How is CFS diagnosed?
Doctors find it difficult to diagnose CFS because it has the same symptoms as many other diseases. When talking with and examining you, your doctor must first rule out diseases that look similar, such as multiple sclerosis and systemic lupus erythematosus in which symptoms can take years to develop. In follow-up visits, you and your doctor need to be alert to any new cues or symptoms that might show that the problem is something other than CFS. When other diseases are ruled out and if your illness meets other criteria as well, your doctor can diagnose you with CFS (see The CFS Case Definition). The CFS Case Definition The EBV work sparked new interest in the syndrome among a small group of medical researchers. They realized they needed a standard way to describe CFS so that they could more easily compare research results. In the late 1980s, CDC brought together a group of CFS experts to tackle this problem. Based on the best information available at the time, this group published in th
When evaluating patients with chronic fatigue of unknown origin, physicians can use the following definition of CFS as a guide. This detailed definition was developed for research use under the leadership of the Centers for Disease Control. It was published in the “Annals of Internal Medicine” in March 1988. Because the disease is still poorly understood, however, the outlined criteria should be considered provisional. The definition is as follows: • New onset of persistent or relapsing fatigue, with at least 50 percent reduction of activity level for at least 6 months. • Exclusion of other conditions through History, Physical Examination and Laboratory Examination. • 6 of the following 11 symptoms: • Mild fever • Sore throat • Painful lymph nodes • Muscle weakness • Muscle pain • Prolonged fatigue after exercise • Headaches • Joint pain • Neuropsychologic complaints • Sleep disturbance • Acute onset of symptoms • And 2 of 3 signs on physical examination: • Low grade fever • Throat inf
Doctors find it difficult to diagnose CFS because it has the same symptoms as many other diseases. When talking with and examining you, your doctor must first rule out diseases that look similar, such as multiple sclerosis and systemic lupus erythematosus in which symptoms can take years to develop. In follow-up visits, you and your doctor need to be alert to any new cues or symptoms that might show that the problem is something other than CFS. When other diseases are ruled out and if your illness meets other criteria as well, your doctor can diagnose you with CFS (see The CFS Case Definition). EDITOR’S NOTE: The following information, “Diagnostic Criteria” and “Possible Causes” is from the Life Extension Foundation (LEF) website and was updated in March 2003. DIAGNOSTIC CRITERIA CDC Criteria Oxford Criteria Additional Symptoms Laboratory Tests The criteria for diagnosing CFS were officially defined by the CDC in 1988 and revised in 2001 (CDC 2001). The Oxford criteria differ slightly.
To date, no cause or causes of CFS have been identified and no specific diagnostic tests are available. There are treatable conditions that have symptoms similar to CFS, so conditions such as mononucleosis, Lyme disease, thyroid disorders, diabetes, multiple sclerosis, some cancers, depression, and bipolar disorder must be ruled out. To receive a diagnosis of CFS, a patient must: • Have severe chronic fatigue of six months or longer duration with other known medical conditions excluded by clinical diagnosis; and • Concurrently have four or more of the following symptoms: substantial impairment in 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 sleep; and post-exertional malaise lasting more than 24 hours. Interestingly, regarding the issue of sleep, an article published on December 5, 2007 in BMC Neurology concluded that while people with CFS report
