Saturday, August 7, 2010

Medical similarities between MS and M.E. Permission to re-post

 
Medical similarities between MS and M.E. Permission to re-post by the author, Jodi Bassett
Medical similarities between MS and M.E.
The reason I'm envious is not so much because of the type of illness MS is medically compared to M.E. M.E. and MS are actually very similar medically in many ways, as the following list demonstrates.

Table 1. Medical similarities between MS and M.E.*

MS is primarily a neurological disease, i.e. a disease of the central nervous system (CNS).

M.E. is primarily a neurological disease, i.e. a disease of the central nervous system (CNS).

Demyelination (damage to the myelin Myelin and nerve structure sheath surrounding nerves) has been documented in MS.

Demyelination (damage to the myelin Myelin and nerve structure sheath surrounding nerves)has been documented in M.E.

Evidence of oligoclonal bands in the cerebrospinal fluid has been documented in MS.

Evidence of oligoclonal bands in the cerebrospinal fluid has been documented in M.E.

No single definitive laboratory test is yet available for MS but a series of tests are available which can objectively confirm the diagnosis with some certainty. No single definitive laboratory test is yet available for M.E.but a series of tests are available which can objectively confirm the diagnosis with a high degree of certainty.

MS can be severely disabling and cause significant numbers of patients to be bedbound or wheelchair-reliant.

M.E. can be severely disabling and cause significant numbers of patients to be bedbound, wheelchair-reliant or housebound.

MS can be fatal (either from the disease itself or from complications arising from the disease)

M.E. can be fatal (either from the disease itself or from complications arising from the disease)
 
MS significantly reduces life expectancy.

M.E. significantly reduces life expectancy. (M.E. reduces life expectancy by a greater period than MS: see Table 3.)

Symptoms/problems which occur in MS include:
impaired vision, nystagmus, afferent pupillary defect, loss of balance and muscle coordination, cog wheel movement of the legs, slurred speech
Hearing or speech impairment - resources
Speech disorders, difficulty speaking (scanning speech
Hearing or speech impairment - resources
Speech disorders and slow hesitant speech
Hearing or speech impairment - resources
Speech disorders),
difficulty writing,
difficulty swallowing
Swallowing difficulty
Painful swallowing, proprioceptive dysfunction, abnormal sensations (numbness, pins and needles), shortness of breath, headaches, itching, rashes, hair loss,seizures, tremors, muscular twitching or fasciculation, abnormal gait,stiffness, subnormal temperature, sensitivities to common chemicals,sleeping disorders, facial pallor, bladder and bowel problems, difficulty walking, pain, tachycardia, stroke-like episodes, food intolerances and alcohol intolerance, and partial or complete paralysis.

Symptoms/problems which occur in M.E. include:
impaired vision,nystagmus, afferent pupillary defect, loss of balance and muscle coordination, cogwheel movement of the legs, slurred speech, difficulty speaking (scanning speech and slow hesitant speech), difficulty writing, difficulty swallowing, proprioceptive dysfunction, abnormal sensations(numbness, pins and needles), shortness of breath, headaches, itching, rashes, hair loss, seizures, tremors, muscular twitching or fasciculation,abnormal gait, stiffness, subnormal temperature, sensitivities to common chemicals, sleeping disorders, facial pallor, bladder and bowel problems,difficulty walking, pain, tachycardia, stroke-like episodes, food intolerances and alcohol intolerance, and partial or complete paralysis.


MS can cause orthostatic intolerance (dizziness or faintness on standing).
 
M.E. commonly causes severe orthostatic intolerance (which often worsens to become severe POTS and/or NMH).
 
Short-term memory loss, word finding difficulty, difficulty with concentration and reasoning and other forms of cognitive impairment occur in 50% of MS patients. 10% of MS patients have cognitive impairments severe enough to significantly affect daily life.
 
Short-term memory loss, word finding difficulty, difficulty with concentration and reasoning and other forms of cognitive impairment occur in 100% of M.E. patients. Almost all M.E. patients have cognitive impairments severe enough to significantly affect daily life.
 
MS patients often become severely more ill in even mildly warm weather. Cold weather can also cause significant problems.

M.E. patients often become severely more ill in even mildly warm weather. Cold weather can also cause significant problems.
 
MS can affect autonomic nervous system function (including involuntary functions such as digestion and heart rhythms).
 
M.E. can affect autonomic nervous system function (including involuntary functions such as digestion and heart rhythms).

MS is thought to cause a breakdown of the blood brain barrier.
 
M.E. is thought to cause a breakdown of the blood brain barrier.
 
A positive Babinski's reflex is consistent with several neurological conditions, including MS. (Babinski's reflex or extensor plantar reflex is atest for dysfunction of the corticospinal tract.)

A positive Babinski's reflex (or extensor plantar reflex) is consistent with M.E.

The Romberg test will often be abnormal in MS. (This test measures neurological or inner ear dysfunction.)
 
The Romberg test will be abnormal in 95% or more of M.E.patients.

An abnormal neurological exam is usual in MS. Abnormalities are also commonly seen in neuropsychological testing in MS.
 
An abnormal neurological exam is usual in M.E. Abnormalities are also commonly seen in neuropsychological testing in M.E.


MS causes a certain type of brain lesion detectable in MRI brain scans. Abnormalities are also seen in EEG and QEEG brain maps and SPECT brain scans in MS.
 
M.E. causes a certain type of brain lesion detectable in MRI brain scans. Abnormalities are also seen in EEG and QEEG brain maps and SPECT brain scans in M.E.

Hypothyroidism is found in many MS patients.
 
Hypothyroidism is found in almost all M.E. patients.

The glucose tolerance test is often abnormal in MS.
 
The glucose tolerance test is often abnormal in M.E.

Low blood pressure readings (usually low-normal) are common in MS.
 
Low blood pressure readings are extremely common in M.E. Severely low blood pressure readings as low as, or lower than, 84/48 (or 75/35 according to many anecdotal accounts) are common in severe M.E. or those having severe relapses. This can occur at rest or as a result of orthostatic or physical overexertion. At times BP readings can be so low that they cannot be measured by the machine and error messages appear. Circulating blood volume measurements of only 50% to 75% of expected are also commonly seen in M.E.

Patients with MS have an increased risk of dying from heart disease or vascular diseases.
 
Deaths from cardiac problems are one of the most common causes of death in M.E.

Although MS is primarily neurological, it also has aspects of autoimmune disease.
 
Although M.E. is primarily neurological, it also has aspects of autoimmune disease.

MS usually affects people between the ages of 20 and 40 years, and the average age of onset is approximately 34 years. Onset occurs between the ages of 20 to 40 years in 70% of patients.
 
The average ages affected by M.E. are similar to those seen in MS. However, the average age of onset may be significantly younger in M.E.

MS was once thought to be rare in children, but we know that around 5% of MS sufferers are under 18.
 
Around 10% of M.E. sufferers are under 18.
 
MS affects more than a million adults and children worldwide.

M.E. affects more than a million adults and children worldwide.(M.E. is at least as common as MS, and may be up to twice or three-times as common.)

Permission to re-post by the author, Jodi Bassett
* * *
Shortly after I was diagnosed with CFS (a/k/a ME a/k/a Post Viral Syndrome), a woman at church was diagnosed with MS.  They fawned over her, sending her volunteers.  Not only did they not send me volunteers, they called me lazy and selfish when I said that I was too sick to do my own housework, much less go over and do hers.  She quit her job immediately on diagnosis, I was still struggling to work, but I was the one accused of being "too lazy to work".  Etc., etc., etc.
 
Since our symptoms were almost identical, I demanded an explanation from my specialist, why she got the respectable diagnosis and I got the one that generated nothing but disrespect?  The answer was that she had one symptom that's seen in MS but not in CFS, and I had a symptom that's seen in CFS but not in MS. 
 
I'll note that while Jodi says CFS patients get worse in heat, Dr. Bell says precisely the opposite, that he diagnoses the difference because CFS patients feel better in heat and worse in cold, while MS patients feel worse in heat and better in cold.  I'd be inclined to believe Dr. Bell, simply because when it gets cold, I feel dreadful and can't wait for winter to end so I'll feel better.  Thankfully, I live in a place that has a very short winter and a very long summer.

3 comments:

Peter said...

Hot/cold: Speaking in behalf of my son, he is the same as you. In the hot weather his sore throat and glands return. but overall this is much more comfortable than being constantly cold; probably due to the well known circulation problems of ME/CFS.

William Birtchnell said...

No single definitive laboratory test is yet available for M.E.but a series of tests are available which can objectively confirm the diagnosis with a high degree of certainty.

What tests are these ? I was under the impression ME was diagnosed by exclusion.

CFS Facts said...

Peter, it's not just that I'm "constantly cold" but that in winter I just generally feel worse. Here, we do get summer days well over 100 (108-112 is not unusual), and on those days I feel as sluggish as any "normal" person, but I'm at my best when temperatures are in the 80s and 90s.

William, there are a number of tests which will produce abnormal results, which, if done together, can only add up to ME. A pattern of positives and negatives that would not be seen in any other condition.

Most importantly, a series of tests that proves the patient has something physically wrong, it's not just all in her head. Here's one list:
http://cfs-facts.blogspot.com/2008/02/top-10-tests-that-should-be-done.html

When XMRV testing becomes readily available all over the world, you can add that to the list; meanwhile, a C-Reactive Protein test can show infection/inflammation, i.e., viruses for which there is not yet a specific test. That test was the proof I needed to convince certain people that this is not fakery, I really AM sick.

My doctor refused to do the cortisol test I requested -- cortisol is off in one direction with CFS and in the other direction for depression. Doing that one test would have proven that I was right, I was not depressed, and he was wrong. His ego was at stake, so he wouldn't order it.

And this is always a problem with doctors who've already committed to some other diagnosis ... they don't want to consider anything else. (Read Dr. Groopman's book "How Doctors Think".)