Chronic fatigue syndrome Flashcards
What is chronic fatigue syndrome (CFS)?
Diagnosed after at least 3 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.
What is the epidemiology of CFS?
More common in females; past psychiatric history has not been shown to be a risk factor.
What are the central features of CFS?
Fatigue is the central feature. Other features include sleep problems, muscle and/or joint pains, headaches, painful lymph nodes without enlargement, sore throat, cognitive dysfunction, general malaise or ‘flu-like’ symptoms, dizziness, nausea, and palpitations.
What sleep problems are associated with CFS?
Insomnia, hypersomnia, unrefreshing sleep, and a disturbed sleep-wake cycle.
What cognitive dysfunctions are associated with CFS?
Difficulty thinking, inability to concentrate, impairment of short-term memory, and difficulties with word-finding.
How does physical or mental exertion affect CFS symptoms?
Physical or mental exertion makes symptoms worse.
What investigations are recommended for CFS?
NICE guidelines suggest a large number of screening blood tests to exclude other pathology, including FBC, U&E, LFT, glucose, TFT, ESR, CRP, calcium, CK, ferritin, coeliac screening, and urinalysis.
What are the diagnostic criteria for CFS?
A diagnosis is typically made if the symptoms persist for 3 months.
What is the management strategy for CFS?
Refer to a specialist CFS service if diagnostic criteria are met and symptoms have persisted for 3 months.
What is energy management in CFS?
A self-management strategy that involves managing activities to stay within energy limits, with support from a healthcare professional.
What is the recommendation regarding physical activity and exercise for CFS patients?
Do not advise 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.’
What is the current stance on graded exercise therapy for CFS?
Graded exercise therapy used to be recommended but is now specifically not recommended by NICE.
What role does cognitive behavioural therapy play in CFS management?
NICE stresses this is ‘supportive’ rather than curative for CFS.
What is the prognosis of CFS in children?
CFS has a better prognosis in children.
