Steph.

There have been a few reason why I became interested in CFS lately.

One, is that I started to think that if MG is so different than what is written in the medical text-books, than possibly this is true for other diseases.

Another is that I met quite a few MG patients who were initially diagnosed as CFS. So, I thought there has to be some overlap at least clinically.

There are very few studies looking at the utility of diagnostic tests (such as antibodies and EMG) in MG. But, in all of those studies there is a significant group of patients (at least 25%) who have clinical symptoms of MG, do not have MG (as their tests are normal), but have no other alternative diagnosis. Such patients are "diagnosed" with CFS, functional neurological disorder etc.

MuSK was found after the SFEMG test was established as the "gold standard". Neurologists know that the SFEMG results in MuSK patients are very different than those in AchR patients, but as a diagnostic SFEMG is considered the gold standard they only mention it very quietly. (like for instance in a conference abstract which only a few neurologists will see and is never published).

I found very few "undiagnosed" MG patients in MG support groups. When, there should have been at least 1/4 patients (according to the medical literature which shows that 1/4 patients with MG symptoms does not have MG). So where are those?

I also asked myself where would those patients be referred? Obviously-psychiatrists.
So, I started to look at the psychiatrists who are interested in those entities.
It was quite interesting to find that one of the leaders in the field of CFS in the UK is a psychiatrist who in the early days of his training saw all the patients that the neurologist thought had nothing physically wrong with them.

He found a significant resemblance between their symptoms to those of patients with MG. But, they were similar to patients with MG who also suffered from "depression".

So, this led to the inevitable conclusion that CFS has a significant psychiatric component.

In his land mark paper (which is one of the most cited papers) he compared patients with CFS to a mixture of patients with MG and other neuromuscular diseases. There is not data regarding the severity of disease of either group.

So, I personally believe that at least some of the patients with so-called CFS are patients with MG who have normal tests.

Regardless, there is currently much more clinical research in CFS than there is in MG. There is not even one single study on the effect of exertion on MG patients, nor is there any attempt to assess the true functional abilities of MG patients. Yet, there are numerous such studies in CFS.

Even Rituximab has been studied much more extenesively in CFS than it was or is in MG.

That is why I have a lot of hope from the studies done on CFS.