Chronic fatigue

Chronic fatigue is a disease that has not yet been defined in the generally accepted classifier - ICD. The term "chronic fatigue syndrome" has long been known to clinicians, its criteria have also been described. However, chronic fatigue has not yet been formalized as a separate nosological unit, and its symptoms are almost 100% the same as neurasthenia, which has its own code and cipher in ICD 10 - F48.048.0.

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Causes chronic fatigue

Chronic fatigue of unknown etiology was first described by the fragile nurse F. Nightingale. The girl went through the entire Crimean War without receiving a single serious injury, saving the lives of thousands of wounded soldiers. Three terrible war years undermined the health of the tireless and fearless nurse so much that upon returning home, she found herself bedridden. Doctors did not find a single pathology or clear reason to explain Florence's immobility. Thus, in 1858, the term "chronic fatigue syndrome" or chronic fatigue appeared. It is interesting that, being immobilized, the girl retained mental activity and continued her statistical research on mortality from wounds received in the war, and also wrote works on reforming military hospitals. Chronic fatigue itself began to be studied more closely only a hundred years later, when Europe and some American states were struck by a strange epidemic, similar in symptoms to chronic fatigue. Only in the 80s of the last century, chronic fatigue was included in the list of unstudied diseases and more serious scientific research of this phenomenon began. Among the latest outbreaks of chronic fatigue, one can note the mass illnesses of strong, trained and resistant to any impact - both physical and psychological, special forces. This happened in the 90s of the 20th century after the famous military operation over the Persian Gulf - "Desert Storm". Hundreds of combatants without obvious and explainable reasons fell ill with severe forms of depression, some were bedridden against the background of absolutely normal physical motor activity, there were also suicide attempts. It was impossible to attribute the causes of this epidemic to laziness or idleness, since hundreds of people showed similar symptoms and signs.

Chronic fatigue can affect people regardless of age, gender and social status. According to statistics, CFS occurs in 40 patients out of 100,000 diagnosed with neurasthenia. Chronic fatigue does not manifest itself in organ pathology, biochemical changes in the blood and decreased immunity. Both X-ray and ultrasound examination will most likely not reveal any noticeable deviations from the norm.

As a rule, those suffering from such an illness are given a general diagnosis - VSD (vegetative-vascular dystonia) or neurovegetative dystonia. Any therapy typical for the treatment of neuroses or VSD becomes ineffective over time. Then the question arises of confirming the diagnosis of chronic fatigue. If the period of diagnosis clarification lasts a long time, a noticeable deterioration in the patient's health may occur, up to mental disorders and cognitive functions of the brain. These obvious symptoms are already clearly visible on the electroencephalogram and CT (computer tomogram).

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Risk factors

Today, chronic fatigue is a disease of careerists and perfectionists, unlike the last century, when such a syndrome was considered a sign of laziness, and the condition itself was called "couch disease." Statistics say that chronic fatigue chooses the most energetic and active people, regardless of age. As a rule, these are people with higher education, age range from 20 to 55 years. Women get sick more often, apparently as a result of multifunctional loads, both external - social and domestic, and internal - mental and emotional. However, chronic fatigue is also observed in people who are not associated with an active lifestyle. Thus, the etiology of CFS remains a mystery, despite several recent versions popular in the medical world. These are the theory of viral etiology and the infectious version, which, however, have not yet been statistically confirmed. Also, some clinicians take the theory of general immune exhaustion as a basis. While doctors argue and debate about the causes and diagnostic criteria, chronic fatigue syndrome continues to endanger humanity, affecting an increasing number of people.

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Symptoms chronic fatigue

As a rule, in order to confirm the diagnosis of chronic fatigue, it is necessary to record at least two symptoms from the group of major signs and eight from the group of minor signs.

Main symptoms:

• Sudden weakness lasting more than three months and becoming chronic. Not controlled by adaptogens and stimulants (they can only worsen the condition, causing exhaustion);
• Rapid progression and increase of general fatigue, exhaustion;
• General decrease in work activity over the course of six months (more than two times);
• The absence of underlying pathologies and causes that etiologically explain such a condition as chronic fatigue and apathy.

Minor symptoms:

• Severe chronic fatigue after habitual physical and mental stress;
• Tremor of the limbs, fever at normal body temperature;
• Chronic pain in the throat, sensation of a lump;
• Swelling of the lymph nodes, often painful sensations in this area;
• Muscular asthenia, weakness;
• Muscle pain, myalgia;
• Insomnia or sleepiness (sleep disorder);
• Headaches of unknown etiology;
• Intermittent joint pain;
• Depressive state;
• Cognitive disorders – memory and attention impairment.
• Neuropsychiatric disorders – photophobia, lack of sensitivity to smells, and others.

The main, basic symptom is chronic fatigue lasting more than six months with a generally healthy body condition. Exhaustion is also clearly defined, which is diagnosed using applied methods (Schulte tables). Often the initial diagnosis sounds like hypo or hyperasthenia. A person is unable to cope with this serious illness on his own, no matter how hard he tries to activate his body with cigarettes, coffee, medicinal stimulants. There is also a decrease in body weight, and vice versa - obesity, as a compensatory factor.

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Treatment chronic fatigue

Chronic fatigue does not respond to any method that involves monotherapy. Treatment must be comprehensive and long-term. With all the unification of chronic fatigue symptoms and typical signs, the therapeutic strategy is always individual. However, the standard is the prescription of psychotropic drugs in minimal doses, selective serotonin reuptake inhibitors, tricyclic antidepressants. Support in the form of a complex of vitamins and microelements is considered auxiliary, but necessary. In addition, the use of polyunsaturated fatty acids in the treatment, immunotherapy gives a positive result. Glucocorticoids and L-DOPA can be prescribed in short courses. For pain symptoms, analgesics and non-steroidal anti-inflammatory drugs are prescribed. Course psychotherapy, physiotherapy consolidate the initial results and are mandatory components in the complex treatment of chronic fatigue syndrome. Chronic fatigue takes a long time to treat, but modern medicine hopes to find truly effective methods for its management after the true causes of the spread of this disease are determined.