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Chronic fatigue syndrome
  1. J B Wrighta,
  2. D W Beverleyb
  1. aLime Trees Child and Family Unit, York, UK, bYork District Hospital, York, UK
  1. Dr J B Wright, Lime Trees Child and Family Unit, 31 Shipton Road, York YO3 6RE, UK

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The media has shown some interest in children with chronic fatigue syndrome, although national coverage does not always accurately reflect the position of the current medical publications. For example, one television programme indicated that most adolescents with the illness might expect to be ill for at least four years, a suggestion that research papers do not confirm. It is thus prudent to consider what current research tells us, particularly when there is an apparent disparity of views about the illness between parents, support groups, and professionals.

An editorial in the British Medical Journal 1and a report from the joint working group of the Royal Colleges of Physicians, Psychiatrists and General Practitioners2 both called for more work to be carried out on the assessment and management of children and adolescents with chronic fatigue syndrome. This review seeks to delineate our knowledge from published work as it currently stands and suggests an important area of further work.

Nomenclature and definition

Many terms have been used over the years for illnesses involving severe and prolonged fatigue. In the middle of the 19th century the term neurasthenia was used.3 It was believed that neurasthenia was a form of “nervous exhaustion” brought about by an injury to the nervous system. The treatment advised was rest, and a term apparently given to such people was “sofa cases”.4 Similar euphemisms exist today. Such terms as “skiver’s sickness” and the term “yuppie flu” have been used, although there is no evidence to suggest a clear socioeconomic correlation.2 Many other disorders described and defined over the years have much in common. They include fibromyalgia,5 myasthenia,6neuromyasthenia,7 myalgic encephalomyelitis (ME),8 postviral fatigue syndrome,9idiopathic chronic fatigue and myalgic syndrome,10 Iceland disease,11 Royal Free disease,12 chronic Epstein-Barr virus (EBV) infection,13 …

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