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Chronic fatigue syndrome

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Chronic fatigue syndrome refers to severe, continued tiredness that is not relieved by rest and is not directly caused by other medical conditions.

Chronic fatigue syndrome (CFS) is the common name for a group of significantly debilitating medical conditions characterized by persistent fatigue and other specific symptoms that lasts for a minimum of six months in adults (and 3 months in children or adolescents). The fatigue is not due to exertion, not significantly relieved by rest, and is not caused by other medical conditions. CFS may also be referred to as myalgic encephalomyelitis (ME), post-viral fatigue syndrome (PVFS), chronic fatigue immune dysfunction syndrome (CFIDS), or by several other terms. Biological, genetic, infectious and psychological mechanisms have been proposed, but the etiology of CFS is not understood and it may have multiple causes.


Symptoms of CFS include malaise after exertion; unrefreshing sleep, widespread muscle and joint pain, sore throat, headaches of a type not previously experienced, cognitive difficulties, chronic and severe mental and physical exhaustion, and other characteristic symptoms in a previously healthy and active person. Additional symptoms may be reported, including muscle weakness, increased sensitivity to light, sounds and smells,orthostatic intolerance, digestive disturbances, depression, painful and often slightly swollen lymph nodes, cardiac and respiratory problems. It is unclear if these symptoms represent co-morbid conditions or if they are produced by an underlying etiology of CFS. CFS symptoms vary in number, type, and severity from person to person. Quality of life of persons with CFS can be extremely compromised.

Diagnosis

There are no characteristic laboratory abnormalities to diagnose CFS, so testing is used to rule out other potential causes for symptoms. When symptoms are attributable to certain other conditions, the diagnosis of CFS is excluded. Important conditions and disorders to exclude are current/active major depression, schizophrenia, eating disorders such as anorexia nervosa,bulimia, bipolar disorder, alcohol abuse or other substance abuse; current morbid obesity, and active medical diseases need to be resolved and excluded before a diagnosis of chronic fatigue syndrome can be made.

Fatigue is a common symptom in many illnesses, but CFS is comparatively rare. Estimates of prevalence vary from 7 to 3,000 cases of CFS for every 100,000 adults; national health organizations have estimated more than one million Americans and approximately a quarter of a million people in the UK have CFS.  CFS occurs more often in women than men, and is less prevalent among children and adolescents.

Although there is agreement that CFS poses genuine threats to health, happiness and productivity, various physicians’ groups, researchers and patient advocates promote differing nomenclatures, diagnostic criteria, etiologic hypotheses and treatments, resulting in controversy about many aspects of the disorder. The name “chronic fatigue syndrome” is controversial; many patients and advocacy groups, as well as some experts, believe the name trivializes the medical condition and they promote a name change.

February 16, 2014 |

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