Myalgic Encephalomyelitis (ME) – or Chronic Fatigue Syndrome (CFS) – is a multi-system disorder that baffles healthcare workers in India to this day. With a broad range of symptoms, poor data on existing cases, and no research specific to the country, CFS has been challenging to diagnose and treat.
Marking World Chronic Fatigue Syndrome Awareness Day this year with a Practo Connect webinar on the subject, we got together with two experts to help us understand this condition better. Practo Connect – an educational webinar series exclusively for the doctors, by the doctors – aims to provide practical guidance to medical professionals, and our 13th edition will delve into CFS.
Given that there is no consensus among healthcare professionals on whether or not it is a rheumatic disorder or a neurological ailment, we discussed this from both angles with the help of Dr (Lt Gen) Ved Chaturvedi – Sr Consultant – Rheumatology, Gangaram Hospital, New Delhi – and Dr Joy Dev Mukherji – Sr Consultant – Neurology, Max Super Specialty Hospital, New Delhi.
“CFS can best be described as a situation which we don’t know how to diagnose,” says Dr Mukherji, adding, “The constellation or combination of symptoms that accompany it are so vague that even in 2021, we still don’t know much about this disease.”
Describing further, Dr Chaturvedi says, “Since there are no blood or lab tests that can help us identify CFS in a patient, we have to solely rely on clinical judgement to diagnose them.”
What is Chronic Fatigue Syndrome?
CFS is characterized by extreme fatigue or tiredness, which does not cease with rest and cannot be explained by an underlying medical condition. Dr Mukherji summarizes its symptoms in five succinct points:
- Unusual, unexplained fatigue that lasts for more than six months
- Post-exertional malaise and sleep disturbance
- Orthostatic intolerance whereby patients feel dizzy when they walk or stand
- Cognitive dysfunction, short-term memory loss, confusion, unexplained lack of judgment, and inability to speak the right words at the right time
- Unexplained chronic pain
“The range of symptoms are so broad among people that it can be quite confusing,” says Dr Chaturvedi. “They usually last for more than six months, and the onset can be sudden, triggered by a flu-like sickness and after infection by viral and non-viral pathogens,” he adds.
According to him, even if this predominantly affects people in the age group of 40 to 50, with women being more susceptible to be diagnosed than men, it can also affect adolescents. Adds Dr Mukherji,“Other factors like genetic predisposition, allergies, stress and environmental factors can also increase the risk of contracting this condition. Although there is no cure for CFS, there are treatment options that focus on symptom relief, which differ from patient to patient.”
Given the challenges in correctly diagnosing CFS, many doctors encourage the practice of managing symptoms early without waiting for a diagnosis. The most disruptive or disabling symptoms should be addressed first with the help of cognitive behavioural therapy, graded exercise therapy, activity management, sleep management, rest and relaxation, diet, and other specialist care depending on the patient’s needs, symptoms (type, duration, complexity, severity) and comorbidities.
Join us every month as we partner with leading industry and doctor associations for our educational webinar series, Practo Connect. Watch this, as well as previous webinars, here.