General Medicine

Chronic Fatigue Syndrome

Clinically-evaluated, unexplained, persistent or relapsing fatigue for 6 or more months that is of new or definite onset; not the result of ongoing exertion. not substantially alleviated by rest; resulting in substantial reduction of previous activity level; and concurrent occurrence of 4 or more of the following symptoms during at least 6 consecutive months and not predating the fatigue impairment of memory or concentration, sore throat, tender lymph nodes, multiple joint pains without arthritis, new headaches, unrefreshing sleep and postexertional malaise. CFS is a diagnosis of exclusion. Inquire about important disease-specific symptoms, as subsequent investigations will be based on them. The history and physical examination should focus on discovering alternative organic causes for the patient's symptoms.

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