The chronic fatigue syndrome: an authentic condition or the prelude of a drama
STAVROS J. BALOYANNIS
1st Department of Neurology, Aristotelian University, Thessaloniki, Greece

Μany patients complain for chronic fatigue, sometimes debilitating, associated with anorexia, sleep disturbances, muscular weakness, muscular pains and mild, cognitive impairment, concerning mostly the concentration, the active attention and the memory. In some of them the clinical and laboratory investigation are both unremarkable, no suggestive of any underlying disease. These complains if persit for more than six months may be attributed to chronic fatigue syndrome (CFS), a clinically defined condition, the etiopathogenetic background of which remains elusive. The predominant symptom is always disabling fatigue, that causes a substantial and sometimes persistent reduction in activity level. We have studied 128 patients, 45 men and 80 women, who have appealed for medical care for the presenting complaint of chronic fatigue, in the decade 1980-1990. Although, repeated clinical and laboratory examinations, were unremarkable, some of the patients (15,6%) devepoped well defined diseases within the first five.years from the initial complains, suggesting that the debilitating fatigue was simply the general initial manifestation of one of the following underlyng disorders, multiple sclerosis, neoplasms, Alzheimer's disease, depression and myasthenia. We have the feeling that the chronic fatigue syndrome (CFS) is consisted of a heterogeneous group of various underlying disorders and the patients suffered from it should be monitored closely and every complaint or laboratory data should be carefully evaluated. The final management approach would have to be individualized according to the specific symptoms of the patients, that impose the specific therapeutical needs. Nevertheless acceptance of the patients illness experience and continuous psychological support and attention to symptomatic treatment are essential.