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Chronic fatigue syndrome, also known as myalgic encephalomyelitis, is a condition characterised by chronic and incapacitating fatigue when exerting little effort, which does not improve with rest. Over time this causes dysfunction of the neurological, immune, endocrine and metabolic systems. Its severity is very variable. In some cases physical and cognitive capacity may be significantly affected, disabling patients and limiting their quality of life. In other cases, people with the condition may lead a relatively active life.
Even through the cause of chronic fatigue syndrome is not yet known, it is being actively researched. It is thought the condition may be brought on by a combination of physical and psychological factors. These include viral or bacterial infections, recent negative or traumatic experiences, mental stress, depression and nutritional deficiencies. It is important to study the accompanying symptomatology: pain, sleep disorders, headaches; and cognitive, neurological, neurovegetative and immunological symptomatology in order to reach a proper diagnosis.
The most typical symptom is intense tiredness and fatigue that is not cured by rest and that limits daily life. Fatigue should last more than six months for diagnosis to be confirmed.
Other common symptoms are:
It affects young people, mainly women, between twenty and forty years old. Although there are no studies of its prevalence in the Spanish population, in other countries it affects 0.07% to 0.3% of people.
A general blood test is used along with imaging tests to carry out a differential diagnosis with other causes of persistent fatigue. The basic imaging tests are a chest x-ray and an abdominal ultrasound. A psychopathological assessment is required prior to definitive diagnosis to:
In the case of CFS, as with many immunoinflammatory diseases, there is no specific diagnostic test available; a diagnosis is therefore reached by fulfilling the Fukuda criteria.
Primary criteria (both must be present):
Unexplained and persistent or recurring chronic fatigue (minimum 6 months), which appears again or comes on suddenly and which is not as a result of recent exertion. Does not significantly improve with rest. Produces a considerable decrease in levels of occupational, educational, social or personal activity. Exclusion of other illnesses that may cause prolonged fatigue.
Additional symptoms (occurring concurrently, 4 or more of the related signs and symptoms must be present and be persistent or recurring over 6 months following the onset of fatigue):
There is no treatment to cure chronic fatigue syndrome, but the symptoms can be improved:
There is currently no treatment to cure chronic fatigue syndrome, but symptoms can be improved:
Diagnosis of chronic fatigue syndrome (CFS) is purely clinical, but a general blood test and imaging tests are useful to carry out a differential diagnosis with other causes of persistent fatigue.
The general blood test should include:
Advice for patients with chronic pain, fibromyalgia, and chronic fatigue, from experts in the neuroscience of pain
Chronic fatigue syndrome
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