CHRONIC FATIGUE SYNDROME (CFS)

DIAGNOSTIC CRITERIA

Definition : A heterogeneous disorder characterised by severe and prolonged (Over 6 months) rm(sculos-keletal and mental fatigue, and a variety of emotional disturbances impairing daily activities.

1. Majority are females in the 2040 age group. The principal symptom is physical and mental fatigue aggravated by activity. Clinical features include exact dating of the onset of the symptoms, myalgia, arthralgia, headache, low grade fever, irritability, emotional lability, forgetfulness, depression, insomnia, photophobia, confusion, mood swings, and excess fatigue lasting more than 24 hours after exercise.
2. Is a diagnosis of exclusion as no other physical or psychiatric cause can be found. And a battery of tests might need to be done to exclude other diagnosis.
3. Examination could reveal painful cervical or axillary lymphadenopathy, pharyngitis, and low grade fever.
4. Factors incriminated in its causation include viral infections, Immunological upset leading to cyenic inflammatory process in CNS, neuroendocrine dysfunction, and psychiatric disorders.

Prognosis The majority of cases in general practice seem to recover fully functionally, but the more were cases referred to hospitals remain severely incapacitated for several years. A few recover spontaneously. No fatality reported but there is threat of suicide in some.

MANAGEMENT

General Principles :

1. As cause is unclear, treatment is mainly supportive, empirical, and symptomatic. Improvement is very slow and may take months to years.