Testing for Myalgic Encephalomyelitis
Contrary to what many articles on M.E. in the media will tell you (and some
of the more dubious medical texts unfortunately) it is not true that there
are no tests which can aid in the diagnosis of M.E. nor is it true that M.E.
is an illness where all tests 'will always be normal.'
These are just myths.
'Testing for M.E.' is a (fully referenced) basic overview of some of the
series of tests which may be useful in confirming a suspected M.E.
diagnosis. It also contains links to further information about all aspects
of diagnosis in general from some of the world's leading M.E. experts.
Some of these tests may also be useful in proving illness to social security
(or for medical insurance) which may make this text particularly
useful/timely for those in the UK (and to a lesser extent Australia) who may
be having to deal with inflexible (and impossible if you have
moderate-severe M.E.) 'welfare to work' reforms by Government.
Testing for Myalgic Encephalomyelitis
By Jodi Bassett, February 2006
For various reasons, many of the articles on Myalgic Encephalomyelitis in
the mainstream media (and even some of the medical texts on the illness)
unequivocally proclaim that not only are there no tests which can be
utilised to help confirm a M.E. diagnosis, but that despite extensive
testing no objective or quantifiable abnormalities have ever been found in
any patients with M.E. whatsoever. Despite their popularity, these are
simply absurd claims.
The reality is that objective evidence of quantifiable organic abnormalities
in Myalgic Encephalomyelitis (or M.E. equivalent CFS: ME/ICD-CFS*) patients
has existed since the 1950's. Not only are there a series of tests which
readily allow a ME/ICD-CFS diagnosis to be confirmed, but more than 1000
medical studies have shown a variety of measurable and in some cases
extremely severe abnormalities in many different bodily systems of M.E.
patients. Abnormalities are also visible on physical exam.
Tests will only all be normal in M.E. patients - as with all illnesses - if
completely the wrong tests are done, or if those tested do not in fact have
M.E. in the first place.
As with a wide variety of illnesses; lupus, multiple sclerosis, and ovarian
cancer for example, there is as yet no single test which can diagnose
ME/ICD-CFS in all patients. Therefore, along with these other illnesses,
M.E. must instead be diagnosed by a combination of: taking a detailed
medical history (to rule out other possible causes of symptoms), noting the
type and severity of symptomatology and other characteristics of the
illness, the type of onset of the symptoms (a sudden onset of symptoms is
most common in M.E. and rules out a wide variety of other illnesses) and
looking for some of the physical signs of illness. A series of tests may
also be necessary both to rule out other illnesses, and to help confirm a
suspected M.E. diagnosis.
This text will now focus on the series of tests which can be used to confirm
a M.E. diagnosis as well as detailing some of physical signs common in M.E.
patients which may also be useful for diagnosis.
(Some of the tests listed may however also be useful in proving illness for
the benefit of social security or insurance company entitlements, or may be
used to determine appropriate treatments in patients who have already been
diagnosed with M.E. References useful in providing further information about
exclusionary tests - and all other aspects of diagnosis - are provided at
the end of this text.)
When discussing ME/ICD-CFS diagnosis (and testing) it is important to note
that contrary to much of the propaganda surrounding the illness, it is not
'fatigue' or 'tiredness' that is the one essential characteristic of M.E.
but central nervous system (CNS) dysfunction. It is this that must always be
present for a legitimate diagnosis of M.E. to be made. The presence or
absence of 'fatigue' is largely irrelevant in determining a M.E. diagnosis
except in that its presence may of course make the diagnosis of a large
number of well-known fatigue causing illnesses (depression, vitamin
deficiency, multiple sclerosis or malignancy for example) considerably more
likely. (Hyde & Jain, 1992)
As leading M.E. expert Dr Byron Hyde MD explains: 'The one essential
characteristic of M.E. is acquired CNS dysfunction, [not] chronic fatigue. A
patient with M.E. is a patient whose primary disease is CNS change, and this
is measurable. We have excellent tools for measuring these physiological and
neuropsychological CNS changes: SPECT, xenon SPECT, PET, and
neuropsychological testing.' (2003)
Thus it is these tests which are therefore most critical in the diagnosis of
M.E., although various other types of tests are also useful.......
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