Christoforou, Maritsa E, Lum, Ying Wei, Sroge, Sally C et al. · Cureus · 2025 · DOI
This case study describes a 19-year-old woman with ME/CFS who also had a condition called thoracic outlet syndrome (TOS), where nerves in the upper chest become compressed. After surgery to relieve this compression on both sides of her body, she experienced not only relief from arm numbness and tingling, but also surprising improvements in migraines, brain fog, dizziness, and vision problems. This suggests that some ME/CFS patients might benefit from being evaluated for TOS, as treating it could potentially help with multiple symptoms.
This case highlights a potential overlooked contributor to ME/CFS symptoms that might be surgically treatable. For patients with ME/CFS who have upper limb symptoms or hypermobility features, screening for TOS could identify a remediable cause of some symptoms. It also suggests that neurogenic compression syndromes warrant greater clinical attention in the ME/CFS population.
This is a single case report and cannot prove that TOS is common in ME/CFS or that it causes ME/CFS symptoms broadly. It does not establish that surgery will help other ME/CFS patients with similar presentations. The improvement in systemic symptoms could reflect placebo effect, spontaneous improvement, or benefits specific to this individual's unique anatomy rather than a general TOS-ME/CFS relationship.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Christoforou, Maritsa E, Lum, Ying Wei, Sroge, Sally C, Azola, Alba M, & Rowe, Peter C (2025). Improvement in Upper Limb and Systemic Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Symptoms After Surgical Treatment of Neurogenic Thoracic Outlet Syndrome.. Cureus. https://doi.org/10.7759/cureus.90494
BibTeX
@article{mecfsatlas-christoforou-2025-improvement-upper,
author = {Christoforou, Maritsa E and Lum, Ying Wei and Sroge, Sally C and Azola, Alba M and Rowe, Peter C},
title = {Improvement in Upper Limb and Systemic Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Symptoms After Surgical Treatment of Neurogenic Thoracic Outlet Syndrome.},
journal = {Cureus},
year = {2025},
doi = {10.7759/cureus.90494},
note = {PubMed: 40978926},
url = {https://www.mecfsatlas.com/evidence/christoforou-2025-improvement-upper},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/christoforou-2025-improvement-upper
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