This video series is intended to review the clinical presentation, scientific underpinnings, and treatment approach for patients with post-exertional malaise (PEM)/post-exertional symptom exacerbation (PESE).
For an abbreviated version highlighting the clinical pearls, please watch videos 1, 2, and 7. Videos 3-6 offer a deeper dive into the scientific and evidence-based pathophysiology of PEM/PESE.
***
Post-exertional malaise (PEM)/post-exertional symptom exacerbation (PESE) is an altered physiological state and pathognomonic finding unique to ME/CFS that is now being recognized in those with post-acute sequelae of COVID-19 (PASC), also known as Long COVID.
It is critical that healthcare professionals recognize PEM/PESE and support the patient in avoiding a push-crash-cycle which can exacerbate disease processes and contribute to worsened long-term functional prognoses.
In video two of this seven-part series Brayden Yellman, MD, and Lucinda Bateman, MD, review a cross-sectional study conducted by Dr. Lily Chu, et.al, outlining triggers, time to onset, symptoms and duration of PEM episodes. The phenomenon of variable intensity and frequency triggers for PEM has often been likened to an analogy of debt. Dr. Yellman concludes the video detailing how individuals with PEM/PESE can easily slip into this "energy debt" or "crash cycle," which demands ample and adequate rest and physiologic supports in an effort to return to baseline.
***
This video was made possible by the OMF-funded Medical Education Resource Center (MERC) at BHC, our generous donors, and viewers like you.
Video citations:
Chu L, Valencia IJ, Garvert DW, Montoya JG. Deconstructing post-exertional malaise in myalgic encephalomyelitis/ chronic fatigue syndrome: A patient-centered, cross-sectional survey. PLoS One. 2018;13(6):e0197811. Published 2018 Jun 1. doi:10.1371/journal.pone.0197811
3 окт 2024
