Post-Exertional Malaise

(Post Exertional Malaise)
Understanding PEM
A brief guide to PEM

• Dr Luis Nacul
Co-principal Investigator CureME London School of Hygiene and Tropical Medicine
Medical Director of the Complex Chronic Diseases Program at British Columbia Women’s Hospital in Vancouver, Canada.

• Dr Christopher Snell
former Chair CFS Advisory Committee to the US Secretary for Health.

• Staci Stevens
Founder the Workwell Foundation

• Prof Mark VanNess
Professor and Co-Chair, Health, Exercise & Sport Sciences,
University of the Pacific. Stockton. CA

• Prof Todd Davenport
Program Director Physical Therapy, University of the Pacific, Stockton. CA

• Dr Nina Muirhead
Dermatology surgeon Buckinghamshire NHS Trust
Chair CMRC Medical Education Working Group

• Dr Nigel Speight
Paediatric Consultant with a special interest in ME
Paediatric medical advisor  ME Association
Medical advisor  25% Group for the Severely Affected.

• Dr David Systrom
Pulmonary and Critical Care Physician at Brigham and Women’s Hospital.
Professor of Medicine, Harvard Medical School.

• Dr Charles Shepherd
Medical advisor for the ME Association.

• Grace, UK ME/CFS biobank patient


• MEA Summary Review: Assessing PEM (Post-exertional malaise)  Charlotte Stephens, March 2019. ME Association website.

Assessment of Post-Exertional Malaise (PEM) in Patients with Myalgic Encephalomyelitis (ME) and Chronic Fatigue Syndrome (CFS): A Patient-Driven Survey by Carly S. Holtzman, Shaun Bhatia, Joseph Cotler and Leonard A. Jason. Diagnostics 20199(1), 26;

Deconstructing post-exertional malaise in myalgic encephalomyelitis/ chronic fatigue syndrome: A patient-centered, cross-sectional survey: Chu L, Valencia IJ, Gavert DW, Montoya JM.
Published: PLoS One 2018.

• Postexertional malaise in women with chronic fatigue syndrome.
VanNess JM1, Stevens SR, Bateman L, Stiles TL, Snell CR. Journal of  Womens Health  2010

Diminished Cardiopulmonary Capacity During Post-Exertional Malaise 2008
J. Mark VanNess, Christopher R. Snell & Staci R. Stevens  Journal of Chronic Fatigue Syndrome   2007
“Characterization of Post–exertional Malaise in Patients With Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.” Authors: B. Stussman, A Williams, J Snow, A Gavin, R Scott, A Nath, B Walitt.
Front. Neurol., 18 September 2020