Constraints on and Possibilities for elements of the name:
1. Syndrome – advantage: allows a listing of symptoms without having to have defined cardinal symptoms which would exclude patients that future research may identify as having the same underlying cause of illness.
- disadvantage: allows potentially overly broad interpretation and is seen (erroneously) to bespeak a psychiatric condition. This latter point is unlikely to be of concern to the IOM panel.
2. Disease – advantage/disadvantage: probably neutral, however it does imply known pathology, so that even where causation is unknown, the term disease would be limiting to testable biology. This could be a problem in an illness with a cyclical/remitting process with someone having ‘the disease’ one month, but not the next.
3. Chronic – advantage: declares there is ongoing illness, even where a remitting course is in play.
- disadvantage: requires a criterion of time elapsed before diagnosis, contrary for example to the ICC proposal.
4. Myalgic – advantage: symptom easily explicable by patient and observable in primary care.
- disadvantage: common to many health conditions and perhaps dismissable as not serious.
5. Encephalomyelitis – advantage: definitive of specific pathology regarded as associated with serious health impacts.
- disadvantage: not easily testable, not communicable by patient, and involvement of the spinal cord (as opposed to exterior ganglion ?) lacking evidence.
6. Encephalitis - advantage: definitive of specific pathology regarded as associated with serious health impacts.
- disadvantage: not easily testable, not communicable by patient, may be considered to have known specificity and judged not to apply to M.E patients.
7. Encephalopathy - advantage: definitive of specific pathology regarded as associated with serious health impacts.
- disadvantage: not easily testable, not communicable by patient, may be considered lacking in specificity.
Applying a line of least resistance to the above might lead to: Chronic Myalgic Encephalopathy Syndrome.