ME Myalgic encephalomyelitis, CFS 1.85/5 (27)

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CFS / ME, Chronic fatigue syndrome, Chronic fatigue syndrome ICD-10

Similar states: SFS / ME, Myalgic Encephalopathy (ME). Idiopathic Chronic Fatigue Syndrome (CFS), neurostasis.

Definition

ME is a disabling one exhaustion combined with a variety of other symptoms and duration for at least 4-6 months when other illness is excluded.

Disease Cause

Discussed and not proven. One assumes that several factors are important:

Symptoms

  • Often rapid onset, in some cases after upper respiratory infection
  • Disabeling fatigue
  • Duration of at least 46 months
  • Intense bothers at least half the time
  • Striking exhaustion (more than expected) after physical or mental effort
  • Sleep without being rested
  • Feeling of fever, but without measurable abnormal temperature
  • Impaired memory and concentration (Cognitive difficulty)
  • Sore throat and sore lymph nodes
  • Muscle- og joint pain
  • Increased sensitivity to light, smell and sound
  • Numbness

Diagnosis

Diagnose based on symptoms and exclusion of other illnesses. Frequently, diagnostic criteria are used. There are several editions. Current (1994, Fukuda) criteria here

Proposals for medical examination

Occurrence

Prevalence: 0,2 - 0,4% of adults, equivalent to 10-20.000 people in Norway. Most women. Less common in children. Incidence (new cases annually per 100.000 residents) in Norway (The Norwegian Institute of Public Health) is estimated at 39,4 / 100.000 among women and 12,9 / 100.000 among men. The disease is most common in the age group 10-19 years and 30-39 years.

Differential Diagnoses (a selection)

Other conditions that can explain a similar kind of exhaustion must be excluded.

Treatment

Early mobilization with custom, graduated activity management / graduated rehabilitation without overstimulation

    • Resting all day is not recommended. Resting in bed for more than 4 weeks can cause immunological disorders
  • If accompanying depression is present, it should be treated
  • Cognitive behavioral therapy for mobilization and better quality of life is recommended
  • Learning of coping strategies can be important
  • Customized stretching for muscles and joints combined with careful exercise or activity program is useful
  • The immunosuppressive biological drug rituximab (Rixathon / MabThera) did not show definite effect in a Norwegian study (preliminary results, 2017)

Medical prognosis

Good study data is missing.

  • Among adults, it is stated that 20 - 50% will improve during 1-3 years.
  • Among children, improvement is seen at 54 - 94% after 6 years (reference: Joyce J, 1997)

Pregnancy by ME

One study suggests that worsening, unchanged and improved condition are about as common during a pregnancy.

  • There do not appear to be any more pregnancy-related complications than expected from the population otherwise (reference: Typical RS, 2004)

Specialist in Health Region South East

  • Oslo University Hospital at the ME / CFS Center has an interdisciplinary offer for adults (over 18 years) with Myalgic Encephalopathy (ME) / Chronic Fatigue Syndrome (CFS). The outpatient service covers the Health Region South-East in Norway. The admission to the ward is nationwide.

Literature


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