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Pediatric diagnostic considerations in the 2011 Criteria

In a separate section, the 2011 Criteria discussed how ME might manifest itself somewhat differently in children. The authors write: "Symptoms may progress more slowly in children than in teenagers or adults. In addition to postexertional neuroimmune exhaustion, the most prominent symptoms tend to be neurological: headaches, cognitive impairments, and sleep disturbances."

Headaches are severe or chronic. Migraine headaches "may be accompanied by a rapid drop in temperature, shaking, vomiting, diarrhea and severe weakness." Neurocognitive symptoms may include difficulty with eye-focusing and reading.

"Children may become dyslexic, which may only become evident when fatigued."

There will be slow information-processing which will create difficulty following oral instructions or taking notes. "All cognitive impairments worsen with physical or mental exertion." Young people with the illness may not be able to maintain a full school program. Also, "Pain may seem erratic and migrate quickly...Joint hypermobility is common."

The fluctuation and severity of numerous major symptoms may change in their relative severity and prominence "more rapidly and dramatically than in adults."

The Wiley online library provides access, at no cost, to the full text article, Myalgic encephalomyelitis: International Consensus Criteria