Dr Ramsays Diagnosis Criteria

Onset may be sudden and without apparent cause, for example a sudden attack of acute vertigo. There is usually a history of infection of the upper respiratory tract or, occasionally, the gastrointestinal tract. All cases have low grade pyrexia (up to 38 deg C) usually subsiding within a week.

Subsequently there is persistent and profound fatigue, accompanied by a medley of symptoms such as headache, giddiness and a number of muscle symptoms such as pain, cramp, twitching, tenderness and weakness (especially after exercise). Other symptoms include paraesthesia, frequency of micturition [urination], blurred vision and/or diplopia, hyperacusis (sometimes alternating with deafness or normal hearing), tinnitus, fainting attacks which may be the result of hypoglycaemia and a general sense of "feeling awful".

The Established Syndrome

Once the syndrome is fully established there are three groups of symptoms:

1.Muscle Phenomena

Muscle fatiguability. Even after a minor degree of physical excercise, 3 or more days may elapse before full muscle power is restored. This feature is unique and is the "sheet anchor" of diagnosis. In moderate cases there may be normal muscle power in remission.

Muscle spasm and twitching. In severe cases there may be swollen and very tender bands of muscle including minute focii of exquisite tenderness in trapezii and gastrocnemii (the muscle groups most commonly involved).

2.Circulatory Impairment

Cold extremities.

Hypersensitivity to climactic change.

Ashen grey facial pallor, 20 to 30 minutes before patient complains of being ill

3.Cerebral Dysfunction

Cardinal Features

Impairment of memory

Impairment of powers of concentration

Emotional lability

Other Common Features

Using the wrong words

Alteration to sleep rhythm or vivid dreams

Frequency of micturition

Hyperacuisis

Episodic sweating

Orthostatic tachycardia

6 Replies

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  • Sounds very familiar.

  • Original written in 1956 then operationalized as the London Criteria in 1988.

  • yes, most of that seems familiar. I just wonder how many other conditions it could be with most or all of these symptoms and whether there is any chance of actually getting tests to eliminate the other possibilities once a person has a fibromyalgia diagnosis.

    I have found there is a dead end in terms of investigation for the most part, and that dead end has a big sign that reads either FIBROMYALGIA or CHRONIC FATIGUE SYNDROME. Seems once you have either diagnosis, doctors think you need nothing else except psychological help, drugs for pain, and to counteract your impulse to preserve your health and rest instead of just 'getting on with things'.

    I desperately want to find the hidden exit from this trap of no clear treatment options, no interest in a coordinated and monitored treatment plan with some help from doctors or therapists who know what this illness is and are not too proud or too busy to find out more from the experts.

    Denying funds and treatments/investigations/therapies makes no sense, but we don't seem to have a way to get what we need. Where is it? Only around Julia Newton's practice area or in the US?

  • The community is one of many seeking recognitiona and battling the stigma of invisible diisease together we are stronger

  • I've heard success with hyperbaric oxygen therapy is brilliant for fybromyalgia ( which I also have) as well as the CFS/ME/ Ramsey's disease. Maybe worth a look into it, but it is expensive..... You can google your nearest treatment centre xxx

  • I agree. Thank you for starting this forum.

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