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Prognosis for myalgic encephalomyelitis and chronic fatigue syndrome
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=== Fluctuation === For most ME/CFS patients, their health is never the same and they experience numerous symptoms and disease severity which fluctuate day to day and through the years.<ref>{{Cite web|url=http://www.meassociation.org.uk/about/the-symptoms-and-diagnosis-of-mecfs/ | title = Symptoms, Testing and Assessment.|website=[[The ME Association]]|language=en-US|access-date=2018-10-17}}</ref><ref>{{Cite news | url=http://www.webmd.com/chronic-fatigue-syndrome/chronic-fatigue-syndrome-symptoms | title = Think You Might Have Chronic Fatigue Syndrome? Here are The Symptoms|work=WebMD|access-date=2018-10-17|language=en-US}}</ref><ref>{{Cite news | url=http://phoenixrising.me/mecfs-basics/chronic-fatigue-syndrome-mecfs-facts-chronic-fatigue-syndrome-is-2 | title = About ME/CFS | last = | first = | date = Mar 6, 2011|work=Phoenix Rising|access-date=2018-10-17|archive-url=|archive-date=|language=en-US}}</ref> In multiple sclerosis, the clinical course of the disease can be divided into different subtypes as some patients experience a progressive decline, while others a more relapsing course with ups and downs.<ref>{{Cite web|url=https://www.multiplesclerosis.com/us/treatment.php | title = Types of MS and MS Treatment Options—multiplesclerosis.com|website=multiplesclerosis.com|access-date=2018-10-28}}</ref> [[Jamie Stroothoff|Stroothoff]] et al. tried to make a similar subdivision in ME/CFS. Their analysis showed that the majority of ME/CFS patients describe their illness as fluctuating, with a minority (15.9%) said they were constantly getting worse.<ref>{{Cite journal | last = Stoothoff | first = Jamie | last2 = Gleason | first2 = Kristen | last3 = McManimen | first3 = Stephanie | last4 = Thorpe | first4 = Taylor | last5 = Jason | first5 = Leonard A. | date = 2017 | title=Subtyping Patients with Myalgic Encephalomyelitis (ME) and Chronic Fatigue Syndrome (CFS) By Course of Illness|url=https://www.ncbi.nlm.nih.gov/pubmed/29204592|journal=Journal of Biosensors, Biomarkers and Diagnostics|volume=2|issue=1|doi=10.15226/2575-6303/2/1/00113|pmc=5710812|pmid=29204592|pages=|quote= | author-link = Jamie Stoothoff | authorlink2 = Kristen Gleason | author-link3 = Stephanie McManimen | author-link4 = Taylor Thorpe | authorlink5 = Leonard Jason|via=}}</ref> [[Sandra Howes|Howes]] & [[Ellen Goudsmit|Goudsmit]] had previously reported on a subtype of ME that progressively worsens over time.<ref>Howes S and Goudsmit EM. [https://scholar.google.com/scholar_url?url=https://www.researchgate.net/profile/Ellen_Goudsmit/publication/309188001_Progressive_Myalgic_Encephalomyelitis_ME_or_a_New_Disease_A_Case_Report/links/5803c00008ae6c2449f9610e/Progressive-Myalgic-Encephalomyelit Progressive Myalgic Encephalomyelitis (ME) or A New Disease? A Case Report.] Phys Med Rehabil Int. 2015;2(6): 1052.</ref>
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