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