Chronic fatigue syndrome Flashcards
What is chronic fatigue syndrome?
- Myalgic Encephalomyelitis
- 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.
- Characterised by a sudden or gradual onset of persistent disabling fatigue, post-exertional malaise (PEM)/exertional exhaustion, unrefreshing sleep, cognitive and autonomic dysfunction, myalgia (muscle aches and pain), arthralgia (joint stiffness), headaches, and sore throat and tender lymph nodes (without palpable lymphadenopathy), with symptoms lasting at least 6 months
What are the causes for chronic fatigue syndrome?
Viral and bacterial infections (e.g., Epstein-Barr virus, Mycoplasma pneumonia,Giardia duodenalis), and immunological (e.g., IgG subclass deficiencies), neuroendocrine, genetic, gastrointestinal, and psychological factors have been investigated as initiating triggers.
What are the risk factors for chronic fatigue syndrome?
- Family history
- Infection
- Female sex
- Epstein-Barr infection
What are the signs/ presenting symptoms of chronic fatigue syndrome?
- Persistent Disabling Fatigue → may be present for >6 months
- Post-Exertional Fatigue
*Significant exhaustion and impairment following minimal physical or cognitive effort - Short-Term Memory or Concentration Impairment
- Sore Throat
- Arthralgia
- Headache
- Unrefreshing sleep
- Flu-Like Symptoms (may precede fatigue) → malaise, myalgia, fever
- Painful Lymph Nodes
What investigations are used to diagnose chronic fatigue syndrome?
DePaul Symptom Questionnaire → validated screening tool for CFS
FBC, U&E, LFT, glucose, TFT, ESR, CRP, calcium, CK, ferritin*, coeliac screening and also urinalysis → exclude other diagnoses
How is chronic fatigue syndrome managed?
- Cognitive Behavioural Therapy → very effective
- Graded Exercise Programme
- Mindfulness, Sleep Hygiene, Occupational Therapy
- Referral to a pain management clinic if pain is a predominant feature
