Myalgic encephalomyelitis - enigma at the medicine’s crossroads

Myalgic encephalomyelitis is a complex, multisystem disease with chronic course significantly affecting patients? quality of life. Physical and mental exertion intolerability, muscle pain, sleep problems are the main features accompanied often cognitive inefficacy vegetative symptoms. Prevalence 7?3000 per 100,000 adults. It estimated that 90% patients misdiagnosed. Pathogenesis still only speculative but current research points to disturbances in immunological system, inflammatory pathways, autonomic central nervous mitochondria, as well alterations gut microbiota permeability. The onset typically acute, following an infectious disease. Exertional intolerance lasting for more than six months important diagnostic factor. core must be moderate severe present at least 50% time. Diagnostic criteria should fulfilled differential diagnosis made exclude other potential pathological conditions or diagnose comorbidities. Brain magnetic resonance imaging morphometry has shown gray matter atrophy occipital lobes bilaterally, right angular gyrus, posterior division left parahippocampal consistent memory potentially impairment visual processing. Treatment symptomatic partial benefit. Symptomatic treatment can include medications controlling pain problems, graded exercise behavioral therapy. Larger controlled trials needed shed light on this challenging condition.