Chronic fatigue syndrome is a condition which is also known by several other names including myalgic encephalomyelitis/encephalopathy (ME), chronic fatigue immune dysfunction syndrome (CFIDS) and post viral fatigue syndrome (PVFS).
Despite the various descriptions the most popular terms in use today are ME and CFS which are often used together as though they refer to the same condition, a move deemed controversial by many sufferers and medical experts.
National Institute for Health and Care Excellence (NICE) guidelines
NICE define ME/CFS as a condition which commonly see's a previously active and healthy individual experience a complex range of symptoms including severe fatigue and malaise following mental or physical activity. The full effects of this exhaustion may only appear 24 to 48 hours after the previous activity.
The NICE guidelines state that the condition may be triggered by an infection, although in some cases there is no obvious causative factor and instead the individual may report a gradual decline in health over a period of months or years.
Guidelines (2007) from the National Institute for Health and Care Excellence (NICE) recommend that doctors consider diagnosing CFS if an individual has fatigue with all of the following:
- a clear starting point
- persistent and/or recurrent
- a substantial reduction in activity level
- unexplained by other conditions
- characterised by post-exertional malaise and/or fatigue (feeling worse after physical activity).
and one or more of the following symptoms:
- headaches
- sore throat
- dizziness and/or nausea
- difficulty sleeping, or insomnia
- muscle and/or joint pain without inflammation
- painful lymph nodes that are not enlarged
- cognitive dysfunction, such as difficulty with thinking
- general malaise or flu-like symptoms
- physical or mental exertion that makes symptoms worse
- palpitations, without heart disease.
Not everyone will experience all of the key symptoms and there is also a whole host of 'minor' symptoms which are often not mentioned when patients describe their illness.
Recommendations from NICE with regards to the management of ME/CFS are aimed at maintaining a patient’s current emotional, physical and cognitive capacity and extending it where possible.
Different approaches will be used for different people and will be based on an individuals needs and the severity of their condition.
Some treatment options recommended by NICE include cognitive behavioural therapy or graded exercise therapy for individuals with mild or moderate ME/CFS. The decision to proceed with either treatment will be made jointly by the patient and professional.