M.E.

[kathleenc]

Hello
I have had problems since December 2011 and eventually diagnosed with M.E. my Doctor prescribed amitriptyline 10mg last October this helped with a lot of my problems although I still had "brain fog" my balance was bad and still had numbness in my toes,the bad headaches I suffered improved, I do not like taking medication so after 6 months started taking half a tablet and eventually stopped altogether, but the bad "pressure" headaches returned so much so I went back on the tablets and they improved once again. I would like to know if this sort of headache is common and does it eventually go?
many thanks

[Dr Charles Shepherd]

Headaches are a recognised clinical feature of ME/CFS

But as with any other symptom that makes up this syndrome there can be other explanations as well

So if headaches appear as a 'new symptom' or there is a change in nature or severity of headaches this should always be discussed with your GP - who has the option of referral to a neurologist or headache clinic for further assessment

The Treatment section of the MEA booklet 'ME/CFS//PVFS - An Exploration of the Key Clinical Issues' covers headache management (and amitriptyline) in more detail

And it's interesting to note that there is an overlap between migraine type headaches and ME/CFS

MEA website and pdf literature order form: http://www.meassociation.org.uk

[Dr Charles Shepherd]

Interesting recent research paper on other causes of headache in people with ME/CFS:

Looking for idiopathic intracranial hypertension in
patients with chronic fatigue syndrome

Dr Nicholas Higgins FRCP FRCR,1 Prof. John Pickard F Med Sci,2 Prof. Andrew Lever F Med Sci3

Abstract

Introduction: Headache is common in chronic fatigue syndrome, a condition of unknown cause in which there are no clinical signs. Fatigue is common in idiopathic intracranial hypertension, a headache condition of unknown cause in which the only clinical signs are those of raised intracranial pressure, signs which may be absent. Might, therefore, idiopathic intracranial hypertension be present in some patients diagnosed with chronic fatigue syndrome? Could the two conditions be related?

Patients and methods: From June 2007, patients attending a specialist clinic who fulfilled the diagnostic criteria for chronic fatigue syndrome and in whom headache was an especially prominent symptom were offered CT venography and lumbar puncture, looking for evidence of raised intracranial pressure.

Results: Of the 20 patients who accepted lumbar puncture, eight had pressures of 20 cm H2O or greater, including three who had pressures of 25 cm H2O or greater. Mean pressure was 19 cm H2O.

Conclusions: Some patients with headache and a diagnosis of chronic fatigue syndrome have unrecognised and occult idiopathic intracranial hypertension. The possibility that the two conditions are related cannot be excluded.
Keywords
Chronic fatigue syndrome, idiopathic intracranial hypertension, headache, lumbar puncture

[Dr Charles Shepherd]

Research study on migraine type headaches in ME/CFS:

http://www.ncbi.nlm.nih.gov/pubmed/?ter ... an+mk+2011