I don't suppose anyone's ever done a survey, but how rare IS slow onset? For the past ten years I've been able to check about 3/4 of the boxes for the CCC, and now about the same for the ICC. My onset took 17 agonizingly painful years. It would frighten me to be elbowed out of a diagnosis on that basis.
Here's a possible answer to this, that I posted on another thread:
http://phoenixrising.me/forums/show...Diagnosis-Poll&p=205109&viewfull=1#post205109
One thing that I think is important to point out to everyone is how Byron Hyde defines 'sudden onset'.
It's not as straightforward as you would imagine.
Some people think that they had 'slow onset', whereas Hyde always takes a complex clinical history and finds out for himself, and can come to the opposite conclusion.
'Sudden onset' can easily be missed by the patient because of the fluctuating nature of ME.
As an example, someone might have had a 'sudden' but very
mild and
short first episode of ME (this is just an example - it could be severe but short or mild and long or intermittent etc.), which then disappeared completely before the patient
gradually became more ill again. So this type of onset could easily be considered as slow onset by the patient, but Byron Hyde would define it as 'sudden onset'. This type of 'sudden onset' could easily be missed by the patient, or forgotten about, or just mistaken for flu or similar.
Or there might have been a 'sudden' first episode many many years earlier (that possibly lasted for a few days or for a few weeks or months), that the patient had completely forgotten about or had decided at the time was just a viral infection, and then the symptoms returned again,
slowly, long after the patient had forgotten about the original epidode. So this would also be mistaken for slow onset, whereas Hyde would call it sudden onset.
So things are not clear cut, and all of the patient's clinical details need to be taken into account.