What's PEM & PESE?
Post exertional malaise is PEM
Post exertional symptom exacerbation is PESE
PEM and PESE are a worsening of symptoms following even minor physical or mental exertion, with symptoms typically worsening 12 to 48 hours after activity and lasting for days or even weeks
PEM and PESE symptoms include:
- Profound, disabling fatigue
- Cognitive dysfunction ("brain fog")
- Sleep disturbance
- Racing heart rates
- Dizziness
- Fevers, sweats, and chills
- Sore throat and swollen glands
- Headaches
These conditions are potentially associated with PEM and PESE:
- Myalgic encephalomyelitis
- Long Covid (Post Covid Condition)
- Chronic Lyme disease
- Dysautonomia/postural orthostatic tachycardia syndrome
- Mast cell activation syndrome
PEM and PESE are diagnoses of exclusion
These diagnoses are made after all other conditions that may cause these symptoms and signs have been ruled out.
However, PEM and PESE are unique because exercise and activity generally makes people feel better
Diagnostic delays, lasting sometimes years, are common in PEM/PESE
It's often not too early in the process to help