Note: This comment appeared in Journal of the Royal Society of Medicine Volume 83 June 1990. You can view the table referenced in the comment here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1292703/pdf/jrsocmed00135-0083a.pdf
The difficulty of making a definitive diagnosis of postviral syndrome (myalgic encephalomyelitis) is emphasized by Dr Bowman and his colleagues (December 1988 JRSM, p 712).
After a patient with this condition reported benefit from hyperbaric oxygen (HBO) (1), 36 other patients requested to be treated at Centres administered by ‘Action and Research for Multiple Sclerosis’ (ARMS). Thirty had been investigated in hospital.
They received 20 daily one hour sessions breathing 100% oxygen under pressure. Thirteen patients reported symptomatic improvement at 1.25 atmospheres absolute (ata), 10 responded at 1.5 ata, three at 1.75 ata and two at 2.0 ata.
The patients were asked to record any changes in their symptoms at the end of the course and their accumulated replies are given in Table 1.
A speculative explanation is that high concentrations of oxygen may limit the excessive intracellular lactic acid in skeletal muscle that has been demonstrated in this disease(2). The clinical pattern of myalgic encephalomyelitis has much in common with multiple sclerosis and it is possible that some of these patients had, in fact, got MS.
However, muscle pains are seldom a feature of MS, while they occurred in all but four of these patients. Seventeen out of the 33 with this symptom reported improvement, a response to HBO which might be elaborated into a therapeutic test.
ARMS treated these patients (with the consent of their doctors) on an empirical basis, and it is not implied that HBO is a definitive treatment for ME. However, these reports of subjective improvement suggest that a formal trial should be initiated.
~D J D PERRINS Adviser on Hyperbaric Medicine to ARMS, 4a Chapel Hill, Stansted, Essex CM24 8AG
References
1 Newsletter of the M.E. Association No 21, 1986
2 Arnold DL, Bore PJ, Radda GK, et al. Excessive intracellular acidosis of skeletal muscle on exercise in a patient with a post-viral exhaustion/fatigue syndrome. Lancet 1984;i:1367-9
Source: D J Perrins. The diagnosis of postviral syndrome. J R Soc Med. 1990 Jun; 83(6): 413. PMCID: PMC1292703 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1292703/