Chronic Fatigue Syndrome (CFS) or Systemic Exertion Intolerance Disease (SEID)

  • Medical Author:
    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

  • Medical Editor: Jerry R. Balentine, DO, FACEP
    Jerry R. Balentine, DO, FACEP

    Jerry R. Balentine, DO, FACEP

    Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

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Quick GuideChronic Fatigue Syndrome (CFS) Symptoms, Diagnosis, and Treatment

Chronic Fatigue Syndrome (CFS) Symptoms, Diagnosis, and Treatment

What are risk factors for CFS/SEID?

Without knowing the cause of CFS/SEID, it is difficult to determine risk factors. However, statistics gathered about people with diagnosed CFS/SEID do tell something about some high-risk groups. For example, although people of every age, gender, race, and economic group can get CFS/SEID, it is most commonly diagnosed in people in the 40- and 50-year-old age group. In addition, CFS/SEID is diagnosed about four times as often in women (some investigators consider menopause as a possible risk factor). In the pediatric-aged group, teens are most often affected.

What are systemic exertion intolerance disease or chronic fatigue syndrome symptoms and signs?

The symptoms and signs of CFS/SEID are complex but specific. The patient must have severe chronic fatigue of six months or longer duration with other known medical conditions excluded by clinical diagnosis. In addition, the patients have four or more of the following symptoms that either occurred at the same time or after the severe chronic fatigue. The symptoms are substantial impairment in short-term memory or concentration; sore throat; tender lymph nodes; muscle pain; multi-joint pain without swelling or redness; headaches of a new type, pattern, or severity; unrefreshing sleep; and post-exertion malaise lasting more than 24 hours. Patients may often have additional symptoms such as double vision, mild fevers, earaches, diarrhea, and many other symptoms, but they do not fit into the criteria that are considered to be part of the definition of CFS.

The following are five main symptoms that the new IOM considers key for SEID or CFS:

  • Reduction or impairment in ability to carry out normal daily activities, accompanied by profound fatigue
  • Post-exertional malaise (worsening of symptoms after physical, cognitive, or emotional effort)
  • Unrefreshing sleep
  • Cognitive impairment
  • Orthostatic intolerance (symptoms that worsen when a person stands upright and improve when the person lies back down)
Medically Reviewed by a Doctor on 2/27/2015

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