Chronic Fatigue Syndrome1分析课件.ppt

Manasa Manapragada, PGY-3 CFS is a disabling illness which is characterized by persistent physical and mental fatigue. It is accompanied by rheumatologic, cognitive, and infectious-appearing symptoms. Can begin as early as age 5 Affects both genders, all racial, ethnic and socioeconomic populations These patients function at a much lower level than prior to diagnosis Clinically evaluated, unexplained, persistent, or relapsing fatigue that is: Of new or definite onset Not a result of ongoing exertion Not alleviated by rest Results in a substantial reduction in previous levels of occupational, social, or personal activity Four or more of the following symptoms that persist or recur during 6 or more consecutive months of illness and that do not predate the fatigue: Self-reported impairment of short-term memory or concentration Sore throat Tender lymph nodes Muscle pain Multi-joint pain without swelling or redness Headaches of a new type, pattern, or severity Unrefreshing and/or interrupted sleep Postexertion malaise (a feeling of general discomfort or uneasiness) lasting more than 24 hours Active, unresolved or suspected disease that is likely to cause fatigue (anemia, hypothyroidism, lupus or other inflammatory conditions, cancer, seizures, cardiopulmonary disease, HIV or known chronic infectious process, etc.) Psychotic, melancholic, or bipolar depression (but not uncomplicated major depression) Psychotic disorders Dementia Anorexia or bulimia nervosa Alcohol or other substance misuse Severe obesity Severe disabling fatigue of at least a 6-month duration that: Affects both physical and mental functioning Is present for more than 50% of the time Other symptoms, particularly myalgia and sleep and mood disturbances, may be present.  Same exclusion criteria Pain (almost universal in chronic fatigue) Allergies Chemical sensitivities Secondary infections, including Candida and viral infections Cognitive impairment, including short-term memor