MEDICAL MATTERS
- Medical Matters features questions asked by Members of the ME Association on health-related topics.
- Dr Charles Shepherd and the ME Association's other advisers answer these questions by sharing their expert knowledge.
- Medical Matters is based on the popular ‘Ask the Doctor’ series in ME Essential magazine.
- It is a free resource that supplements the detailed information contained in the full range of literature that can be found in the website shop.
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Questions in the Category: Numbness
Does ME involve spinal cord inflammation?
Earlier this year, I suddenly developed severe back pain, loss of balance and was unable to walk in a straight line. I was sent to casualty where I had a CT and MRI scan. I was then diagnosed as having severe spinal inflammation.
The MEA purple book states that there is no evidence of brain or spinal inflammation (= encephalomyelitis) in ME/CFS.
But are we missing something here? Could symptoms such as back pain, poor coordination and abnormal sensations that are commonly reported in ME be caused by inflammation in the spinal nerves?
Symptoms: Pins and Needles
I’m in my early forties and have had moderate ME/CFS for about 5 years. I have all the usual symptoms but I now have a new and rather distressing sensation in my arms and sometimes in my legs. It is very similar to the ‘pins and needles’ sensation you can get when your legs have been crossed for too long. These abnormal sensations come and go and don’t seem to be triggered by anything in particular. Is this yet another symptom of ME/CFS? Or do I need to go and see my doctor?
Symptoms: Slurred Speech (Dysarthria)
Can ME/CFS cause slurred speech? This is something that I occasionally have to cope with – especially when I am very feeling very tired and/or haven’t slept well and am not able to concentrate properly. Should I see my doctor about it?
Symptom: Nerve Pain
Like most people with ME/CFS, pain is a fairly constant and frustrating symptom. But this has become more persistent and severe over the past few months. My GP has prescribed various pain relieving drugs – including low doses of amitriptyline and gabapentin – none of which has had much effect. As well as the pain, which often has a burning quality to it, the areas around it sometimes feel numb and strange. I’m starting to feel quite depressed as a result – is there anything else that could be done to help?
Treatments: Drugs – Sensitivities & Side-effects
This is more of a warning than a question. Earlier this year I experienced a rapid and noticeable deterioration in the fatigue part of my ME/CFS. I was also getting muscle cramps – a new symptom to add to the list. All of this coincided with a prescription from my doctor for water losing tablets (diuretics) to treat high blood pressure. At first, she didn’t think there was any connection. But after doing some blood tests it turned out that I had a low level of potassium – something that can occur as a side-effect of using this type of drug. After a change in medication, my potassium level returned to normal and my ME/CFS symptoms also improved. So it’s worth noting that drugs can sometimes cause a significant exacerbation of symptoms for people with ME/CFS.
Neuroinflammation
I keep reading about what is called ‘neuroinflammation' in relation to research into ME/CFS. I assume this means inflammation in the nervous system. But is this the same as encephalomyelitis (the E in ME)? I know that encephalomyelitis is largely dismissed by many doctors and is the reason why some doctors refuse to even use the name ME/ myalgic encephalomyelitis.
Dr Charles Shepherd
Dr Shepherd has been Trustee and Hon. Medical Adviser to the ME Association for more than 40 years. He is integral to the charity's activities and provides information and support based on his professional knowledge, personal experience as a doctor with ME/CFS, and the understanding gained from helping many thousands of people with the condition. He was a member of the comittee responsible for the 2021 NICE Clinical Guideline and is a recognised expert on ME/CFS in the UK. His knowledge extends to Post-Viral Fatigue Syndromes (PVFS), Myalgic Encephalopathy/Encephalomyelitis (ME), Chronic Fatigue Syndrome (CFS), and Post-Acute Sequelae of SARS-CoV-2 infection (PASC) or Long Covid.
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Medical Matters is based on the popular ‘Ask the Doctor‘ series featured in the highly-regarded member’s magazine, ME Essential, and in the healthcare professional magazine, ME Medical. Both are produced by the ME Association and published as hard-copy magazines every 3 months and sent to members and healthcare professionals by post to home or business addresses.
If you are an HCP you can sign-up here to receive ME Medical magazine (people with ME/CFS can also nominate their HCP by completing the sign-up form).