Can physical assessment techniques aid diagnosis in people with chronic fatigue syndrome/myalgic encephalomyelitis? A diagnostic accuracy study
This is the first study that explores agreement on the presence of physical signs in the screening of patients with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) and demonstrates proof of concept of these signs.
The latest scanning techniques have proven the long held osteopathic view that cerebrospinal fluid drains into the lymphatic system. Recent findings by Iliff and co-workers published in August 2012 using two photon laser microscopy has shown for the very first time cerebrospinal fluid draining through perivascular spaces into the lymphatic system. The author argues that these scans support his theory that chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is a disorder of retrograde lymphatic drainage leading to neurotoxic build up within the central nervous system and can be treated using The Perrin technique, based on traditional osteopathic concepts, to restore a healthier neuro-lymphatic flow.
Muscle fatigue in chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) and its response to a manual therapeutic approach: A pilot study
The objective of this study was to evaluate the efficacy of a manual treatment protocol for CFS/ME sufferers.
Research over the past twenty years by the author into the bio-mechanical aspects of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis has led to a hypothesis that a common aetiological pathway involves an insult to the lymphatic drainage of toxins from the central nervous system. Hypothalamic involvement in the pathogenesis of CFS/ME is discussed.
An evaluation of the effectiveness of osteopathic treatment on symptoms associated with Myalgic Encephalomyelitis. A preliminary report
The term Myalgic Encephalomyelitis (ME) was initially used in the 1950s . ME describes a syndrome where there is general muscle pain associated with evidence of a disturbed nervous system . ME, commonly referred to as Chronic Fatigue Syndrome (CFS), or post-viral fatigue syndrome is a condition in which mental and physical fatigue predominate. It is characterized by gross abnormal muscle fatigue which occurs after relatively mild activity. Other symptoms regularly complained of include sleep disturbance, headaches, cognitive dysfunction, feeling depressed, bouts of low grade fever (not exceeding 38-6°C), increased sensitivity to light, back and neck pain, sore throat, irritable bowel and bladder . The symptoms of ME typically become apparent following a viral infection , although other trigger factors have been noted. Vaccinations against cholera, tetanus, typhoid and influenza have been associated with the onset of ME . It has also been observed that any psychological disturbances in ME occur secondary to, or share a common pathophysiology with an immunological dysfunction . In many cases there appears to be no apparent triggering factor .
MRI has previously provided conflicting results when used to search for brain abnormalities in sufferers of chronic fatigue syndrome (CFS). Eighteen CFS patients and nine healthy volunteers each underwent MRI on two occasions, one year apart. The resulting images were examined for abnormalities in brain atrophy, deep white matter hyperintensities (WMH) and cerebral blood and cerebrospinal fluid (CSF) flow. Mean proportionate CSF volume was not significantly different between subject groups. All participants showed a slight increase in CSF between scans, but no significant difference was found between those with CFS and those without. Between-group comparisons of ventricular volume revealed no significant differences at study commencement and no significant change over the year. No significant inter-group differences were found for any of the cerebral blood and CSF flow parameters. Low levels of WMH were found in all participants. Objective scoring of WMH using Scheltens’ scale revealed no change in summary components (prosencephalic deep white matter hyperintensities, basal ganglia hyperintensities and infratentorial hyperintensities) or in individual component variables between the baseline and 1 year follow-up scans. No abnormal patterns in rate and extent of brain atrophy, ventricle volume, white matter lesions, cerebral blood flow or aqueductal CSF flow were detected in the CFS population. These results throw open the debate into whether MRI scanning can reveal diagnostic signs of CFS and clinically questions the diagnoses of CFS made on the basis of previous research conclusions.
Lymphatic Drainage of the Neuraxis in Chronic Fatigue Syndrome: A Hypothetical Model for the Cranial Rhythmic Impulse
The cranial rhythmic impulse is a palpable, rhythmic fluctuation believed to be synchronous with the primary respiratory mechanism. The precise physiologic mechanism of the cranial rhythmic impulse is not fully understood. Based on traditional and current views of the cranial rhythmic impulse, animal studies, and clinical findings in patients with chronic fatigue syndrome, the author argues that the cranial rhythmic impulse is the rhythm produced by a combination of cerebrospinal fluid drainage from the neuraxis (brain and spinal cord) and pulsations of central lymphatic drainage induced by the sympathetic nervous system. In addition, evidence is provided to demonstrate that a disturbed, palpable, and visible neurolymphatic process leads to chronic fatigue syndrome. This process may also explain the pathophysiologic mechanisms leading to other disease states. Finally, the author’s proposed manual treatment protocol for patients with chronic fatigue syndrome is described.