Chronic fatigue syndrome

Medicine > Neurosciences

Background knowledge 🧠

Definition

Chronic Fatigue Syndrome (CFS), also known as Myalgic Encephalomyelitis (ME), is a complex and debilitating disorder characterised by profound fatigue that is not improved by bed rest and may be worsened by physical or mental activity.

Epidemiology

Affects all age groups, but most commonly adults in their 40s and 50s.
More prevalent in women.

Aetiology

The exact cause is unknown.
Possible contributing factors: Viral infections, immune dysfunction, stress, hormonal imbalances, and genetic predisposition.

Clinical Features 🌡️

Symptoms

Persistent and unexplained fatigue lasting for at least six months.
Post-exertional malaise (worsening of symptoms after physical or mental exertion).
Unrefreshing sleep.
Cognitive impairment (often described as “brain fog”).
Muscle pain, joint pain, and headaches.
Sore throat and tender lymph nodes.

Investigations 🧪

Tests

Diagnosis is primarily clinical, based on patient history and symptomatology.
There is no specific diagnostic test for CFS.
Exclusion of other conditions that can cause similar symptoms (e.g., thyroid disorders, sleep disorders, depression).

Management 🥼

Management

No cure; management is symptomatic and supportive.
Graded exercise therapy (GET) and cognitive-behavioral therapy (CBT) have shown some benefit.
Pharmacological treatment for managing pain, sleep disturbances, and other associated symptoms.
Lifestyle modifications like pacing activities and stress reduction techniques.

Prognosis

Highly variable; some patients improve over time while others may experience a fluctuating course.
A significant number of patients may not return to pre-illness levels of functioning.

Key Points

Chronic fatigue syndrome is a complex disorder characterised by debilitating fatigue that is not improved with rest.
Causes remain unknown and diagnosis is primarily clinical.
Management focuses on symptom relief and supportive care, as there is currently no cure.

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