Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Fibromyalgia: Definitions, Similarities, and Differences. 2019

Benjamin H Natelson
Department of Neurology, Pain & Fatigue Study Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address: benjamin.natelson@mountsinai.org.

This commentary presents a simplified way of making the diagnosis of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) using the 1994 Centers for Disease Control and Prevention case definition. The format used can easily be modified for other case definitions. The commentary then discusses whether ME/CFS is the same or a different illness from fibromyalgia. Because overlap exists between the 2 syndromes, some investigators have posited that they are variants of the same illness. I have viewed this as an empirically testable hypothesis and have summoned considerable amounts of data that suggest that the 2 illnesses differ. Were differences to exist, that would suggest different pathophysiologic processes for each, leading to different treatments.

UI MeSH Term Description Entries
D005356 Fibromyalgia A common nonarticular rheumatic syndrome characterized by myalgia and multiple points of focal muscle tenderness to palpation (trigger points). Muscle pain is typically aggravated by inactivity or exposure to cold. This condition is often associated with general symptoms, such as sleep disturbances, fatigue, stiffness, HEADACHES, and occasionally DEPRESSION. There is significant overlap between fibromyalgia and the chronic fatigue syndrome (FATIGUE SYNDROME, CHRONIC). Fibromyalgia may arise as a primary or secondary disease process. It is most frequent in females aged 20 to 50 years. (From Adams et al., Principles of Neurology, 6th ed, p1494-95) Diffuse Myofascial Pain Syndrome,Fibrositis,Rheumatism, Muscular,Fibromyalgia, Primary,Fibromyalgia, Secondary,Fibromyalgia-Fibromyositis Syndrome,Fibromyositis-Fibromyalgia Syndrome,Myofascial Pain Syndrome, Diffuse,Fibromyalgia Fibromyositis Syndrome,Fibromyalgia-Fibromyositis Syndromes,Fibromyalgias,Fibromyalgias, Primary,Fibromyalgias, Secondary,Fibromyositis Fibromyalgia Syndrome,Fibromyositis-Fibromyalgia Syndromes,Fibrositides,Muscular Rheumatism,Primary Fibromyalgia,Primary Fibromyalgias,Secondary Fibromyalgia,Secondary Fibromyalgias,Syndrome, Fibromyalgia-Fibromyositis,Syndrome, Fibromyositis-Fibromyalgia,Syndromes, Fibromyalgia-Fibromyositis,Syndromes, Fibromyositis-Fibromyalgia
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D015673 Fatigue Syndrome, Chronic A syndrome characterized by persistent or recurrent fatigue, diffuse musculoskeletal pain, sleep disturbances, and subjective cognitive impairment of 6 months duration or longer. Symptoms are not caused by ongoing exertion; are not relieved by rest; and result in a substantial reduction of previous levels of occupational, educational, social, or personal activities. Minor alterations of immune, neuroendocrine, and autonomic function may be associated with this syndrome. There is also considerable overlap between this condition and FIBROMYALGIA. (From Semin Neurol 1998;18(2):237-42; Ann Intern Med 1994 Dec 15;121(12): 953-9) Chronic Fatigue Syndrome,Encephalomyelitis, Myalgic,Infectious Mononucleosis-Like Syndrome, Chronic,Postviral Fatigue Syndrome,Chronic Fatigue Disorder,Chronic Fatigue and Immune Dysfunction Syndrome,Chronic Fatigue-Fibromyalgia Syndrome,Myalgic Encephalomyelitis,Royal Free Disease,Systemic Exertion Intolerance Disease,Chronic Fatigue Disorders,Chronic Fatigue Fibromyalgia Syndrome,Chronic Fatigue Syndromes,Chronic Fatigue-Fibromyalgia Syndromes,Fatigue Disorder, Chronic,Fatigue Syndrome, Postviral,Fatigue Syndromes, Chronic,Fatigue-Fibromyalgia Syndrome, Chronic,Fatigue-Fibromyalgia Syndromes, Chronic,Infectious Mononucleosis Like Syndrome, Chronic,Postviral Fatigue Syndromes,Syndrome, Postviral Fatigue

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