Tag: differential diagnosis

Consideration of narcolepsy in the differential diagnosis of chronic fatigue syndrome

Abstract:

OBJECTIVE: To justify the inclusion of narcolepsy in the differential diagnosis of patients with chronic fatigue.

CLINICAL FEATURES: We report three patients aged 17 (two women and one man) and one woman aged 45 who had been diagnosed as having chronic fatigue syndrome (CFS). They had no psychiatric illness. Their main problem was severe daytime sleepiness, presenting as “tiredness and fatigue”. The history, sleep study and multiple sleep latency test suggested a diagnosis of narcolepsy.

INTERVENTION: Treatment with methylphenidate resulted in complete resolution of symptoms in two patients and significant improvement in the other two.

CONCLUSIONS: The differential diagnosis of CFS requires the exclusion of other conditions. If daytime sleepiness is a major complaint, other symptoms of narcolepsy should be sought and the diagnosis confirmed with sleep study and a multiple sleep latency test.

 

Source: Ambrogetti A, Olson LG. Consideration of narcolepsy in the differential diagnosis of chronic fatigue syndrome. Med J Aust. 1994 Apr 4;160(7):426-9. http://www.ncbi.nlm.nih.gov/pubmed/8007866

 

Primary fibromyalgia and the chronic fatigue syndrome

Abstract:

Thirty-three primary fibromyalgia patients were investigated for chronic fatigue syndrome symptoms. Significant fatigue was reported by 21/33 patients (63.6%), and patients reported various flulike symptoms, yet only 7/33 patients (21.2%) fulfilled criteria for the chronic fatigue syndrome. Only one patient reported painful lymph glands and four patients reported fever. Thus, symptoms of painful glands or fever might serve as clinical indicators, distinguishing between fibromyalgia and the chronic fatigue syndrome.

 

Source: Wysenbeek AJ, Shapira Y, Leibovici L. Primary fibromyalgia and the chronic fatigue syndrome. Rheumatol Int. 1991;10(6):227-9. http://www.ncbi.nlm.nih.gov/pubmed/2041979