Diagnosis of ME/CFS debate

Speaking of criteria, Dr. Bruce Carruthers (medical advisor to the National ME/FM Network, and lead author of the 2003 Canadian Clinical Criteria for ME/CFS) introduced new recommendations for the Canadian criteria. His committee has recommended abandoning the 6 month waiting period, and suggested calling ME/CFS Post-Exertional-Neuroimmune-Exhaustion (or PENE). The committee clarified some of the symptoms required in the prior criteria, and modifications were added for pediatric cases.

[Ed. note:  Enough is enough! The 2003 criteria are satisfactory and widely used. The new “changes” are really quite trivial, and the new name is ridiculous.  ME/CFS was gaining popularity with doctors and patients alike, so introducing a new name just confuses everybody.]

Lenny Jason, PhD (DePaul University, Chicago) next compared and contrasted the original Ramsey definition of Myalgic Encephalomyelitis, the 1994 CDC (Fukuda or research) criteria, and the 2003 Canadian clinical criteria. The Ramsey criteria are quite succinct, requiring only (1) acute onset of symptoms following a viral-like episode, (2) post-exertional malaise, (3) cognitive difficulties, and (4) autonomic issues. He pointed out that the 1994 Fukuda criteria emphasize fatigue over post-exertional malaise as the key symptom. Also, only 4 of 8 symptom criteria are required by the Fukuda definition, but the diagnosis would be strengthened if 7 of the 8 were required. Finally, the Canadian criteria identified more severe functional and cognitive symptoms, thereby selecting fewer psychiatric cases and more severely ill patients.

[Ed. note. We continue to use primarily the 1994 CDC criteria because they have been accepted for over 15 years and used in the majority of scientific papers, However, we also record the 2003 Canadian criteria. Clinicians should be familiar with both.]