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Tiredness/fatigue in adults - Management
When should I suspect chronic fatigue syndrome/myalgic encephalomyelitis or encephalopathy?
- In adults, suspect chronic fatigue syndrome (CFS)/myalgic encephalomyelitis or encephalopathy (ME) if both of the following criteria are met:
- The person has fatigue that has all of the following features:
- Persistent (for 4 months or longer) or recurrent.
- New or had a specific onset (that is, it is not lifelong).
- Unexplained by other conditions (including body mass index greater than 40 kg/m2).
- Has resulted in a substantial reduction in activity level.
- Characterized by post-exertional malaise and/or fatigue (typically delayed, for example by at least 24 hours, with slow recovery over several days).
- The person has one or more of the following symptoms:
- Difficulty with sleeping (such as insomnia, hypersomnia, unrefreshing sleep, or a disturbed sleep-wake cycle).
- Muscle or joint pain that is multi-site and without evidence of inflammation.
- Headaches.
- Painful lymph nodes without pathological enlargement.
- Sore throat.
- Cognitive dysfunction (such as difficulty thinking, inability to concentrate, impairment of short-term memory, and difficulties with word-finding, planning/organizing thoughts, and information processing).
- Physical or mental exertion makes symptoms worse.
- General malaise or flu-like symptoms.
- Dizziness or nausea.
- Palpitations in the absence of identified cardiac pathology.
- The diagnosis of CFS/ME should be reconsidered if none of the following features are present:
- Post-exertional fatigue or malaise.
- Cognitive difficulties.
- Sleep disturbance.
- Chronic pain.
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