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Routine: DVBCWFS5

DVBCWFS5.m

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  1. DVBCWFS5 ;ALB/RLC CHRONIC FATIGUE SYNDROME WKS TEXT - 1 ; 12 FEB 2007
  1.  ;;2.7;AMIE;**183**;Apr 10, 1995;Build 8
  1.  ;
  1.  ;
  1. TXT ;
  1.  ;;Narrative:  Chronic fatigue syndrome (CFS) is an illness characterized
  1.  ;;by debilitating fatigue and several flu-like symptoms.  It may have 
  1.  ;;both physical and psychiatric manifestations and closely resembles 
  1.  ;;neurasthenia, neurocirculatory asthenia, fibrositis, or fibromyalgia. 
  1.  ;;
  1.  ;;   FOR VA PURPOSES, A DIAGNOSIS OF CFS MUST MEET BOTH OF THE FOLLOWING CRITERIA:
  1.  ;;
  1.  ;;   1.  New onset of debilitating fatigue that is severe enough to 
  1.  ;;       reduce or impair average daily activity below 50 percent of the
  1.  ;;       patient's pre-illness activity level for a period of 6 months, and
  1.  ;;   2.  Other clinical conditions that may produce similar symptoms 
  1.  ;;       must be excluded by thorough evaluation, based on history, 
  1.  ;;       physical examination, and appropriate laboratory tests.
  1.  ;;
  1.  ;;   IT MUST ALSO MEET SIX OR MORE OF THE FOLLOWING TEN CRITERIA:
  1.  ;;
  1.  ;;   1.  Describe in detail:
  1.  ;;
  1.  ;;       a.  Acute onset of the condition.
  1.  ;;       b.  Low grade fever.
  1.  ;;       c.  Nonexudative pharyngitis.
  1.  ;;       d.  Palpable or tender cervical or axillary lymph nodes.
  1.  ;;       e.  Generalized muscle aches or weakness.
  1.  ;;       f.  Fatigue lasting 24 hours or longer after exercise.
  1.  ;;       g.  Headaches (of a type, severity or pattern that is different
  1.  ;;           from headaches in the premorbid state).
  1.  ;;       h.  Migratory joint pains.
  1.  ;;       i.  Neuropsychologic symptoms.
  1.  ;;       j.  Sleep disturbance.
  1.  ;;
  1.  ;;A.  Review of Medical Records:
  1.  ;;
  1.  ;;    Comment on:
  1.  ;;
  1.  ;;    1.  Date diagnosis established.
  1.  ;;    2.  Does it meet the requirements outlined above?
  1.  ;;    3.  History of hospitalizations or surgery, reason or type of surgery,
  1.  ;;        location and dates, if known.
  1.  ;;
  1.  ;;B.  Medical History (Subjective Complaints):
  1.  ;;
  1.  ;;    Comment on:
  1.  ;;
  1.  ;;    1.  Estimate the percentage of restriction of routine daily activities,
  1.  ;;        including employment if applicable, due to CFS.  State the duration
  1.  ;;        (in months) of this level of restriction and give specific examples
  1.  ;;        of activities that are restricted.
  1.  ;;    2.  State whether there is debilitating fatigue, whether it is constant
  1.  ;;        or nearly so, or if it waxes and wanes.  Does fatigue last 24 hours
  1.  ;;        or longer after exercise?
  1.  ;;    3.  State the total number of days of incapacitating episodes (defined as
  1.  ;;        requiring bed rest and treatment by a physician) due to CFS during the
  1.  ;;        past 12-month period.
  1.  ;;    4.  Describe symptoms of cognitive impairment, such as inability to
  1.  ;;        concentrate, forgetfulness, and confusion, and state their frequency
  1.  ;;        and whether they are constant or nearly so, or if they wax and wane.
  1.  ;;    5.  Describe other current symptoms, such as headaches, sleep disturbance,
  1.  ;;        fever, sore throat, generalized muscle aches or weakness, migratory
  1.  ;;        joint pains, or other neuropsychologic symptoms, and state their
  1.  ;;        frequency and whether they are constant or nearly so, or if they wax
  1.  ;;        and wane.  If headaches are present, are they of a type, severity, or
  1.  ;;        pattern that is different from headaches in the premorbid state?
  1.  ;;    6.  Does the patient require continuous medication for CFS?
  1.  ;;
  1.  ;;C.  Physical Examination (Objective Findings):
  1.  ;;
  1.  ;;    1.  General appearance.
  1.  ;;    2.  Describe evidence of pharyngitis and enlargement or tenderness of
  1.  ;;        cervical or axillary lymph nodes.
  1.  ;;    3.  Describe other significant abnormal physical findings.
  1.  ;;
  1.  ;;D.  Diagnostic and Clinical Tests:
  1.  ;;
  1.  ;;    1.  Include results of all diagnostic and clinical tests conducted
  1.  ;;        in the examination report.
  1.  ;;
  1.  ;;E.  Diagnosis:
  1.  ;;
  1.  ;;
  1.  ;;Signature:                             Date:
  1.  ;;END