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1DVBCWFS3 ;ALB/RLC CHRONIC FATIGUE SYNDROME WKS TEXT - 1 ; 12 FEB 2007
2 ;;2.7;AMIE;**121**;Apr 10, 1995;Build 9
3 ;
4 ;
5TXT ;
6 ;;Narrative: Chronic fatigue syndrome (CFS) is an illness characterized
7 ;;by debilitating fatigue and several flu-like symptoms. It may have
8 ;;both physical and psychiatric manifestations and closely resembles
9 ;;neurasthenia, neurocirculatory asthenia, fibrositis, or fibromyalgia.
10 ;;
11 ;; FOR VA PURPOSES, A DIAGNOSIS OF CFS MUST MEET BOTH OF THE FOLLOWING CRITERIA:
12 ;;
13 ;; 1. New onset of debilitating fatigue that is severe enough to
14 ;; reduce or impair average daily activity below 50 percent of the
15 ;; patient's pre-illness activity level for a period of 6 months, and
16 ;; 2. Other clinical conditions that may produce similar symptoms
17 ;; must be excluded by thorough evaluation, based on history,
18 ;; physical examination, and appropriate laboratory tests.
19 ;;
20 ;; IT MUST ALSO MEET SIX OR MORE OF THE FOLLOWING TEN CRITERIA:
21 ;;
22 ;; 1. Describe in detail:
23 ;;
24 ;; a. Acute onset of the condition.
25 ;; b. Low grade fever.
26 ;; c. Nonexudative pharyngitis.
27 ;; d. Palpable or tender cervical or axillary lymph nodes.
28 ;; e. Generalized muscle aches or weakness.
29 ;; f. Fatigue lasting 24 hours or longer after exercise.
30 ;; g. Headaches (of a type, severity or pattern that is different
31 ;; from headaches in the premorbid state).
32 ;; h. Migratory joint pains.
33 ;; i. Neuropsychologic symptoms.
34 ;; j. Sleep disturbance.
35 ;;
36 ;;A. Review of Medical Records:
37 ;;
38 ;; Comment on:
39 ;;
40 ;; 1. Date diagnosis established.
41 ;; 2. Does it meet the requirements outlined above?
42 ;; 3. History of hospitalizations, dates and location, if known, reason.
43 ;;
44 ;;B. Medical History (Subjective Complaints):
45 ;;
46 ;; Comment on:
47 ;;
48 ;; 1. Estimate the amount of routine daily activities, including employment
49 ;; if applicable, that are restricted due to CFS. Give specific examples.
50 ;; 2. Is there debilitating fatigue? Constant or nearly so; wax and wane.
51 ;; 3. Are there incapacitating episodes (defined as requiring bed rest
52 ;; and treatment by a physician), what are their frequency and duration.
53 ;; 4. Cognitive impairment - constant or nearly so; wax and wane.
54 ;; 5. Any other current symptoms - constant or nearly so; wax and wane.
55 ;; 6. Does the patient require continuous medication for CFS?
56 ;;
57 ;;C. Physical Examination (Objective Findings):
58 ;;
59 ;; 1. General appearance.
60 ;; 2. Throat.
61 ;; 3. Cervical/axillary lymphadenopathy.
62 ;;
63 ;;D. Diagnostic and Clinical Tests:
64 ;;
65 ;; 1. Include results of all diagnostic and clinical tests conducted
66 ;; in the examination report.
67 ;;
68 ;;E. Diagnosis:
69 ;;
70 ;;
71 ;;Signature: Date:
72 ;;END
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