CHRONIC FATIGUE SYNDROME

1. CHRONIC FATIGUE SYNDROME
DIAGNOSIS OF EXCLUSION

2. CHRONIC FATIGUE SYNDROME
• CHRONIC AND PERSISTENT FATIGUE WHICH IS
UNEXPLAINED AND IT RESULTING IN
IMPAIRMENT IN DAILY FUNCTIONING

3. CFS
BEFORE DIAGNOSIS EXCLUDE
1.OBESITY (BMI >40)
2.ALCOHOL /SUBSTANCE ABUSE
3.EATING DISORDER
4.MEDICAL CONDITION
5.MAJOR DEPRESSIVE DISORDER
6. SCHIZOPHRENIA

4. CDC CRITERIA
• 6 MONTH DURATION
• NEW ONSET
• NOT RELIEVED BY REST
• NOT RESULT OF ORGANIC CAUSES
• 4 OF THE FFOLLOWING
– SORETHROAT
– AXILLARY OR CERVICAL LYMPHNODE
– IMPAIRED MEMORY/CONCENTRATION
– MUSCLE PAIN
– PAIN IN SEVERAL JOINTS
– NEW HEADACHE
– UNREFRESHING SLEEP

5. PREDISPOSING FACTORS
• PHYSICAL INACTIVITY
• CHILDHOOD TRAUMA
– LIKE NEUROENDOCRINE DISORDER
• PSYCHIATRIC ILLNESS AND PHYSICAL
HYPERACTIVITY

6. PREDISPOSING FACTORS
• MANY PATIENTS HAVE THE PREDECENT UPPER
RESPIRATORY INFECTION LIKE SYMPTOMS
• MOSTLY FOLLOW THE INFECTION
– Esp. Q FEVER, LYME DISEASE

7. PATHOPHYSIOLOGGY
• NOT KNOWN
• NEUROIMAGING
– REDUCTION IN GREY MATTER VOLUME WHICH IS
ATTRIBUTED TO REDUCTION IN PHYSICAL
ACTIVITY (CAN BE REVERSED BY CBT /GET)

8. • NEUROPHYSIOLOGICAL STUDIES – ALTERED
CNS ACTIVATION PATTERN DURING MUSCLE
CONTRACTION

9. • MILD HYPOCORTISOLISM IS ASSOCIATED WITH
CFS, WHICH IS NOT RESPONDING TO CBT.

10. SHORTENED FATIQUE QUESTIONARIE
IS USED (LIKERT CHART)
• HOW HAVE U FELT DURING THE LAST 2
WEEKS?
• I FEEL TIRED
• I TIRE EASILY
• I FEEL FIT
• FEEL EXHAUSTED
YES(7) NO(1)
YES(7) NO(1)
YES(7) NO(1)
YES(7) NO(1)

11. SFQ
• IF THE QUESTIONNARIE SCORE IS MORE THAN
18  SEVERE FATIGUE
• MANAGEMENT
– CBT(COGNITIVE BEHAVIOURAL THERAPY)
– GET (GRADED EXERCISE THERAPY)