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Chronic Fatigue Syndrome Diagnosis

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Chronic Fatigue Syndrome Diagnosis

  • Diagnosis
  • CDC Criteria (1994)
  1. Major Criteria (both criteria required)
    1. Severe Fatigue >6 months
      1. Persistent or relapsing in course
      2. Does not resolve with bed rest
      3. Significant reduction in average daily activity (below 50% of prior activity)
    2. Other causes excluded
      1. See Fatigue Causes
  2. Minor Criteria (4 or more present for 6 months)
    1. Headache
      1. New type, severity or pattern
      2. Typically non-focal Headache
    2. Migratory Polyarthralgias
      1. Non-inflammatory (no swelling or erythema)
    3. Myalgias
    4. Postexertional malaise or Fatigue
      1. Duration >24 hours
    5. Short-term memory or concentration impaired
    6. Pharyngitis
    7. Tender cervical or axillary adenopathy
    8. Non-restorative sleep
  3. References
    1. Fukada (1994) Ann Intern Med 121(12): 953-9 [PubMed]
  • Diagnosis
  • Oxford Criteria
  1. Fatigue is primary symptom
  2. Timing
    1. Onset at a definite point in time
    2. Duration 6 months or greater
    3. Present at least 50% of time
  3. Severity
    1. Severe and disabling
    2. Affects physical and cognitive functioning
  4. Associated symptoms (at least one must be present)
    1. Myalgias
    2. Mood Disorder
    3. Sleep disorder
  5. Symptoms not due to alternative diagnosis
    1. Established medical condition known to cause Fatigue
    2. Established neurologic or psychiatric disorder
      1. Schizophrenia
      2. Bipolar Disorder
      3. Substance Abuse
      4. Eating Disorder
      5. CNS disorder
  6. References
    1. Sharpe (1991) J R Soc Med 84(2): 118-21 [PubMed]
  • Diagnosis
  • Old CDC Criteria - modification history
  1. Earlier CDC 1988 guidelines required 6 minor criteria
    1. Included those listed above
    2. Other criteria present in prior guidelines
      1. Initial symptom onset acute or subacute
      2. Mild fever (37.5 - 38.6 Celsius) or chills
      3. Generalized Muscle Weakness
      4. Neuropsychiatric Symptoms
        1. Photophobia
        2. Transient visual scotomata
        3. Excessive irritability
        4. Confusion
        5. Difficult thinking
        6. Inability to concentrate
        7. Major Depression
  2. Earlier CDC 1988 guidelines required physical sign documentation
    1. Prior guidelines (not required by CDC)
      1. Two or more signs must be documented
      2. Physician must document each sign twice
      3. Signs must be present for longer than 1 month
    2. Criteria
      1. Low grade fever (37.6 - 38.6)
      2. Non-exudative Pharyngitis
      3. Palpable or tender lymph nodes (size <2 cm)
        1. Anterior or Posterior Cervical Lymphadenopathy
        2. Axillary Lymphadenopathy
  3. References
    1. Holms (1988) Ann Intern Med 108:387-9 [PubMed]
    2. Levine (1997) Am J Med 105:35 [PubMed]