Cerebrospinal fluid opening pressure in relation to symptomatology and craniocervical anatomy in patients with myalgic encephalomyelitis/chronic fatigue syndrome

The study examined cerebrospinal fluid (CSF) pressure in 34 patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The median CSF opening pressure was 18 cmH2O, ranging from 11 to 29.5 cmH2O. Patients were divided into two groups: 62 percent had lower pressure (less than 20 cmH2O) and 38 percent had higher pressure (20 cmH2O or more). The higher pressure group showed a wider spinal canal and larger foramen magnum diameter (33.9 mm compared to 31.7 mm). Fifty percent of patients reported symptom improvement 1 to 4 days after lumbar puncture, with the higher pressure group experiencing more pronounced relief (80 percent versus 19 percent). The results suggest that elevated CSF pressure and certain anatomical structures in the craniocervical region may be associated with ME/CFS symptoms.