The Chronic Fatigue Syndrome

• CFS overview
• CFS Symptoms
• CFS evolution
• CFS treatments

CFS overview Chronic fatigue syndrome (CFS), also Department of Health and Social Services known as myalgic encephalomyelitis (ME), and the British Medical Association post-viral fatigue syndrome (PVFS), and officially recognized it as a legitimate various other names, is a syndrome (or and potentially distressing disorder. group of syndromes) of unknown and Opponents of the term ME maintain there possibly multiple etiologies, affecting is no inflammation, although there are the central nervous system (CNS), cases of CFS that present inflammation immune, and many other systems and (see Sophia Mirza). United Kingdom and organs. There is no simple diagnostic Canadian researchers and patients test; CFS is a diagnosis of exclusion, generally use this term in preference to although recent research indicates CFS. biological hallmarks of the syndrome, Chronic fatigue syndrome (CFS); this and a diagnostic test is predicted soon. name was introduced in 1988 by a group Most definitions (other than the 1991 UK of United States researchers based at Oxford criteria[1]) require a number of the Centers for Disease Control and features, the most common being severe Prevention, and is used increasingly mental and physical exhaustion or over other designations, particularly in depletion which is "unrelieved by rest" the United States. (according to the 1994 Fukuda Chronic fatigue immune dysfunction definition),[2] and is often worsened by syndrome (CFIDS); many people, many even trivial exertion (controversially, patients and advocacy groups in the USA the Oxford and Fukuda criteria require use the term CFIDS (pronounced this to be optional only). CFS occurs [See-Fids]), originally an acronym for more often, but not exclusively, in the above or "Chronic Fatigue & Immune women, possibly due to immunological Dysfunction Syndrome". This term was factors (women are overall more introduced by patients current with the susceptible to similar disorders). CFS biomedical research in an attempt to is most easily diagnosed when formerly reduce the psychiatric stigma attached active adults become ill, but it has to "chronic fatigue", as well as the been reported in persons of all ages, public perception of CFS as a including young children and psychiatric syndrome. The term also particularly teenagers. calls attention to the immune Patients with this diagnosis commonly dysfunction in patients for which report many other symptoms which are far evidence has been steadily growing since more wide-ranging than these research the illness was first identified, and diagnostic criteria, including: pain, which now appears to be an integral part muscle weakness, loss of brain function, of this illness. hypersensitivity, orthostatic Post-viral [fatigue] syndrome (PVS or intolerance, digestive disturbances, PVFS); this is a related disorder. depression, immune system weakness, and According to original ME researcher Dr. cardiac and respiratory problems. These Melvin Ramsay, "The crucial symptoms, like the syndrome's hallmark differentiation between ME and other 'fatigue', range from mild to forms of post-viral fatigue syndrome life-threateningly severe. Some cases lies in the striking variability of the resolve or improve over time, and where symptoms not only in the course of a day available, treatments bring a degree of but often within the hour. This improvement to many others. Most variability of the intensity of the diagnostic criteria insist that the symptoms is not found in post-viral symptoms must be present for at least fatigue states" (Ramsay 1989). However, six months, and all insist on there other researchers and advocates argue being no other cause for the fatigue: that other post-viral syndromes (such as i.e. the fatigue must be idiopathic, not post-polio syndrome) do show similar caused by conditions such as radiation variability, and point to the striking treatment for cancer, or diabetes. CFS similarity between post-viral fatigue remains a controversial diagnosis, and syndrome and CFS symptoms, noting that even its terminology and classification many CFS cases are triggered by a viral are controversial. Recently, genetics illness. and stress have been found to be factors Chronic Epstein-Barr virus (CEBV) or in the development of CFS. Chronic Mononucleosis; the term CEBV was Originally studied in the late 1930s as introduced by virologists Dr. Stephen an immunological neurological disorder Straus and Dr. Jim Jones in the United under the medical term "myalgic States. The Epstein-Barr virus, a encephalomyelitis" (ME), CFS has been neurotropic virus that more commonly classified by the World Health causes infectious mononucleosis, was Organization (WHO) as a disease of the thought by Straus and Jones to be the central nervous system since 1969. In cause of CFS. Subsequent discovery of 1992 and early 1993 the terms the closely related human herpesvirus 6 "post-viral fatigue syndrome" (PVFS) and shifted the direction of biomedical "chronic fatigue syndrome" (CFS) were studies, although a vastly expanded and added to ME under the exclusive ICD-10 substantial body of published research designation of G93.3. continues to show active viral infection Lacking a diagnostic test of any kind, or reinfection of CFS patients by these CFS has historically been mis-diagnosed, two viruses. These viruses are also for example in patients presenting CFS found in healthy controls, lying symptoms with similar biological dormant. conditions or infections (such as Lyme Low Natural Killer cell disease; this or Epstein-Barr) (the latter of which is name is used widely in Japan. It often the cause of glandular fever, or reflects research showing a reduction in infectious mononucleosis), or the number of natural killer cells in psychological conditions (ranging from many CFS patients. More significantly, depression to hypochondria). A lack of the activity of the remaining natural information and awareness has led to killer cells is reduced, often by as many patients being stigmatized as much as two thirds. hypochondriac or lazy. The Centers for Yuppie Flu; this was a factually Disease Control & Prevention (CDC) have inaccurate nickname for CFS, first now recognized CFS as a serious illness published in a November 1990 Newsweek and have recently launched a campaign to article. It reflects an assumption that raise public and medical awareness about CFS mainly affects the affluent it. ("yuppies"), and implies that it is a There are a number of different terms form of malingering or burnout. CFS, which have been identified at various however, affects people of all races, times with this disorder. genders, and social standings, and this Myalgic encephalomyelitis (pronounced nickname is inaccurate and considered [my-al'jik en-sef'a-lo-my'e-ly'tis]) or offensive by patients. It is likely that M.E, "inflammation of the brain and this article contributed to the damaging spinal cord with muscle pain", as a public (and even medical) perception of disease entity has been recognized and CFS as a psychiatric or even described in the medical literature psychosomatic condition. since 1938, with the seminal paper being Uncommonly used terms include Akureyri that by Wallis in 1957; Sir Donald Disease, Iceland disease (in Iceland), Acheson's (a former Chief Medical Royal Free disease (after the location Officer) major review of ME was of an outbreak), atypical poliomyelitis, published in 1959;[3] in 1962 the epidemic vasculitis, raphe nucleus distinguished neurologist Lord Brain encephalopathy, and Tapanui flu (after included ME in his textbook of the New Zealand town Tapanui where the neurology, and in 1978 the Royal Society first doctor in the country to of Medicine accepted ME as a distinct investigate the disease, Dr Peter Snow, clinical entity. In 1988 both the UK lived). 1 A B C D 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109