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$Unique_ID{BRK03706}
$Pretitle{}
$Title{Encephalomyelitis, Myalgic}
$Subject{Encephalomyelitis, Myalgic Epidemic Neuromyasthenia Iceland Disease
Akureyri Disease Benign Myalgic Encephalomyelitis Epidemic Myalgic
Encephalomyelitis Royal Free Disease Tapanui Flu Raphe Nucleus Encephalopathy
Chronic Epstein-Barr Virus Infection Multiple Sclerosis Polymyalgia
Rheumatica}
$Volume{}
$Log{}
Copyright (C) 1987, 1988, 1989 National Organization for Rare Disorders,
Inc.
416:
Encephalomyelitis, Myalgic
** IMPORTANT **
It is possible the main title of the article (Myalgic Encephalomyelitis)
is not the name you expected. Please check the SYNONYMS listing on the next
page to find alternate names, disorder subdivisions, and related disorders
covered by this article.
Synonyms
Epidemic Neuromyasthenia
Iceland Disease
Akureyri Disease
Benign Myalgic Encephalomyelitis
Epidemic Myalgic Encephalomyelitis
Royal Free Disease
Tapanui Flu
Raphe Nucleus Encephalopathy
Information on the following diseases can be found in the Related
Disorders section of this report:
Chronic Epstein-Barr Virus Infection
Multiple Sclerosis
Polymyalgia Rheumatica
General Discussion
** REMINDER **
The information contained in the Rare Disease Database is provided for
educational purposes only. It should not be used for diagnostic or treatment
purposes. If you wish to obtain more information about this disorder, please
contact your personal physician and/or the agencies listed in the "Resources"
section of this report.
Myalgic Encephalomyelitis is thought to be an infectious disorder
affecting the central, peripheral and autonomic nervous systems and the
muscles. Major symptoms may include general exhaustion, headache, muscle
pain, weakness, and possible mental changes. The exact cause of this
disorder is not known, but researchers believe a virus associated with an
immune system abnormality may be responsible. Adults are most commonly
affected, with more cases seen in females than in males. Epidemics of
Myalgic Encephalomyelitis have occurred worldwide, but cases tend to appear
sporadically. Symptoms can resolve in a few weeks but may recur at any
time. Other cases may persist for many years.
Symptoms
Symptoms of Myalgic Encephalomyelitis are thought to include a preliminary
stage consisting of headache, abnormal tiredness, sore throat, coughing,
diarrhea or vomiting, a general feeling of ill health, and/or depression.
This stage can last from one to three weeks. Pain in the neck, back, arms,
legs or major joints, muscle tenderness and neck or back stiffness may
initially occur as localized symptoms. A low fever or subnormal body
temperature may develop. Symptoms such as unstable emotions, poor memory,
depression, and difficulty in concentrating may be present. Unusual skin
sensations, disease of the lymph nodes, liver enlargement, increased tendon
reflexes, muscle twitching, sensory loss, abnormal foot muscle contraction,
eye inflammations, mild vision disturbances, cranial nerve paralysis, urine
retention and respiratory problems may also occur. Strenuous exercise or
emotional stress may cause symptoms to become more severe. Nerve pain may
subside after several days. Pain in the muscles and joints may persist
and/or recur for months or years.
Causes
The exact cause of Myalgic Encephalomyelitis is not known. Researchers
believe the disorder may be caused by a viral infection in association with
an immune system abnormality. Although the Epstein-Barr Virus is suspected
to be implicated in this disorder, scientists have not yet proven a
relationship between onset of Myalgic Encephalomyelitis and the Epstein-Barr
Virus.
Affected Population
Myalgic Encephalomyelitis appears to affect adults almost exclusively and it
occurs more often in females than in males.
Related Disorders
Symptoms of the following disorders can be similar to Myalgic
Encephalomyelitis. Comparisons may be useful for a differential diagnosis:
Chronic Epstein-Barr Virus Infection is caused by the same virus that
causes Infectious Mononucleosis. Although all individuals who become
infected with EBV remain so for the rest of their lives, in most people, the
virus becomes and stays inactive when the patient recovers from the initial
bout of illness. In Chronic EBV infection (CEBV), however, the virus fails
to become inactive or is periodically reactivated, so that the patient is
chronically or recurrently ill. Medical researchers do not understand the
reason for this. Both the nature and the severity of symptoms vary from
patient to patient. CEBV can be debilitating, but is not necessarily so.
(For more information on Chronic Epstein-Barr Virus Infection, choose "CEBV"
as your search term in the Rare Disease Database).
Multiple Sclerosis (MS) is a chronic disorder of the central nervous
system which may be progressive, relapsing and remitting, or stable. This
disorder is characterized by lesions that may form randomly throughout the
brain and spinal cord. These lesions may prevent proper transmission of
nerve signals and thus result in a variety of neurological symptoms.
Mobility may be impaired and other symptoms such as vision difficulties,
speech impairment, abnormal skin sensations and bowel and/or bladder control
problems may occur. The exact cause of MS is not known, although researchers
believe it may be caused by either an immune system abnormality, or a virus
triggered early in life. (For more information on Multiple Sclerosis, choose
"MS" as your search term in the Rare Disease Database).
Polymyalgia Rheumatica is a disorder characterized by pain and stiffness
in certain muscle groups without causing permanent weakness or atrophy.
Symptoms appear quickly and may be most severe in the mornings. Mobility may
become impaired after long periods of sitting still. Pain on both sides of
the body may develop, and symptoms such as fever, loss of appetite, fatigue,
weight loss and depression may occur. Despite severe pain, the muscles may
not show any abnormality upon examination. A form of anemia may also be
present in some patients. (For more information on Polymyalgia Rheumatica,
choose "Polymyalgia Rheumatica" as your search term in the Rare Disease
Database).
Therapies: Standard
Treatment of Myalgic Encephalomyelitis may be delayed by the difficulty in
diagnosing the disorder. A standard electrophoresis test may identify
abnormalities of the immune system common to most patients with Myalgic
Encephalomyelitis. A complete physical examination is also recommended.
Specific treatment may be aimed at controlling symptoms. Antidepressant
drugs may help eliminate depression. Digestive system problems may be
alleviated with the drug metoclopramide. Headaches may be relieved by the
drug pizotifen and severe muscle aches by the drug carbamazepine. Some
patients may possibly benefit from Vitamin B-12 injections. Specialists such
as virologists, neurologists, and specialists in infectious diseases may be
able to help in some cases.
Therapies: Investigational
Research is underway to determine if a Coxsackie B virus associated with
stress and amino acid (tryptophan) deficiencies may be implicated in onset of
Myalgic Encephalomyelitis. When the disorder is better understood,
scientists may be able to determine a better course of treatment or possibly
some method of prevention.
This disease entry is based upon medical information available through
September 1988. Since NORD's resources are limited, it is not possible to
keep every entry in the Rare Disease Database completely current and
accurate. Please check with the agencies listed in the Resources section for
the most current information on this disorder.
Resources
For more information on Myalgic Encephalomyelitis, please contact:
National Organization for Rare Disorders (NORD)
P.O. Box 8923
New Fairfield, CT 06812-1783
(203) 746-6518
American Encephalomyelitis Society
494 Meadow Lane
Gulph Mills, PA 19406
(215) 688-3832
Myalgic Encephalomyelitis Association
The Moss
3rd Avenue Stanford-Le-Hope
Essex SS17 8EL
England
NIH/National Institute of Allergy and Infections Diseases (NIAID)
9000 Rockville Pike
Bethesda, MD 20892
(301) 496-5717
Centers for Disease Control (CDC)
1600 Clifton Road, NE
Atlanta, GA 30333
(404) 639-3534
Chronic Fatigue Syndrome Society
P.O. Box 230108
Portland, OR 97223
(503) 684-5261
National Chronic Fatigue Syndrome Association
12106 East 54th Terrace
Kansas City, MO 64133
References
EPIDEMIOLOGICAL APPROACHES TO 'EPIDEMIC NEUROMYASTHENIA': SYNDROMES OF
UNKNOWN ETIOLOGY (EPIDEMIC MYALGIC ENCEPHALOPATHIES): M. Thomas; Postgrad
Med J (November 1978, issue 54(637)). Pp. 768-770.
RAPHE NUCLEUS ENCEPHALOPATHY (MYALGIC ENCEPHALOMYELITIS, EPIDEMIC
NEUROMYASTHENIA: C.P. Maurizi; Med Hypotheses (April 1985, issue 16(4)).
Pp. 351-354.