Myalgic Encephalomyelitis / Chronic Fatigue Syndrome Information (2018)

Centers for Disease Control and Prevention

Reviewed and summarized by Medscape editors

August 09, 2018

The information about myalgic encephalomyelitis / chronic fatigue syndrome was released on July 12, 2018, by the CDC.[1,2]

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex, chronic, debilitating disease with systemic effects. ME/CFS is characterized by reduced ability to perform pre-illness activities that lasts for more than 6 months and is accompanied by profound fatigue, which is not improved by rest.

A hallmark of ME/CFS is that symptoms can worsen after physical, mental, or emotional effort, a manifestation known as postexertional malaise (PEM). Patients with ME/CFS also have unrefreshing sleep.

Other common manifestations are orthostatic intolerance, cognitive impairment, and pain. As can be observed in people with other long-term chronic illnesses, secondary psychological symptoms such as depression and anxiety may also be present in some patients with ME/CFS.

Onset of illness can be either acute or gradual. Acute onset may follow an infectious-like syndrome (eg, fever, malaise, aching muscles, respiratory or gastrointestinal symptoms) or a specific acute infection (eg, acute infectious mononucleosis from a new infection with Epstein-Barr virus). The illness also may follow other trauma such as car accidents or surgery. Gradual onset can occur over months or years.

Patients frequently experience a substantial impairment in both physical and mental function at some point in their illnesses.

There are no confirmatory tests, cures, or drugs approved by the FDA specifically for ME/CFS. While some patients and healthcare providers have reported improvement in ME/CFS after use of off-label or unlicensed medications, the efficacy of these medicines has not been tested in multiple, large, well-controlled clinical trials.

While many biological abnormalities have been reported in patients with the illness, none of these “biomarkers” have a sufficiently low false negative and false positive rate to constitute a diagnostic test. A healthcare provider can make the diagnosis of ME/CFS based on a thorough medical history and physical examination, laboratory test results, and evaluating for other fatiguing illnesses with a targeted work-up.

Comorbid conditions are often present and may include sleep disorders, irritable bowel syndrome, fibromyalgia, depression, or anxiety. The presence of these conditions does not exclude the diagnosis of ME/CFS.

Helping patients get relief from symptoms and achieve improvement in quality of life are the main goals of treatment.

Each patient’s program typically includes a combination of therapies to address symptoms, techniques to help patients cope, and strategies to manage daily activities.

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