Chronic fatigue syndrome (CFS or ME) [2]
CFS was sometimes used contemptuously "the yuppie disease" because it was thought that she was a young, hardworking, career oriented people hit. It is now evident:
• that most patients between 20 and 50 years old, but the disease also occurs in children aged 7 years;
• that CFS is more common among women (about 1 man 3 women);
• the disease in all socioeconomic groups of songs, but something more teachers and medical and paramedical professions;
• that CFS patients often have a very active, busy and quite stressful lives.
Causes
About the causes of CFS are different theories, but none provides a conclusive proof.
• A possible hypothesis is that CFS is caused by a yet-unidentified virus which activates the immune system constantly.
There are indeed many known viruses during the infection period, a strong fatigue. Of some viruses such as Epstein-Barr virus (better known as mononucleosis or kissing the disease) are known to cause exceptionally a chronic active infection, with persistent fatigue as a result. Correlations between Epstein-Barr and CFS, and between CFS and other known viruses such as Herpes type 6 and HIV and a number of enteroviruses, have been extensively studied, but not a causal link could be established.
• Although so far no "CVS virus could be identified, allowing the possibility that a virus, or even another transient trauma, a chronic reaction of the immune system. This means that the immune system remains constantly active even when the infection is over. Abnormally high doses of immune-activating factors - some indeed can cause fatigue, would result in the bloodstream and lead to chronic exhaustion.
Moreover, very recent research has shown that the organ systems in which the patient complains, the most muscles, the immune system, blood system-persistent viruses are found. Pathogenic viruses in healthy individuals are relatively short term (several weeks or months) evacuated, while the viruses in CFS patients a long time, even years after the infection, persist.
• Other theories go back in the direction of endocrine disorders, or search for psychological factors.
• And finally, it remains possible that CFS is caused by a single, as yet unknown factor.
Diagnosis
There is no test to the diagnosis of CFS can be stated unequivocally.
The doctor will also be good in the first place to listen to his / her patient, and the complaints he / she sets against the standard criteria (see above).
The most common symptoms of CFS are:
• The disease began suddenly, but was usually preceded by an infection (flu-like illness, pharyngitis, gastroenteritis ...);
even a minimal effort causes extreme fatigue in the muscles (myalgia), which we only slowly recovering. Often they also suffer from involuntary muscle contractions;
• one can not, or only part-time work;
• headache
• cognitive disorders such as concentration and attention problems, memory loss, difficulty speaking (mistake in words). Together these symptoms are a reduction of intellectual potential;
• Large fluctuations in the fitness condition: one is not tired all day;
one-to-patient exaggerated physical or intellectual effort may provoke a flare;
• an overactivity of the autonomic nervous system, eg, frequent urination (heart) palpitations, etc.;
• flu-like symptoms that occasionally flare up, with sore throat and painful swollen lymph nodes;
• distorted body with night sweats, cold extremities (fingers, toes ...) and sometimes mild fever and chills;
• sleep disorders (in the initial phase, sleepiness, and then fall asleep and / or sleep);
• poor fine motor skills and balance disorders that worsen at night;
• disorders of the senses to paresthesia (itching and tickling)
• tinnitus (noise observations) and photophobia (photophobia);
• pronounced alcohol intolerance;
• emotional labliteit;
• atypsiche depression (not a true depression), sometimes with depersonalization (self-alienation) and disorientation;
• IBS.
In a second phase, the doctor will try to objectify the complaints by a clinical examination. In most cases, this however, but little result.
• In some patients, they propose that a-true-atypical strep throat and swollen lymph nodes down.
• The neurological examination often shows an abnormal Romberg test to (falter and tendency to fall when we closed feet and eyes straight to it) and sometimes involuntary muscle contractions, other neurological signs are only for when the disease was preceded by an infection that also central nervous system is affected.
• The weakness can be clearly determined by a effort, but not at rest.
• Blood pressure is usually low.
• Usually, the clinical examination supplemented by a number of routine investigations such as laboratory tests of blood, an echocardiogram or rhythm examination of the heart (ECG), an EEG (electro-cardiogram), a radiograph of the chest (RX thorax), a spinal puncture, a brain scan, an MR examination of the brains (magnetic resonance) ...
These and other studies are also useful for other precipitating causes of chronic fatigue (eg MS) to exclude.
