“While it is presently very difficult
for modern medicine to fully explain all severe ME symptoms, disordered
neural function within the brain and spinal cord would come close.
How this occurs is unknown but there are
counterparts in certain newly described autoimmune conditions and viral
infections of the nervous system.
In addition to a direct stimulation of
neurones in different parts of the brain and spinal cord there is also an
impaired filtering function of the brain stem and a reduced threshold for
neurones to fire off.
This allows external stimuli such as
movement, light, sounds, touch and sometimes even worrying thoughts to
produce widespread neuronal activation with ultimate excitotoxic damage to
The consequence is impaired activity of
the brain generally but particularly the hypothalamus and prefrontal cortex
leading to fatigue, disordered sleep, impaired memory, attention, faintness,
palpitations, disordered respiration, temperature dysregulation etc.
Outwardly many patients appear well and
routine blood and other investigations are normal.
Internally there are severe symptoms
which, if unchecked, escalate leading ultimately to immobility and
increasing pain and spasms in a proportion of patients.
Clearly a greater understanding of this
highly disabling condition is required with a greater focus on disrupted
immune and neural pathways and not just psychosocial factors as has
previously been the case.”