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Chronic Fatigue syndrome / Myalgic Encephalomyelitis
How is it treated?
There is no pharmacologic or behavioural cure for CFS/ME. Pacing is the most effective strategy and offers the best approach to recovery in combination with symptomatic pharmacotherapy (such as that for sedation and muscle pain) and a flexible schedule of individualised physical and mental activity plan. The role of cognitive behaviour therapy in CFS/ME is debatable, but may help some patients. Regular and graded physical activities are recommended within the range of tolerance; over-enthusiastic exercise therapy has been associated with worsening symptoms of muscle pain and fatigue. Immunological treatment (Ampligen or human immunoglobulin), steroid replacement (hydrocortisone and fludrocortisone), galantamine, antibiotics and antiviral drugs are generally not recommended. Open-labeled trials suggest acylcarnitine supplementation may be helpful in some cases. The cornerstone of management is still supportive and a positive outlook, pacing, attention to diet (high dietary antioxidants, low wheat and dairy products), avoidance of caffeinated drinks and a regular pattern of daily activity (physical as well as mental) are the best ingredients that aid recovery.
The clinical outcome in CFS/ME usually takes one of the three courses: complete recovery (more common in children but rare in adults), relapsing course (majority of adults) and permanent incapacity (approximately 25% of adult patients). Progressive and rapid deterioration of symptoms is highly uncharacteristic of CFS/ME.
The UK Royal College of Paediatrics and Child Health has published Evidence Based Guideline for the Management of CFS/ME (Chronic Fatigue Syndrome/Myalgic Encephalopathy) in Children and Young People available from Web: http://www.rcpch.ac.uk/doc.aspx?id_Resource=1480 and a Young Person's Guide to CFS/ME which is available from Web: http://www.rcpch.ac.uk/doc.aspx?id_Resource=2013.
How is it diagnosed?
| Inheritance patterns and prenatal diagnosis 
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