DVBCWFS1 ;ALB/CMM CHRONIC FATIGUE SYNDROME WKS TEXT - 1 ; 6 MARCH 1997
 ;;2.7;AMIE;**12**;Apr 10, 1995
 ;
 ;
TXT ;
 ;;Narrative:  Chronic fatigue syndrome (CFS) is an illness characterized
 ;;by debilitating fatigue and several flu-like symptoms.  It may have 
 ;;both physical and psychiatric manifestations and closely resembles 
 ;;neurasthenia, neurocirculatory asthenia, fibrositis, or fibromyalgia. 
 ;;
 ;;   FOR VA PURPOSES, A DIAGNOSIS OF CFS MUST MEET BOTH OF THE FOLLOWING
 ;;   CRITERIA:
 ;;   1.  New onset of debilitating fatigue that is severe enough to 
 ;;       reduce or impair average daily activity below 50 percent of the
 ;;       patient's pre-illness activity level for a period of 6 months,
 ;;       and
 ;;
 ;;
 ;;   2.  Other clinical conditions that may produce similar symptoms 
 ;;       must be excluded by thorough evaluation, based on history, 
 ;;       physical examination, and appropriate laboratory tests.
 ;;
 ;;
 ;;   IT MUST ALSO MEET SIX OR MORE OF THE FOLLOWING TEN CRITERIA:
 ;;   1.  Describe in detail:
 ;;       a.  Acute onset of the condition.
 ;;
 ;;
 ;;       b.  Low grade fever.
 ;;
 ;;
 ;;       c.  Nonexudative pharyngitis.
 ;;
 ;;
 ;;       d.  Palpable or tender cervical or axillary lymph nodes.
 ;;
 ;;
 ;;       e.  Generalized muscle aches or weakness.
 ;;
 ;;
 ;;       f.  Fatigue following lasting 24 hours or longer after exercise.
 ;;
 ;;
 ;;       g.  Headaches (of a type, severity or pattern that is different
 ;;           from headaches in the premorbid state.
 ;;
 ;;
 ;;       h.  Migratory joint pains.
 ;;
 ;;
 ;;       i.  Neuropsychologic symptoms.
 ;;
 ;;
 ;;       j.  Sleep disturbance.
 ;;
 ;;
 ;;A.  Review of Medical Records:
 ;;
 ;;    Comment on:
 ;;    1.  Date diagnosis established.
 ;;
 ;;
 ;;    2.  Does it meet the requirements outlined above?
 ;;
 ;;
 ;;B.  Medical History (Subjective Complaints):
 ;;
 ;;    Comment on:
 ;;    1.  Estimate the amount of routine daily activities that are 
 ;;        restricted due to CFS.  Give specific examples.
 ;;
 ;;
 ;;    2.  If there are incapacitating episodes (requiring bed rest and 
 ;;        treatment by a physician), what is their frequency and duration?.
 ;;
 ;;
 ;;    3.  Does the patient require continuous medication for CFS?
 ;;
 ;;
 ;;C.  Physical Examination (Objective Findings):
 ;;
 ;;
 ;;D.  Diagnostic and Clinical Tests:
 ;;
 ;;    1.  Include results of all diagnostic and clinical tests conducted
 ;;        in the examination report.
 ;;
 ;;
 ;;E.  Diagnosis:
 ;;
 ;;
 ;;Signature:                             Date:
 ;;END