Murga, Íñigo, Lafuente, José-Vicente · Atencion primaria · 2019 · DOI
This study traces how ME/CFS has been named and diagnosed over the past 150+ years, from 'neurasthenia' in the 1800s to today's 'post-exertional malaise.' The researchers reviewed medical literature to show how our understanding of this disease has evolved, and highlight that doctors still diagnose it mainly by symptoms and by ruling out other conditions, since no single biological marker has been found.
Understanding the diagnostic history of ME/CFS helps patients and primary care physicians recognize the disease earlier and avoid lengthy diagnostic delays. This review demonstrates that the disease's complexity and lack of a single biological marker are long-standing challenges, validating patient experiences of diagnostic confusion and emphasizing the need for improved clinical recognition.
This literature review does not establish new diagnostic criteria, identify biomarkers, or prove the underlying cause of ME/CFS. It cannot determine whether central sensitization or neuro-immune-endocrine dysfunction is the correct pathophysiological model, as it is a survey of existing literature rather than original research with patient data.
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
Murga, Íñigo & Lafuente, José-Vicente (2019). [From neurasthenia to post-exertion disease: Evolution of the diagnostic criteria of chronic fatigue syndrome/myalgic encephalomyelitis].. Atencion primaria. https://doi.org/10.1016/j.aprim.2019.04.004
BibTeX
@article{mecfsatlas-murga-2019-neurasthenia-post,
author = {Murga, Íñigo and Lafuente, José-Vicente},
title = {[From neurasthenia to post-exertion disease: Evolution of the diagnostic criteria of chronic fatigue syndrome/myalgic encephalomyelitis].},
journal = {Atencion primaria},
year = {2019},
doi = {10.1016/j.aprim.2019.04.004},
note = {PubMed: 31182238},
url = {https://www.mecfsatlas.com/evidence/murga-2019-neurasthenia-post},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/murga-2019-neurasthenia-post
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