A Comprehensive Update of the Current Understanding of Chronic Fatigue Syndrome

Abstract

: This is a comprehensive literature review of chronic fatigue syndrome (CFS). We provide a description of the background, etiology, pathogenesis, diagnosis, and management regarding CFS. CFS is a multifaceted illness that has many symptoms and a wide array of clinical presentations. As of recent, CFS has been merged with myalgic encephalomyelitis (ME). Much of the difficulty in its management has stemmed from a lack of a concrete understanding of its etiology and pathogenesis. There is a potential association between dysfunction of the autoimmune, neuroendocrine, or autonomic nervous systems and the development of CFS. Possible triggering events, such as infections followed by an immune dysregulation resulting have also been proposed. In fact, ME/CFS was first described following Epstein Barr virus (EBV) infections, but it was later determined that it was not always preceded by EBV infection. Patient diagnosed with CFS have shown a noticeably earlier activation of anaerobic metabolism as a source of energy, which is suggestive of impaired oxygen consumption. The differential diagnoses range from tick-borne illnesses to psychiatric disorders to thyroid gland dysfunction. Given the many overlapping symptoms of CFS with other illnesses makes diagnosing it far from an easy task. The Centers for Disease Control and Prevention (CDC) considers it a diagnosing of exclusion, stating that self-reported fatigue for at minimum of six months and four of the following symptoms are necessary for a proper diagnosis: memory problems, sore throat, post-exertion malaise, tender cervical or axillary lymph nodes, myalgia, multi-joint pain, headaches, and troubled sleep. In turn, management of CFS is just as difficult. Treatment ranges from conservative, such as cognitive behavioral therapy (CBT) and antidepressants, to minimally invasive management. Minimally invasive management involving ranscutaneous electrical acupoint stimulation of target points has demonstrated significant improvement in fatigue and associated symptoms in a 2017 randomized controlled study. The understanding of CFS is evolving before us as we continue to learn more about it. As further reliable studies are conducted, providing a better grasp of what the syndrome encompasses, we will be able to improve our diagnosis and management of it.

Mirogabalin as a Novel Gabapentinoid for the Treatment of Chronic Pain Conditions: An Analysis of Current Evidence

“…Fibromyalgia plagues between 1 to 6% of the world and requires treatment with both pharmacologic and lifestyle modalities ( 45 ). Given the success of mirogabalin with DPNP and PHN, it was expected to produce similar results in fibromyalgia.…”

Male vs. Female Differences in Responding to Oxygen–Ozone Autohemotherapy (O2-O3-AHT) in Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)

“…Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex pathology, and was recently reviewed in [ 1 ]. ME/CFS must be considered a serious and long-term syndrome, which is characterized by fatigue and debilitating muscular–skeletal pain, conditions that affect many fundamental aspects of people’s social habits [ 2 , 3 , 4 ]. Fatigue is a major symptom in ME/CFS and its treatment is accounted for in many forerunners in Italy [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ].…”

Neurofascial Dextrose Prolotherapy for Managing Chronic Ankle Ligament Injury

“…Chronic ankle ligament injury is a common problem in musculoskeletal clinics (1,2). Chronic ankle instability is a sequela of repeated sprains; however, it can happen after a single sprain, even after six years (3). Various methods have been introduced to treat ligamentous injuries (4,5), such as corticosteroid injection (6), platelet-rich plasma, prolotherapy (7), and even botulinum toxin injection (8) but the most effective treatment of ankle tendinopathy requires further investigations.…”