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Diagnosis and Differential Diagnosis
Published in Marc H. De Baets, Hans J.G.H. Oosterhuis, Myasthenia Gravis, 2019
The most frequent false positive diagnosis of MG is probably made in patients with a chronic fatigue syndrome,18,124 or a somatizing disorder, e.g., the recently defined postviral fatigue syndrome.125 In these patients the complaints of undue fatigue and exertion intolerance may be very impressive and have a fluctuation over the day or in longer periods. By careful testing no muscle weakness is demonstrable. These patients tend to have placebo reactions, e.g., to anticholinesterases.18,124
Postviral fatigue syndrome and creatine: a piece of the puzzle?
Published in Nutritional Neuroscience, 2022
Seeing a patient with postviral fatigue syndrome (PFS) is not an easy task for a health care provider. You can hardly discuss the cause of this condition, give sound advice on its course and prognosis, or prescribe an effective treatment, since the syndrome largely remains a mystery in terms of etiology, diagnosis, and medical care. From its discovery in 1950-s as a misterious Iceland disease1 to the present day, one thing we know for sure is that PFS (also known as chronic fatigue syndrome, or benign myalgic encephalomyelitis) is characterized by intense persistent fatigue, with a duration of over six months, and associated to other related symptoms (eg, muscle and joint pains, anxiety, cognitive and sleep disorders, intolerance to physical exertion).2 We also begin to realize that PFS is a relatively common condition, with the overall estimated prevalence is approximately 9 cases per 1,000 people according to the most commonly used definition criteria.3 Having this in mind, a health professional thus may come into contact with numerous patients with this perplexing condition asking difficult questions, with treatment options perhaps emerges as the most challenging. In the absence of approved pharmacological treatments or cure for PFS,2 a large portion of patients may turn to dietary supplements, including widely popular creatine. Do we have enough information to back up the use of creatine in PFS?