A neuroimmune disease that results in many varied symptoms
ME/CFS comes with a wide variety of symptoms — from profound muscle weakness to debilitating cognitive dysfunction to an abnormal intolerance to otherwise minor exertion.
However, the symptoms are not random — there is a pattern. Since the nervous system controls all the systems in the body, problems with the nervous system itself can show up as problems in multiple body systems, with a variety of symptoms.
One way to understand the pattern of symptoms in ME/CFS is to review the official diagnostic definition of ME/CFS.
Another way to begin to understand the symptoms in ME/CFS is to listen to discussions among patients. The following are some relevant discussions that you might find informative.
Hypersensitivity to light (photophobia) and to sound (hyperacusis):
“Sensory gating” is where the brain automatically filters out irrelevant senses so that you can concentrate on relevant tasks. Sensitivity to sound (hyperacusis) & light (photophobia) are common in ME/cfs. Could this be a failure of “sensory gating”?
Muscle twitching and sudden limb jerking:
People with ME/cfs often experience involuntary movements such as muscle twitching (fasciculations) or sudden limb jerking (myoclonus). What is the difference between these two types of neurological symptoms?
Cognitive dysfunction (“brain fog”):
In the brain there is a regular firing of nerve cells that form a “thalamo-cortical loop” between the thalamus and the cortex. A reduced speed of this rhythmic firing has been linked to both slow information processing and poor attention/concentration. Since this rhythmic firing can actually be measured with an ElectroEncephaloGram (EEG), does this mean that brain fog could possibly be measured with a simple, non-invasive test?
A classic 2014 study finally provided proof of neuroinflammation in ME/cfs patients. Now people are trying to replicate this study. Interestingly, most of the neuroinflammation appeared to be in the subcortical (autonomic) brain, instead of in the cortical (conscious) brain. What could these research efforts tell us about the neurological symptoms of ME/cfs?
Orthostatic Intolerance (OI) is a very common symptom of ME/cfs, and may also be seen in Long Covid. Postural Orthostatic Tachycardia Syndrome (POTS) and Orthostatic Hypotension (OH) are two types of orthostatic intolerance. But what exactly is the physiological mechanism behind these types of orthostatic intolerance? And what is the role of dysautonomia of blood vessels, blood volume, and the baroreflex?
Do your fingers wrinkle in warm water? Did you know that this finger wrinkling is actually controlled by the autonomic nervous system? Does a lack of finger wrinkling mean dysautonomia? What if anti-inflammatories restore your wrinkles?
Brain MRI abnormalities:
Does your brain MRI show white matter abnormalities, also known as “T2 Hyperintensities”? Did your neurologist tell you they are “perfectly normal” even though no healthy person your age has them? You’re not alone.
Anhedonia and Emotional Apathy:
Anhedonia is the condition where you no longer derive pleasure from the things that used to bring you pleasure. Emotional apathy is the condition where you no longer feel the emotions you would normally feel in a given context. (These are both distinct from depression.) Have you developed anhedonia or emotional apathy as a result of coming down with ME/cfs?
Derealization or depersonalization:
Ever feel completely detached from reality? Or feel like you’re detached from yourself? One Phoenix Rising member made a video to try to describe to others what it’s like to live with a feeling of derealization or depersonalization.
Palpitations and arrhythmias:
Do you have trouble doing any sort of aerobic exercise? You’re not alone, as this exercise intolerance is a core feature of ME/cfs. Interestingly, it happens to have the same physiological basis as orthostatic intolerance!
Muscle soreness (myalgia):
Rib cage pain:
Costochondritis is a painful inflammation of the rib cage cartilage, and is an intermittent symptom in some ME/cfs patients. Do you notice intermittent pain in the rib cage area? Does it interfere with sleeping on your side?
Worse symptoms after eating:
Worse symptoms after going to the bathroom:
Excessive thirst and urination:
Reflux: heartburn, coughing, vomiting:
What do nausea, heartburn, and coughing have in common? They are all symptoms of different types of gastrointestinal reflux. Reflux occurs when the autonomic system fails to fully close a valve (sphincter) in the throat or stomach. What are the four different types of reflux, and which are associated with which symptom?
Digestion and malnutrition:
Some ME/cfs patients report dysfunction of the pupils in their eyes, whether unusual dilation in both eyes (mydriasis), in only one eye (anisocoria), or rhythmic contractions (hippus). Could this be another type of dysautonomia?
Teeth clenching and grinding:
Scientists are increasingly finding traces of human-made chemicals throughout our environment. We don’t know if these chemicals are related to a patient’s hypersensitivity to environmental factors, but one member attempted to list the different possible chemicals found in our environment, for anyone looking to limit their exposure to these chemicals.