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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

During the course of an obscure illness in a teenage girl it was eventually realized that the diagnosis was 'epidemic neuromyasthenia'. The illness which occurred between February and September 1976 was characterized by fatigue, pallor, headache, nuchal pain, alterations in mentation, dizziness, nausea and vomiting, paraesthesiae, weakness and heaviness of limbs, and a prolonged relapsing course. Investigation brought to light fourteen patients with similar symptoms--twelve female and two male. In view of the shortcomings of retrospective enquiries, especially those involving the assessment of notes made by other people, and the problem of trying to define a nonfatal illness with protean symptoms, many of a nonspecific nature, with few physical findings and negative laboratory studies, caution is necessary. Under these circumstances it is claimed on clinical epidemiological evidence that a diagnosis of 'epidemic neuromyasthenia' could be sustained confidently in three patients and probably in a fourth. Six patients were considered possible cases and four were rejected.
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PMID:'Epidemic neuromyasthenia' in Southwest Ireland. 74 20

The term fibromyalgia, though often used, is not justified since no fibrosis has been shown on the histological level. The aim of this article is to make a critical analysis of the semiology usually attributed to fibromyalgias, to cite the main related syndromes whose nosology is often unclear (benign myalgic encephalomyelitis, epidemic neuromyasthenia, diffuse idiopathic multifocal pain syndrome, chronic fatigue, AMP desaminase deficiency, etc.), to prefer the purely descriptive term of "persistent, diffuse myalgia with no recognized organic etiology". According to the author's experience, a psychological etiology is detectable in only 25% of the cases. Morphological or functional muscular abnormalities are sometimes found, but their significance is not well known. A real multifactorial vicious circle partly explains the physiopathological complexity.
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PMID:[Does fibromyalgia exist?]. 218 44

Outbreaks of epidemic neuromyasthenia have occurred throughout the world for many years, but sporadic cases have only recently been recognized. Fifty consecutive previously well patients with prolonged and excessive fatigue after an apparent acute infection were investigated. Most were well educated, active, unmarried women aged 30 to 40 years. The precipitating infection had many clinical presentations. The chronic phase of the illness was characterized by a fairly common set of symptoms. Physical examination and laboratory testing generally gave normal results. Of the 50 patients 16 were found to be infected with Epstein-Barr virus, 7 with other viruses, 4 with parasites and 2 with Mycoplasma pneumoniae. The causative agent was not known in 22 cases. The mean duration of the illness was 27.6 months, and the mean proportion of time lost from work or school was 39%. Drug therapy was not beneficial; supportive therapy was useful. Further investigation is required to determine optimal management of sporadic neuromyasthenia.
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PMID:Sporadic postinfectious neuromyasthenia. 404 36

Outbreaks of illness variously identified by a number of terms, including epidemic neuromyasthenia, myalgic encephalomyelitis, Iceland disease, and atypical poliomyelitis, have been reported from many countries during the past 45 years. Since the first well-described outbreak occurring in 1934, > 60 outbreaks have been reported, but few of these have been described in considerable detail. These outbreaks are usually cited in historical reports of chronic fatigue syndrome (CFS) since each of these outbreaks appears to contain a number of cases meeting the current case definition of CFS. There has been inadequate attention given to the fact that epidemic neuromyasthenia and related clusters characterized by various complaints, including fatigue, do not have an accepted epidemiological or clinical definition, and only rarely have descriptions of these clusters included a specific case definition. When such case definitions have been applied, the occurrence of cases meeting the current case definition for CFS appears to be both variable and infrequent. This report utilizes examples of several well-documented outbreaks to emphasize specific aspects that should be considered in the investigation of future clusters.
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PMID:Epidemic neuromyasthenia and chronic fatigue syndrome: epidemiological importance of a cluster definition. 814 46

Outbreaks of illnesses of unknown etiology typified by a chronic relapsing course of constitutional symptoms and nervous system involvement have collectively been referred to as chronic fatigue syndrome, epidemic neuromyasthenia, and myalgic encephalomyelitis. To examine heterogeneity of clinical presentation, a comparative review was undertaken for 12 well-documented outbreaks reported since 1934. A systemic syndrome characterized by excessive fatigue, myalgias, headache, low-grade fever, and other constitutional symptoms was common to cases in all outbreaks. However, marked heterogeneity in the range of neurological features was apparent. On the basis of predominant neurological manifestations, outbreaks could be grouped into four levels of increasing neurological involvement: affective neuropsychological changes (level I); prominent cutaneous sensory symptoms with both affective and cognitive neuropsychological changes (level II); marked objective paresis with cutaneous sensory as well as affective and cognitive neuropsychological changes (level III); and cutaneous sensory, affective and cognitive neuropsychological, posterior column, cranial nerve, and mixed upper and lower motor neuron changes (level IV). Groups with the most prominent objective neurological findings (levels III and IV) comprised exclusively outbreaks reported between the 1930s and 1950s. All but one outbreak in groups with less prominent neurological findings (levels I and II) were reported between the 1960s and 1980s; a range of neurological features was observed for these groups. Because a complete neurological examination is not emphasized as part of the diagnostic workup in current outbreaks, it is possible that less obvious neurological findings may be overlooked. Careful evaluation of neurological features in epidemic and endemic cases of what is now called chronic fatigue syndrome may be one approach to distinguishing subtypes of what has been described in the past as a nosological entity.
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PMID:A comparative review of systemic and neurological symptomatology in 12 outbreaks collectively described as chronic fatigue syndrome, epidemic neuromyasthenia, and myalgic encephalomyelitis. 814 51

Chronic fatigue as a presenting complaint, in the absence of other evident organic illness, was seldom reported historically before the second half of the 19th century. Its first eruption was the so-called 'bed cases' or 'sofa cases' among middle-class females in the period from 1860 to about 1910. 'Neurasthenia' does not necessarily represent an early forerunner of chronic fatigue. Many patients receiving that diagnosis did not complain of fatigue. Others with functional fatigue did not receive the diagnosis 'neurasthenia'. Both medical-anecdotal and quantitative sources make it clear that by the time of the First World War, chronic fatigue was a common complaint in Europe and North America. Medical concepts of chronic fatigue since the 1930s have run along four separate lines: (1) 'postinfectious neuromyasthenia', going back to an atypical 'poliomyelitis' epidemic in 1934; (2) 'chronic Epstein-Barr virus' infection, an illness attribution that increased in frequency after the discovery in 1968 that this virus caused mononucleosis; (3) 'myalgic encephalomyelitis', dating from an epidemic at the Royal Free Hospital in London in 1955; and (4) 'fibrositis', or 'fibromyalgia', used as a rheumatological description since the turn of the century. Recently, these four separate paths have tended to converge into the diagnosis of 'chronic fatigue syndrome'.
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PMID:Chronic fatigue in historical perspective. 849 Nov 7

Chronic fatigue syndrome (CFS) is not a new disease. Similar morbidities have been known as different names since past several centuries. For example, neurasthenia, epidemic neuromyasthenia, myalgic encephalomyelitis, Akureyri disease, Royal Free disease, chronic EBV disease, post-viral fatigue syndrome etc. Much of the recent interest in CFS was generated by incidence of infection-like outbreak at Lake Tahoe in Nevada. The Center for Disease Control (USA) realized that correlation was poor between those patients who had virologic evidence of EBV infection and those who had the symptoms of chronic fatigue. This is a review of the history of CFS. (1) Historical perspectives in chronic fatigue cases in past old period, (2) Post-viral infectious fatigue and chronic fatigue (myalgic encephalomyelitis), (3) Recent trend of CFS studies and its clinical similar situation. Finally, I would like to state that we intend to draw up a new diagnostic guideline for CFS in Japan.
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PMID:[History of chronic fatigue syndrome]. 1756 85

Post-infectious fatigue or post-infectious neuromyasthenia (PIN) is an illness characterized by persisting fatigue and disability after apparent acute infections. In most cases the illness is attributed to a chronic Epstein-Barr virus infection. Symptoms include weakness and fatigue in the absence of physical findings or significant laboratory abnormalities. These patients are frequently depressed and have considerable disability resulting in prolonged loss of time from work. The illness may be persistent or can be relapsing, but often lingers for two years or more. There is no effective therapy. Pin is probably caused by an acute infection occurring in patients who are psychologically susceptible. They require emotional support, reassurance and explanation.
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PMID:Post-infectious fatigue. 2126 31

Changes in the terminology and diagnostic criteria for chronic fatigue syndrome/myalgic encephalomyelitis are explained in this paper. This syndrome is a complex and controversial entity of unknown origins. It appears in the medical literature in 1988, although clinical pictures of chronic idiopathic fatigue have been identified since the nineteenth century with different names, from neurasthenia, epidemic neuromyasthenia, and benign myalgic encephalomyelitis up to the current proposal of disease of intolerance to effort (post-effort). All of them allude to a chronic state of generalised fatigue of unknown origin, with limitations to physical and mental effort, accompanied by a set of symptoms that compromise diverse organic systems. The International Classification of Diseases (ICD-10) places this syndrome in the section on neurological disorders (G93.3), although histopathological findings have not yet been found to clarify it. Multiple organic alterations have been documented, but a common biology that clarifies the mechanisms underlying this disease has not been established. It is defined as a neuro-immune-endocrine dysfunction, with an exclusively clinical diagnosis and by exclusion. Several authors have proposed to include CFS/ME within central sensitivity syndromes, alluding to central sensitisation as the common pathophysiological substrate for this, and other syndromes. The role of the family doctor is a key figure in the disease, from the detection of those patients who present a fatigue of unknown nature that is continuous or intermittent for more than 6 months, in order to make an early diagnosis and establish a plan of action against a chronic disease with high levels of morbidity in the physical and mental sphere. OBJECTIVE: To carry out a bibliographic review of the terminology and diagnostic criteria of the chronic fatigue syndrome/myalgic encephalomyelitis, in order to clarify the pathology conceptually, as a usefulness in the diagnosis of Primary Care physicians.
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PMID:[From neurasthenia to post-exertion disease: Evolution of the diagnostic criteria of chronic fatigue syndrome/myalgic encephalomyelitis]. 3118 38