11

 

 Diagnosing ME or MS

 

 For the majority of patients with ME, the diagnosis is relatively simple. The pattern of fatigue,

 malaise, muscle and joint pain, headaches and cognitive problems makes ME the diagnosis if

standard blood tests are normal.  But some patients have symptoms that are weighted more toward the neurological and the distinction between ME and multiple sclerosis (MS) becomes difficult.

 

 Fatigue is usually different in MS from ME. Typically the fatigue of ME is a crushing exhaustion, while the fatigue of MS is more of a "burned-out" tiredness. The diagnosis of MS is made mostly by the true muscle weakness, muscle atrophy, and abnormal reflexes, rarely seen in ME. MS rarely has muscle pain, temperature regulatory disturbances, sore throat, lymph node pain, and abdominal pain. But the symptoms of some patients may be strikingly similar.

 

 When symptoms are heavily neurologic, laboratory testing is useful in distinguishing between the two illnesses. In ME the MRI scan of the brain may have small punctuate areas of high intensity, but not the big blotches of MS.

 

 ME is characterised by debilitating fatigue with associated myalgias, tender lymph nodes,

arthralgias, chills, feverish feelings, and postexertional malaise. Diagnosis of ME is primarily by

exclusion with no definitive laboratory test or physical findings.  Similarities with fibromyalgia

exist and concomitant illnesses include irritable bowel syndrome, depression, and headaches.

 

 MS is not diagnosed by the process of exclusion. It is diagnosed by careful history taking,

thorough neurological examination, and tests such as MRI (not CAT Scan), physiological tests and laboratory tests, such as serum and CSF immunological changes.

 

           M.E.           Symptoms              M.S.

 

           Yes           Fatigue                Yes

           Yes           Muscle Pain             No

           No           True muscle weakness      Yes

           Yes           Joint pain              No

           Yes           Headache              Yes

           Yes           Sore Throat             No

           Yes           Lymph node pain         No

           Yes           Cognitive              Yes

           No           Urinary incontinence       Yes

           Yes           Temperature instability        No

           Yes           Abdominal pain          No

           Yes           Eye symptoms           Yes

           Yes           Numbness/tingling         Yes

 

 

                                             Janet Graham