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.
