[From neurasthenia to post-exertion disease: Evolution of the diagnostic criteria of chronic fatigue syndrome/myalgic encephalomyelitis].

Observed Findings

• ME/CFS has been described in medical literature under multiple names since the 1800s, reflecting evolving understanding of the condition.
• The disease is classified as a neurological disorder (ICD-10: G93.3) despite absence of histopathological findings.
• Multiple organic abnormalities have been documented across various body systems, but no single unifying biological mechanism has been identified.
• Current diagnosis relies exclusively on clinical presentation and exclusion of other diseases, with no validated biomarker.
• Some authors propose ME/CFS belongs within central sensitivity syndromes sharing common pathophysiological mechanisms.

Inferred Conclusions

• The terminology and diagnostic approach to ME/CFS have evolved substantially over 150 years, yet fundamental diagnostic challenges persist.
• Primary care physicians play a critical role in early detection and require clear diagnostic frameworks to identify patients with unexplained chronic fatigue lasting >6 months.
• CFS/ME should be conceptualized as a neuro-immune-endocrine dysfunction with high morbidity affecting physical and mental functioning.
• Despite substantial clinical documentation of disease features, the underlying pathophysiology remains incompletely understood and requires further biological investigation.

Remaining Questions