Chronic Fatigue
Syndrome is characterized by debilitating fatigue, experienced as
exhaustion, poor stamina, neurological problems, and a variety of
flu-like symptoms. The illness is also known as chronic fatigue immune
dysfunction syndrome (CFIDS), and in the United Kingdom as myalgic
encephalomyelitis (ME). Chronic Fatigue Syndrome is also mistaken
for Fibromyalgia which is a chronic musculoskeletal syndrome. Pain
is generally accompanied by sleep disorders, fatigue, gastrointestinal
disorders, and depression.
Chronic
Fatigue Syndrome:
For many people,
CFS begins after a cold, bronchitis, hepatitis, or an intestinal problem.
For some, it follows a bout of infectious mononucleosis, or mono,
which temporarily saps the energy of many teenagers and young adults.
Often, people say that their illnesses started during a period of
high stress. In others, CFS develops more gradually, with no clear
illness or other event starting it.
Unlike flu symptoms,
which usually go away in a few days or weeks, CFS symptoms either
hang on or come and go frequently for more than six months.
Chronic Fatigue Syndrome Symptoms include:
Headache.
Tender Lymph Nodes.
Fatigue and Weakness.
Muscle and Joint Aches.
Inability to Concentrate.
Fibromyalgia
Symptoms include:
Pain is the primary
symptom, found in virtually 100% of cases— specifically, pain
and tenderness in certain areas of the body when pressure is applied
to them. These areas include:
Back of the Head.
Elbows.
Hips.
Knees.
Neck.
Upper Back.
Upper Chest.
Associated
Features:
Chronic
Fatigue Syndrome
Sleep
Disorders.
Fatigue.
Gastrointestinal Disorders.
Depression.
Fibromyalgia
Sleep
Disorders - Restless Leg Syndrome, Sleep Apnea.
Gastrointestinal - Pain, bloating, wind, cramps.
Numbness or tingling sensations.
Chronic Headaches.
Heightened sensitivity to odours, loud noises, bright lights.
Painful Menstrual Periods and Painful Sexual Intercourse - Dyspareunia.
Frequent Urination.
Rapid or irregular heart rate, and shortness of breath.
Sensation of swelling in the hands and feet, even though swelling
is not present.
Differential
Diagnosis:
Some disorders have similar symptoms. The clinician, therefore, in
his diagnostic attempt has to differentiate against the following
disorders which need to be ruled out to establish a precise diagnosis.
Fibromyalgia.
Flu (viral Infection).
Cause:
Chronic
Fatigue Syndrome
The cause of
Chronic Fatigue Syndrome is not yet known. Current theories are
looking at the possibilities of neuroendocrine dysfunction, viruses,
environmental toxins, genetic predisposition, or a combination of
these.
Fibromyalgia
Causes of fibromyalgia
are not known. The condition produces vague symptoms that may be
associated with diminished blood flow to certain parts of the brain.
Clinicians have identified several other possible causes, including
the following:
Autonomic nervous
system dysfunction.
Chronic sleep disorders.
Emotional stress or trauma.
Immune or endocrine system dysfunction.
Upper spinal cord injury.
Viral or bacterial infection.
Treatment:
Chronic
Fatigue Syndrome
Since no cause
for CFS has been identified and the pathophysiology remains unknown,
treatment programs are directed at relief of symptoms, with the
goal of the patient regaining some level of pre-existing function
and well-being. Although desirable, a rapid return to pre-illness
health may not be realistic, and patients who expect this prompt
recovery and do not experience it may exacerbate their symptoms
because of overexertion, become frustrated
Fibromyalgia
The goal of
treatment is to reduce pain, improve sleep, and relieve associated
symptoms. Treatment is tailored to the individual. Some patients
experience significant relief of symptoms, some find moderate improvement,
and others report little or no relief. Only about 5% of fibromyalgia
patients become symptom free. Most treatment regimens include medication,
lifestyle changes, exercise, physical therapy, and behavior modification
Counseling
and Psychotherapy [ See
Therapy Section ]:
Learning about
what CFS is and what it is not is a critical component of therapy.
This approach includes learning how to adjust activities and behaviors
that may aggravate the illness. A formal method to impart this information
is known as cognitive behavioral therapy. Cognitive behavioral therapy
has been shown to facilitate patient coping and to allow increased
activities without triggering increased symptoms.
Pharmacotherapy
[ See Psychopharmacology
Section ] :
Pharmacologic
therapy is directed toward the relief of specific symptoms experienced
by the individual patient.
