Myalgic encephalomyelitis symptoms, causes for ringing in ears - PDF Review

This article reviews the diagnostic criteria for both myalgic encephalomyelitis (ME) (ie, chronic fatigue syndrome) and fibromyalgia (FM) and describes how to differentiate them from depressive and anxiety disorders, the psychiatric conditions with which they are most often confused.
New criteria for diagnosing FM were published in 2010.3 These criteria eliminate the previously required need for tender points on physical examination and add the criteria of fatigue, unrefreshing sleep, cognitive symptoms, and a long list of somatic symptoms (none of which are specific to FM) to the pathognomonic symptom of widespread pain (Table 2). Myalgic encephalomyelitis (ME) is known before as a yuppie flu which was described to affect young office workers located in big cities. ME is also defined as a complex, severe, and acquired illness that leads to various symptoms related mainly to the dysfunction of the brain, gastrointestinal, immune, cardiac, and endocrine systems. To clearly define this disease condition, the terms chronic fatigue syndrome and myalgic encephalitis will be analyzed. Consider the diagnoses of ME and FM in “psychiatric” patients with a disproportionate number of physical symptoms, especially in those who are not responding as expected to psychiatric interventions. Since fatigue, unrefreshing sleep, and cognitive symptoms are common to many psychiatric conditions, these new criteria do not aid in the differentiation between FM and a psychiatric diagnosis.

Most often the symptoms of this disease condition will produce economical and negative social consequences which may lead to a long-term disability. The tests that will be mentioned here are those that are used to rule out other etiological factors that cause fatigue or other symptoms that are associated with this disease. Doctors will only prescribe medications which provide symptomatic relief in muscular pains, sleeping problems, and depression problems.
PEM occurs following mental or physical exertion and is described as worsening symptoms lasting 24 hours or more.
Seek care first from the health care provider who knows you best and will work with you to rule out other possible causes of symptoms and identify other conditions. Acupuncture, hydrotherapy, yoga, tai chi, and massage therapy have been found to help and are often prescribed for symptom management.
Although they have some symptoms in common (eg, fatigue, cognitive problems, unrefreshing sleep), ME and FM differ from each other and from all known psychiatric conditions.


Pain is not a core symptom of any common psychiatric condition but is reported to be elevated in major depression.2 Autonomic, neuroendocrine, and immune symptoms are not common in any psychiatric condition. A careful review of the entire constellation of symptoms is needed to identify whether the psychological or physical symptoms predominate.
Sleep problems, pain, heart rate irregularities, gastrointestinal difficulties, allergies, and depression are some of the symptoms that can be relieved treated. Diagnostic clarity depends on knowledge of the diagnostic criteria for each condition and identifying the pathognomonic, non-overlapping symptoms. In patients with aching, tiring pain all over as the primary presenting symptom in combination with several other somatic symptoms, FM should be considered.

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