Myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS) are serious, debilitating conditions that affect millions of people in the United States and around the world. ME/CFS can cause significant impairment and disability. Despite substantial efforts by researchers to better understand ME/CFS, there is no known cause or effective treatment. Diagnosing the disease remains a challenge, and patients often struggle with their illness for years before an identification is made. Some health care providers have been skeptical about the serious physiological - rather than psychological - nature of the illness. Once diagnosed, patients often complain of receiving hostility from their health care provider as well as being subjected to treatment strategies that exacerbate their symptoms. Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome proposes new diagnostic clinical criteria for ME/CFS and a new term for the illness - systemic exertion intolerance disease(SEID). According to this report, the term myalgic encephalomyelitis does not accurately describe this illness, and the term chronic fatigue syndrome can result in trivialization and stigmatization for patients afflicted with this illness. Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome stresses that SEID is a medical - not a psychiatric or psychological - illness. This report lists the major symptoms of SEID and recommends a diagnostic process.One of the report's most important conclusions is that a thorough history, physical examination, and targeted work-up are necessary and often sufficient for diagnosis. The new criteria will allow a large percentage of undiagnosed patients to receive an accurate diagnosis and appropriate care. Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome will be a valuable resource to promote the prompt diagnosis of patients with this complex, multisystem, and often devastating disorder; enhance public understanding; and provide a firm foundation for future improvements in diagnosis and treatment.

An important medical milestone for anyone connected with ME/CFS! Myalgic Encephalomyelitis / Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols includes a clinical definition (clinical diagnostic criteria) for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The clinical case definition was developed by an expert medical consensus panel of treating physicians, teaching faculty and world leaders in the research of ME/CFS. An expert subcommittee of Health Canada established the Terms of Reference for the consensus panel. The definition more adequately reflects the complexity of symptoms of a given patient’s pathogenesis and should establish ME/CFS as a distinct medical entity and help distinguish it from overlapping medical conditions in the absence of a definitive laboratory test. “The clinical definition will enable clinicians to make an early diagnosis which may assist in lessening the impact of ME/CFS in some patients,” said Dr. Bruce M. Carruthers, lead author of the definition. “It will reduce the expensive problem of patients being sent to many specialists before being diagnosed and will allow patients to receive appropriate treatments in a timely fashion.” The panel's clinical case definition determines that more of the prominent symptoms are compulsory and symptoms that share a common region of pathogenesis are grouped together for clarity. In addition to severe prolonged fatigue, the definition includes the hallmark symptoms of post-exertional malaise and/or fatigue, sleep dysfunction, pain, two or more of the given neurological/cognitive manifestations, and at least one of the given symptoms from two of the categories of autonomic, neuroendocrine, and immune manifestations. Diagnostic exclusions and common co-morbid entities are also given. The special issue of the Journal of Chronic Fatigue Syndrome also includes a discussion of prominent symptoms, clinical practice diagnostic and treatment guidelines based on the best available research evidence, and an overview of available research on ME/CFS. The expert panel of 11 physicians—who have diagnosed and/or treated more than 20,000 ME/CFS patients between them—has developed a clinical case definition that provides a flexible conceptual framework based on the characteristic patterns of symptom clusters, which reflect specific areas of pathogenesis. The expert subcommittee of Health Canada selected the expert consensus panel. Authors include: Dr. Bruce M. Carruthers, lead author of the consensus document; co-author of the draft of the original version of the ME/CFS clinical definition, diagnostic and treatment protocols document; internal medicine, Galiano, British Columbia. Dr. Anil Kumar Jain, co-author of the draft the original version of the ME/CFS consensus document, affiliate of Ottawa Hospital, Ontario. Dr. Kenny L. De Meirleir, Professor Physiology and Medicine, Vrije Universiteit Brussel, Brussels, Belgium; ME/CFS researcher and clinician; organizer of the World Congress on Chronic Fatigue Syndrome and Related Disorders; a board member of the American Association for Chronic Fatigue Syndrome; and co-editor of Chronic Fatigue Syndrome: Critical Reviews and Clinical Advances (Haworth) Dr. Daniel L. Peterson, affiliate of the Sierra Internal Medicine Associates in Incline Village, Nevada; ME/CFS researcher and clinician; a board member of the American Association for Chronic Fatigue Syndrome; and member of the International Chronic Fatigue Syndrome Study Group Dr. Nancy G. Klimas, Clinical Professor of Medicine in Microbiology/Immunology/Allergy and Psychology, University of Miami School of Medicine; ME/CFS researcher and clinician; a board member of the American Association for Chronic Fatigue Syndrome; and member of the federal CFS Coordinating Committee Dr. A. Martin Lerner, staff physician at William Beaumont Hospital in Royal Oak, Michigan; Clinical professor and former chief of the Division of Infectious Diseases at Wayne State University's School of Medicine; and ME/CFS researcher and clinician Dr. Alison C. Bested, haematological pathologist; former head of the Division of Haematology and Immunology at the Toronto East General and Orthopaedic Hospital; affiliate of the Environmental Health Clinic and Sunnybrook & Women's College Health Sciences Centre, Toronto, Ontario; ME/CFS researcher and clinician Dr. Pierre Flor-Henry, Clinical Professor of Psychiatry, University of Alberta; Clinical Director of General Psychiatry and Director of the Clinical Diagnostic and Research Centre, both based at Alberta Hospital in Edmonton, Alberta, Canada; ME/CFS brain researcher Dr. Pradip Joshi, internal medicine, Clinical Associate Professor of Medicine at Memorial University of Newfoundland in St. John's, Canada Dr. A. C. Peter Powles, Professor Emeritus, Faculty of Health Science, McMasters University, Hamilton; Professor, Faculty of Medicine, University of Toronto; Chief of Medicine and Sleep Disorders Consultant, St. Joseph's Health Centre, Toronto; Sleep Disorder Consultant at the Sleep Disorder Clinic at St. Joseph's Healthcare, Hamilton, and Central West Sleep Affiliation, Paris, Ontario Dr. Jeffrey A. Sherkey, family medicine, affiliate of the University Health Network, Toronto, Ontario; and diagnosed with chronic fatigue syndrome nearly 10 years ago Marjorie I. van de Sande, Consensus Coordinator; and Director of Education for the National ME/FM Action Network, Canada Myalgic Encephalomyelitis / Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols also addresses diagnostic exclusions and common co-morbid entities. This groundbreaking book is must reading for anyone connected with the disease—personally or professionally.

Disability and Chronic Fatigue Syndrome: Clinical, Legal, and Patient Perspectives explores methods to assess severity of illness and impairment in persons suffering with CFS. It shows that more work needs to be done to develop objective measures of impairment that accurately reflect the patient's degree of disability. Contributors explore possible answers to the questions: How can a clinician quantify the degree of impairment? How can the legal and judicial systems weigh the facts and the impact of this illness on each person with CFS? How does a patient persevere and get past the barriers, despite his/her illness?

A guide for practitioners, scientists, and patients, Clinical Management of Chronic Fatigue Syndrome provides an insightful overview of current clinical management of CFS and guidelines for dealing with the disease and its compounding issues. It also provides, especially for patients, an objective framework in which they can approach the confusing psychological and physical ramifications of the disease so that they may sort through possibly misleading information on current treatments. CFS has been the focus of an increasing number of research investigators seeking to unravel the enigmatic interrelationship of immunologic, neurologic, endocrinologic, and psychologic abnormalities associated with this debilitating disorder. Because many practical issues have been underestimated by the medical community, and considerable misinformation exists regarding the appropriate evaluation and management of the CFS patient, the American Association for Chronic Fatigue Syndrome (AACFS) held its first clinical conference to address this problem, the results of which are presented in this book. Each chapter, based on material presented at the October 1994 conference has been completely updated and revised during a peer review process, making Clinical Management of Chronic Fatigue Syndrome a useful and up-to-date guide for practitioners and scientists, as well as patients. Despite the potential of nervous system functional assessments, the diagnosis of CFS continues to be a major problem because a consensus diagnostic tool is lacking, and the monitoring of the disorder is based primarily on patient report. Moreover, dealing with the financial aspects of CFS continues to be a major problem for patients, so professionals with experience dealing with insurance companies explored this issue, as well as ways in which CFS could be considered in a broader perspective of health care, particularly focusing on governmental involvement. The chapters provide an insightful overview of current clinical management of patients and guidelines for dealing with the disease and its complicating issues. General topics of relevance covered in the book's chapters include a review of advances in basic science neurocognitive dysfunction diagnostic issues use of alternative/complementary medicine cognitive behavioral and rehabilitative therapies financial issues advances in governmental role women's issues In this book, practitioners and scientists in the field and patients living with CFS have a thorough resource on current clinical and patient management of the disease.

Chronic Fatigue Syndrome: Advances in Epidemiologic, Clinical, and Basic Science Research highlights the presentations and issues discussed at the Fourth Annual International Conference of the American Association of Chronic Fatigue Syndrome (CFS). You will explore the strengths and weaknesses of current case definitions of CFS and how these can be improved. Also, you will examine how to distinguish CFS from similiar ailments such as fibromyalgia and multiple chemical sensitivity. This book puts different therapeutic modalities to the test, and addresses the neurological and psychiatric manifestations associated with CFS.

Fibromyalgia, Chronic Fatigue Syndrome, and Repetitive Strain Injury provides a summary of information from a conference on chronic fatigue syndrome (CFS), fibromyalgia syndrome (FS), and related disorders. Many of the contributors are known for being actively involved in the study of the target disorders and represent countries around the world. In addition to health professionals, the contributors represent the legal profession and the insurance industry of Canada. The unique feature of this volume is its emphasis on disability and compensation. In Fibromyalgia, Chronic Fatigue Syndrome, and Repetitive Strain Injury readers will find concise summaries of the formal presentations given at the Vancouver Conference in July 1994. The underlying tenor in the chapters is on viewing affective (psychological) pathology as a contributor to the underlying processes of these disorders. Readers are encouraged to follow closely the logic of each author's academic exercise. They will find that in many cases, the authors provoke more answers than they are able to answer, in the hope of promoting continued research toward finding concrete answers. The conference was designed to address etiology, pathogenesis, clinical features, treatment, disability, medico-legal issues and cost containment. The program agenda was issue driven rather than condition based. The papers were presented in a manner which allowed delegates and speakers to see the overlap and differences between these conditions. The purpose of Fibromyalgia, Chronic Fatigue Syndrome, and Repetitive Strain Injury is to provide education for primary care physicians, specialist physicians, other health care disciplines, patients, and the public. A second purpose is to enable investigators in the three topic areas to get new information from specialists around the world to develop new ideas, which will inform future research and consensus.