Definition

Clinically evaluated, unexplained persistent or relapsing chronic fatigue that is of new or definite onset (i.e. not lifelong), is not the result of ongoing exertion, is not substantially alleviated by rest, and results in substantial reduction in previous levels of occupational, educational, social or personal activities. Together with the concurrent occurrence of four or more of the following symptoms: substantial impairment in short-term memory or concentration, sore throat, tender lymph nodes, muscle pain, multi-joint pain without swelling or redness, headaches of a new type, pattern, or severity, unrefreshing sleep or postexertional malaise lasting more than 24 h, the symptoms must have persisted or

Table 32.1 The differential diagnosis of fatigue.

recurred during 6 or more consecutive months of illness and must not have predated the fatigue.

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