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Discussion:
Newcomers how to diagnosis CFS - the steps
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This is the Canadian diagnostic criteria. In the US the CDC is being pressured to revise their current criteria.

Canadian Diagnostic Criteria for Chronic Fatigue
From the Canadian Consensus Document:

A patient with ME/CFS will meet the criteria for fatigue, post-exertional malaise and/or fatigue, sleep dysfunction, and pain; have two or more neurological/cognitive manifestations and one or more symptoms from two of the categories of autonomic, neuroendocrine, and immune manifestations; and adhere to item 7 [below].

1. Fatigue
The patient must have a significant degree of new onset, unexplained, persistent, or recurrent physical and mental fatigue that substantially reduces activity level.

2. Post-Exertional Malaise and/or Fatigue
An inappropriate loss of physical and mental stamina, rapid muscular and cognitive fatigability, post-exertional malaise and/or fatigue and/or pain and a tendency for other symptoms to worsen. The recovery period is pathologically slow -- usually 24 hours or longer.

3. Sleep Dysfunction
Unrefreshing sleep or sleep quality, or rhythm disturbances such as reversed or chaotic sleep rhythms.

4. Pain
A significant degree of pain, which can be in the muscles and/or joints, and is often widespread and migratory. Often, there are headaches of a new type, pattern or severity.

5. Two or more of the following neurological/cognitive manifestations:
* Confusion
* Impairment of concentration and short-term memory consolidation
* Disorientation
* Difficulty with information processing
* Categorizing and word retrieval
* Perceptual and sensory disturbances (such as spatial instability and disorientation, inability to focus vision)
* Ataxia (inability to coordinate muscular movement), muscle weakness or twitching
* Cognitive, sensory or emotional overload, which may cause a crash or anxiety

6. At least 1 symptom from two of the following categories:
* Autonomic manifestations, including: neurally mediated hypotension, postural orthostatic tachycardia syndrome, delayed postural hypotension, light-headedness, pallor, nausea and irritable bowel syndrome, urinary frequency and bladder dysfunction, palpitations with or without cardiac arrhythmias, exertional dyspnea (difficult or labored breathing)
* Neuroendocrine manifestations, including: subnormal body temperature and marked temperature fluctuation, sweating episodes, recurrent feelings of feverishness and cold extremities, intolerance of extreme heat or cold, marked weight change (anorexia or abnormal appetite), loss of adaptability and worsening of symptoms with stress
* Immune manifestations, including: tender lymph nodes, recurrent sore throat, recurrent flu-like symptoms, general malaise, or new sensitivities to food, medications and/or chemicals.

7. Illness persists for at least 6 months
Onset is usually distinct but may be gradual. In children, only 3 months is needed for a diagnosis.

The criteria also state that a small number of patients have no pain or sleep dysfunction but fit no other diagnosis. Those people can be diagnosed with ME/CFS if they had an infectious illness at onset.
Posted on 06/16/09, 11:32 pm
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