CHRONIC FATIGUE SYNDROME GETS A NEW NAME
Institute of Medicine. Beyond myalgic encephalomyelitis/chronic fatigue syndrome: redefining an illness. www.iom.edu/~/media/Files/Report%20Files/2015/MECFS/MECFS_ReportBrief.pdf. Accessed June 4, 2015.
Myalgic encephalomyelitis/chronic fatigue syndrome has a new name and more clearcut diagnostic criteria following a report by the Institute of Medicine. The new name, systemic exertion intolerance disease (SEID), better reflects how exertion exacerbates symptoms.
According to the report, the proposed diagnostic criteria for SEID is all three of the following:
• A substantial reduction or impairment in the ability to engage in pre-illness levels of occupational, educational, social, or personal activities that persists for more than six months and is accompanied by fatigue, which is often profound, is of new or definite onset (not lifelong), is not the result of ongoing excessive exertion, and is not substantially alleviated by rest
• Post-exertional malaise
• Unrefreshing sleep
Plus, at least one of the following:
• Cognitive impairment
• Orthostatic intolerance
The group also recommended that a new code be assigned in the ICD-10 that is not linked to chronic fatigue or neurasthenia.
COMMENTARY
Systemic exertion intolerance disease (SEID) will likely take some time to be integrated into practice as the new name for this condition. This change will also refocus attention on this difficult illness, which has always been challenging because the symptoms of SEID are nonspecific and overlap with many other illnesses, from hypothyroidism to depression. The guidelines are a welcome addition to the literature, giving us better direction in diagnosing a difficult disease. —NS
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