Chronic fatigue syndrome Flashcards
What is chronic fatigue syndrome?
Diagnosed after at least 4 months of disabling fatigue affecting mental and physical function more than 50% of the time in the absence of other disease which may explain symptoms
Epidemiology of chronic fatigue syndrome
more common in females
past psychiatric history has not been shown to be a risk factor
Fatigue is the central feature, other recognised features include:
sleep problems, such as insomnia, hypersomnia, unrefreshing sleep, a disturbed sleep-wake cycle
muscle and/or joint pains
headaches
painful lymph nodes without enlargement
sore throat
cognitive dysfunction, such as difficulty thinking, inability to concentrate, impairment of short-term memory, and difficulties with word-finding
physical or mental exertion makes symptoms worse
general malaise or ‘flu-like’ symptoms
dizziness
nausea
palpitations
Investigations of chronic fatigue syndrome?
NICE guidelines suggest carrying out a large number of screening blood tests to exclude other pathology e.g. FBC, U&E, LFT, glucose, TFT, ESR, CRP, calcium, CK, ferritin, coeliac screening and also urinalysis
Diagnosis is typically made if the symptoms persist for?
3 months
Management of chronic fatigue syndrome
Refer to a specialist CFS service if the diagnostic criteria are met and symptoms have persisted for 3 months
Energy management
- a self-management strategy that involves a person with ME/CFS managing their activities to stay within their energy limit, with support from a healthcare professional
Physical activity and exercise
- do not advise people with ME/CFS to undertake exercise that is not part of a programme overseen by an ME/CFS specialist team
- should only be recommended if patients ‘feel ready to progress their physical activity beyond their current activities of daily living’
- graded exercise therapy used to be recommended but is now specifically not recommended by NICE
Cognitive behavioural therapy
- NICE stress this is ‘supportive’ rather than curative for CFS