromise in ME /CFS. PSYCHOLOGICAL PROBLEMS IN ME/CFS There is a substantial body of literature which strongly refutes claims that patients are overly suggestible; it is quite specific that patients are not somatising, and it confirms that patients are not exhibiting “abnormal illness behaviour” and that the illness is not explained by inactivity or psychiatric disorder. Any depressive symptoms present are more likely to be a consequence rather than a cause of illness. Serious doubts are raised about the validity of the application of a psychiatric label. A conviction by patients of physical illness is demonstrated to be understandable and legitimate. (continued on page 46) Invest in ME Charity Nr 1114035 www.investinme.org is to be found in the higher cortical modulation of cardiovascular autonomic control). ME/CFS patients have higher heart rates and lower pulse pressure and have baseline differences from normals. is important to avoid histamine releasers. Muscle weakness increases the risk of 45
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