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.