yogabook / pathologie / chronic fatigue syndrome cfs

Chronic fatigue syndrome CFS / chronic fatigue syndrome / chronic fatigue syndrome / myalgic encephalomyelitis (ME)

Definition of

Chronic illness with a leading symptom of unusually rapid physical and mental exhaustion. The main and secondary criteria defined by Carruthers et al. from the revision of the Canadian consensus document are the recognized standard. To make a diagnosis, the main criterion puls 7 of the 13 secondary criteria must be present:

Main criterion

1. neuroimmunological exhaustion after exertion / post-exertional neuroimmune exhaustion, PENE

Secondary criteria

1. 1. neurological impairments (at least one symptom from each of three of the following categories)
2. 1.1. neurocognitive impairments, e.g. information processing or short-term memory
3. 1.2 Pain: headaches, pain in muscles, tendons, joints, abdominal or chest area
4. 1.3 Sleep disorders: disturbed sleep patterns, non-restorative sleep
5. 1.4. neurosensory perception or movement disorders
6. 2. immunological, gastrointestinal, urogenital disorders (at least one symptom from each of three of the following categories)
7. 2.1. flu-like symptoms, chronic or recurrent, activated or aggravated by stress
8. 2.2 Susceptibility to viral infections, prolonged recovery phases
9. 2.3. gastrointestinal complaints
10. 2.4. Urogenital complaints
11. 2.5 Intolerance to food, medication, odors or chemicals
12. 3. impairment of energy production/transport (at least one symptom)
13. 3.1. cardiovascular, e.g. orthostatic intolerance
14. 3.2. respiratory-related
15. 3.3 Loss of thermostability (feeling cold, hot flushes etc.)
16. 3.4 Intolerance to temperature extremes

A discussion proposal by the Institute of Medicine / National Academy Of Medicine from 2015 provides for 3 main criteria, all of which must be met, plus a secondary criterion:

1. Main criterion: significant impairment of the ability to carry out professional, educational, social and personal activities as before the illness, which lasts for at least 6 months and is accompanied by fatigue that is a) often severe or b) new or with c) a definite onset.

Secondary criteria:

1. Cognitive impairment
2. Orthostatic intolerance, i.e. difficulty remaining in an upright position for long periods of time.

In order to be able to make a diagnosis, the symptoms must be of sufficient severity, i.e. the activity level must be no more than 50% of the level before the illness. The 2011 criteria catalog provides for 4 degrees of severity:

1. 1. mild: about 50 percent reduction in activity level
2. 2. moderate: mostly housebound
3. 3. severe: usually confined to bed
4. 4. very severe: completely confined to bed, dependent on help with basic activities

ICD 93.3

Cause

1. unknown

Predisposing

1. unknown

Symptoms

1. (see criteria)

Therapy

1. A causative therapy is not yet known. Treatment is symptomatic.
2. Physical activities as a therapeutic tool should be used with extreme caution, as they can sometimes lead to overload or aggravation. Programs with physical activities require the willingness of those affected to expand their activities beyond the current level.
3. Cognitive behavioral therapy (coping)
4. In a meta-analysis, the median proportion of complete recoveries was 5% and the median proportion of those returning to work was 39.5%. A maximum of 8-63% achieved at least partial recovery.