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Chronic Fatigue Syndrome/ Myalgic Encephalomyelitis in Children and Young People
Published in Cathy Laver-Bradbury, Margaret J.J. Thompson, Christopher Gale, Christine M. Hooper, Child and Adolescent Mental Health, 2021
Fatigue with all of the following featuresNew, or had a specific onset, i.e. not life-long Persistent and/or recurrentUnexplained by other conditionsHas resulted in a substantial reduction in activity level, characterised by post-exertional malaise and/or fatigue, typically delayed by at least 24 hours, with slow recovery over several days
Fibromyalgia Syndrome: Canadian Clinical Working Case Definition, Diagnostic and Treatment Protocols–A Consensus Document
Published in I. Jon Russell, The Fibromyalgia Syndrome: A Clinical Case Definition for Practitioners, 2020
Anil Kumar Jain, Bruce M. Carruthers, Maijorie I. van de Sande, Stephen R. Barron, C. C. Stuart Donaldson, James V. Dunne, Emerson Gingrich, Dan S. Heffez, Y.-K. Frances Leung, Daniel G. Malone, Thomas J. Romano, I. Jon Russell, David Saul, Donald G. Seibel
Post-exertional malaise: Patients typically exhibit post-exertional fatigue and a sense of weakness with an increase in body pain and stiffness. For this reason, patients are often hesitant to exert themselves to avoid the consequences (281). It may take an inordinate amount of time for patients to regain the premorbid levels of physical function, mechanical competence, and confidence in their own abilities.
Musculoskeletal disorders (and rheumatology)
Published in Shibley Rahman, Avinash Sharma, A Complete MRCP(UK) Parts 1 and 2 Written Examination Revision Guide, 2018
Shibley Rahman, Avinash Sharma
The main features which need to be present to confirm a diagnosis are fatigue that: is new in onset, persistent or recurrent and unexplained by other conditionsis characterised by post-exertional malaiseresults in a substantial reduction in activity level
An exercise immune fitness test to unravel mechanisms of Post-Acute Sequelae of COVID-19
Published in Expert Review of Clinical Immunology, 2023
The PASC Syndrome is a phenotypically ill-defined and continuously evolving clinical syndrome the characterization of which is considered by some authors to be primarily driven by patient self-reported symptoms [43]. PASC is a debilitating syndrome with onset three months post COVID-19 infection. This sub-population of survivors of acute COVID-19 infection develop, often with a time-lag of >3 months, a highly variable phenotype with >200 described symptoms, of which fatigue, headache, cognitive dysfunction, post-exertional malaise, orthostatic intolerance, and dyspnea are among the most prominent ones. In a population of more than 20 million adults in the U.S. who currently have PASC, more than 80% are so debilitated that they cannot function in their activities of daily living [44]. A related phenotype, hyperventilation-induced hypocapnia, is characterized by a multitude of extremely disabling symptoms such as exertion-induced dyspnea, tachycardia, chest pain, fatigue, dizziness and syncope [45]. A considerable phenotypic overlap exists between PASC and Myalgic-Encephalopathy/Chronic Fatigue Syndrome (ME/CFS). In people with ME/CFS, exercise can cause serious setbacks and deterioration in function [46]. Post-exertional malaise (PEM) appears to be a common and a significant challenge for the majority of this patient group [47].
Evaluating case diagnostic criteria for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): toward an empirical case definition
Published in Disability and Rehabilitation, 2023
Karl E. Conroy, Mohammed F. Islam, Leonard A. Jason
We found support for four out of the five symptom categories contained in the IOM [2] criteria (post-exertional malaise, sleep problems, cognitive dysfunction, and orthostatic intolerance), with items relating to fatigue loading onto the post-exertional malaise factor. However, our analyses produced additional symptom factors not found in the IOM, such as gastro-intestinal distress and circulatory/neuroendocrine dysfunction (see Tables 2 and 3). Furthermore, we found no justification for the IOM's inclusion of cognitive impairment and orthostatic intolerance as an and/or criterion. Among the participants in our sample, the majority of those who reported orthostatic intolerance also reported cognitive impairment (96.4%; 1569 of 1627). Thus, only 3.6% of participants (58 of 1627) would be able to meet the IOM criteria by reporting orthostatic intolerance without accompanying symptoms of cognitive impairment. Our judgment is that including cognitive impairment as a required symptom distinct from orthostatic intolerance is not only more parsimonious but represents a more salient symptom of ME/CFS.
Fatigue in ANCA-associated vasculitis (AAV) and systemic sclerosis (SSc): similarities with Myalgic encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). A critical review of the literature
Published in Expert Review of Clinical Immunology, 2022
Charmaine van Eeden, Mohammed S. Osman, Jan Willem Cohen Tervaert
The lack of drug interventions has resulted in implementing non-pharmacological management strategies for patients with ME/CFS. Energy conservation is an important feature in ME/CFS management as patients who overexert and surpass their energy stores have subsequent ‘crashes’ resulting in multiple days in bed trying to recover. This feature is captured in the most recent classification criteria for ME/CFS [33,122], under post-exertional malaise. Exercise is only advised in patients who are coping with their current daily activities, in severely ill patients, that act of taking a shower may be all the exercise they can handle [20]. Patients, who have learned how to pace their activity and take breaks to conserve their energy, have been shown to reduce their overall fatigue severity [20,123]. Improved sleep habits and pacing mental activities may also aid in symptoms of fatigue and cognitive dysfunction [20]. Pain, cardiovascular, and gastrointestinal symptoms should be addressed on a symptomatic basis. Patient support is key in ME/CFS, validation of their symptoms and monitoring of their mental health is important in establishing patients who are able to successfully cope with their diagnosis [20].