Chronic Fatigue Syndrome
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Introduction
Chronic fatigue syndrome (CFS) is a difficult condition. It affects more women than men, with the majority in their 30s.
The Case of...
a simple case introducing clincial presentation and calling for a differential diagnosis to get students thinking.
Causes and Risk Factors
CFS is likely multifactorial in cause, which may include infectious agents, immunological factors, neurohormonal factors, or nutritional deficiency.
Pathophysiology
Signs and Symptoms
CFS is diagnosed by the presence of the following two criteria:
1) new or definite onset of unexplained, clinically evaluated, persistent, or relapsing chronic fatigue, not relieved by rest, which results in occupational, educational, social, or personal dysfunction.
2) concurrent presence of at least 4 of the following symptoms, for a minimum of 6 months:
- impaired short-term memory or concentration, severe enough to cause significant decline in function
- sore throat
- tender cervical or axillary lymph nodes
- muscle pain
- multi-joint pain, with no swelling or redness
- new headache
- unrefreshing sleep
- post-exertional malaise, lasting >24 hours
- history
- physical exam
History
Physical Exam
Investigations
- lab investigations
- diagnostic imaging
Lab Investigations
Diagnostic Imaging
Differential Diagnosis
Treatments
Lifestyle and counselling
Promote sleep hygiene, regular physical activity, optimal diet.
Provide support and reassurance that most patients improve over time.
Psychotherapy can include CBT, family therapy. Support groups can be very useful.
Medications
Medications can be used to help relieve symptoms. These include: antidepressants, anxiolytics, NSAIDs, antimicrobials, or anti-allergy medications.
Consequences and Course
Resources and References
Topic Development
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