Diagnosis of Chronic Fatigue Syndrome

Diagnosis

When a person complains of chronic fatigue, taking a medical history and performing a physical examination are the most important steps. In addition, an evaluation of the individual’s mental state should also be carried out. When chronic fatigue is reported, it is necessary to carefully assess the possibility of underlying psychiatric conditions, including depression. In patients with chronic fatigue, it is important not to rely only on diagnostic tests; the patient’s medical history and symptoms must be carefully understood so that appropriate examinations and tests can be performed to identify the exact cause. To determine the disease causing the fatigue symptoms, laboratory screening tests and other clinically suspected tests are performed together.

Diagnostic tests may include related blood and urine tests and X-ray imaging, and if necessary, depending on the attending physician’s judgment, various other tests such as stress and autonomic nervous system tests, EEG, mental status tests, exercise capacity assessment, orthostatic hypotension testing, and cerebral blood flow testing may be included.

1. Diagnosis of Chronic Fatigue Syndrome There is still no special test developed to diagnose chronic fatigue syndrome. Therefore, as explained above, if chronic fatigue symptoms continue even after efforts to identify the cause, the diagnosis is made using the so-called exclusion diagnosis method—confirming that the symptoms are not fatigue caused by another cause—and by using the characteristics of the symptoms. The following are the diagnostic criteria for chronic fatigue syndrome that are currently most widely used.

Diagnostic Criteria for Chronic Fatigue Syndrome (1994 Centers for Disease Control and Prevention case definition)

▶ Step 1 · Feeling chronic fatigue symptoms that persist or recur for 6 months or longer · No specific cause is found even after examination and testing at a hospital · Fatigue symptoms do not improve even with 충분한 rest and reduced workload · Work performance is significantly reduced compared with before because of the fatigue symptoms In such cases, chronic fatigue syndrome should be suspected first.

▶ Step 2 People with the above symptoms especially have · Decreased memory or concentration · Sore throat · Muscle pain · Joint pain (without swelling or redness in the joint area) · Enlarged and painful lymph nodes in the neck or armpits · A new type of headache different from usual · A feeling of not being refreshed even after sleeping and waking up · Unusually severe fatigue lasting more than 24 hours after exercise, unlike usual If 4 or more of the above symptoms are present continuously or recur for 6 months or longer, chronic fatigue syndrome can be diagnosed.

▶ If a patient with chronic fatigue of unknown cause does not meet the above criteria,     it is classified as idiopathic chronic fatigue.

So far, I have explained the diagnosis of chronic fatigue syndrome. In the next part, we will look at the treatment of chronic fatigue syndrome.

Source: Korea Disease Control and Prevention Agency National Health Information Portal