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Chronic fatigue syndrome

Definition:

  • Chronic Fatigue Syndrome (CFS), also known as Myalgic Encephalomyelitis (ME), is a complex and debilitating disorder characterized 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.

Etiology:

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

Clinical Features:

  • 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.

Diagnosis:

  • 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:

  • 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.

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