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That strikes home. But is it? The NICE guidelines were based on evidence of usefulness. I don't see that here. PEM is important because it flags up a particular disease dynamic - feeling illi with an aberrant time relation to exertion. That aberrant time relation is what makes it a useful...

Except that chronic fatigue syndrome isn't a respiratory condition.

To my eye the questionnaire asks for far too much 'interpreted' information. With my limited experience of Longish Covid I am never really sure what made me worse or when or whether I am doing less than I would have done or whatever. I just feel knackered and too knackered to think about what I...

It doesn't have to be. Stress is by definition a response to a threat. If the autonomic nervous system is screwed up by something like dysregulated cholinesterase (a bit like the screwed up AChR in myasthenia) then the effects could stop people in their tracks in the absence of any current...

Yes, one can sympathise but I am pretty sure this is not being served up to the public in good faith. It seems that people with FND follow these threads. If they read this I would like them to know that I am not a patient sniping at someone else's disease. I am a professor of medicine trained...

No.

We will no doubt debate it at length next week!

Moved posts I have had access to the NIH intramural study report but it is embargoed until next week. We can have a full discussion then. I think it may be useful to examine their attempts to analyse brain activity and the role of sympathetic drive. I am not convinced so far that they are not...

I suspect that they have simply demonstrated that people with covid develop antibodies to Covid. Peptides are not a good way to look for autoantibodies of clinical relevance.

If necrosis is significant it should show up easily on standard MRI. Muscle biopsy is an invasive procedure and suffers badly from sampling variation. Before doing more biopsies I think we should have a basic study of muscle by MRI after similar activity. There are other techniques using...

Yes, I think it is important to take into account the fact that when categorising diseases, like animal species, it is very often combinations that are crucial. Having wings is pretty non-specific for creatures. But a four-legged creature with wings is unique - a Hippogriff. Insects have six...

Yes, @dave30th, I liked the conclusion: presumably 'relevant mechanistic functional networks' means 'stuff that does that'. Good thing you were never obliged to believe in the Holy Trinity - one is three and three is one. Isaac Newton refused to and very nearly never got the stipend that...

It sounds like that but in neurology a 'localising sign' is a sign that allows you to localise the cause to somewhere in the brain according to the rules of neurology. The rules of neurology mostly involve swapping sides! If the symptoms were on the same side we would be faced with an...

'Localised' or 'localising' is a jargon term meaning more or less 'pointing to a lesion in such and such a place'. I think they mean that the signs fit with the CVA lesion - i.e. are on the other side, as usual.

I see this as a mistake. It probably will get no traction but I think it is muddying the waters for PWME. We have a protocol for ME, in as much as it is possible to create one. It is the NICE Guideline that a lot of people put a lot of hard work into. There are no other ME specific protocols to...

And we have known that in spades since we started using monoclonals. I was the first person, as far as I know, in 1979, to use monoclonal antibodies to stain joint tissues in rheumatic disease. The problem was readily apparent from the start. And the reason was obvious. With traditional...

Funny thing that these markers are not used for diagnosing anything else much either! Not very good for diabetes, brain tumour, respiratory failure, kidney failure, Crohn's disease and so on. So those might also be psychological?

I have never heard of the British Society for Physical and Whatsit. Physical Medicine in the UK officially died in 1973. So this is either a group of Chelsea Pensioners in bathchairs or Rip van Winkels. They might get thirteen people turn up to an annual general meeting I suppose.

A bit like a joint initiative between a white elephant and a dead parrot then? I don't think there is any greater need to be threatened by this group than the OAPs who go Nordic walking on Hampstead Heath on a Tuesday morning.

Nothing new about the problem but it is good that someone has tried to address it systematically.