DVBCWFS5 ;ALB/RLC CHRONIC FATIGUE SYNDROME WKS TEXT - 1 ; 12 FEB 2007
;;2.7;AMIE;**183**;Apr 10, 1995;Build 8
;
;
TXT ;
;;Narrative: Chronic fatigue syndrome (CFS) is an illness characterized
;;by debilitating fatigue and several flu-like symptoms. It may have
;;both physical and psychiatric manifestations and closely resembles
;;neurasthenia, neurocirculatory asthenia, fibrositis, or fibromyalgia.
;;
;; FOR VA PURPOSES, A DIAGNOSIS OF CFS MUST MEET BOTH OF THE FOLLOWING CRITERIA:
;;
;; 1. New onset of debilitating fatigue that is severe enough to
;; reduce or impair average daily activity below 50 percent of the
;; patient's pre-illness activity level for a period of 6 months, and
;; 2. Other clinical conditions that may produce similar symptoms
;; must be excluded by thorough evaluation, based on history,
;; physical examination, and appropriate laboratory tests.
;;
;; IT MUST ALSO MEET SIX OR MORE OF THE FOLLOWING TEN CRITERIA:
;;
;; 1. Describe in detail:
;;
;; a. Acute onset of the condition.
;; b. Low grade fever.
;; c. Nonexudative pharyngitis.
;; d. Palpable or tender cervical or axillary lymph nodes.
;; e. Generalized muscle aches or weakness.
;; f. Fatigue lasting 24 hours or longer after exercise.
;; g. Headaches (of a type, severity or pattern that is different
;; from headaches in the premorbid state).
;; h. Migratory joint pains.
;; i. Neuropsychologic symptoms.
;; j. Sleep disturbance.
;;
;;A. Review of Medical Records:
;;
;; Comment on:
;;
;; 1. Date diagnosis established.
;; 2. Does it meet the requirements outlined above?
;; 3. History of hospitalizations or surgery, reason or type of surgery,
;; location and dates, if known.
;;
;;B. Medical History (Subjective Complaints):
;;
;; Comment on:
;;
;; 1. Estimate the percentage of restriction of routine daily activities,
;; including employment if applicable, due to CFS. State the duration
;; (in months) of this level of restriction and give specific examples
;; of activities that are restricted.
;; 2. State whether there is debilitating fatigue, whether it is constant
;; or nearly so, or if it waxes and wanes. Does fatigue last 24 hours
;; or longer after exercise?
;; 3. State the total number of days of incapacitating episodes (defined as
;; requiring bed rest and treatment by a physician) due to CFS during the
;; past 12-month period.
;; 4. Describe symptoms of cognitive impairment, such as inability to
;; concentrate, forgetfulness, and confusion, and state their frequency
;; and whether they are constant or nearly so, or if they wax and wane.
;; 5. Describe other current symptoms, such as headaches, sleep disturbance,
;; fever, sore throat, generalized muscle aches or weakness, migratory
;; joint pains, or other neuropsychologic symptoms, and state their
;; frequency and whether they are constant or nearly so, or if they wax
;; and wane. If headaches are present, are they of a type, severity, or
;; pattern that is different from headaches in the premorbid state?
;; 6. Does the patient require continuous medication for CFS?
;;
;;C. Physical Examination (Objective Findings):
;;
;; 1. General appearance.
;; 2. Describe evidence of pharyngitis and enlargement or tenderness of
;; cervical or axillary lymph nodes.
;; 3. Describe other significant abnormal physical findings.
;;
;;D. Diagnostic and Clinical Tests:
;;
;; 1. Include results of all diagnostic and clinical tests conducted
;; in the examination report.
;;
;;E. Diagnosis:
;;
;;
;;Signature: Date:
;;END
--- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HDVBCWFS5 3996 printed Dec 13, 2024@01:51:11 Page 2
DVBCWFS5 ;ALB/RLC CHRONIC FATIGUE SYNDROME WKS TEXT - 1 ; 12 FEB 2007
+1 ;;2.7;AMIE;**183**;Apr 10, 1995;Build 8
+2 ;
+3 ;
TXT ;
+1 ;;Narrative: Chronic fatigue syndrome (CFS) is an illness characterized
+2 ;;by debilitating fatigue and several flu-like symptoms. It may have
+3 ;;both physical and psychiatric manifestations and closely resembles
+4 ;;neurasthenia, neurocirculatory asthenia, fibrositis, or fibromyalgia.
+5 ;;
+6 ;; FOR VA PURPOSES, A DIAGNOSIS OF CFS MUST MEET BOTH OF THE FOLLOWING CRITERIA:
+7 ;;
+8 ;; 1. New onset of debilitating fatigue that is severe enough to
+9 ;; reduce or impair average daily activity below 50 percent of the
+10 ;; patient's pre-illness activity level for a period of 6 months, and
+11 ;; 2. Other clinical conditions that may produce similar symptoms
+12 ;; must be excluded by thorough evaluation, based on history,
+13 ;; physical examination, and appropriate laboratory tests.
+14 ;;
+15 ;; IT MUST ALSO MEET SIX OR MORE OF THE FOLLOWING TEN CRITERIA:
+16 ;;
+17 ;; 1. Describe in detail:
+18 ;;
+19 ;; a. Acute onset of the condition.
+20 ;; b. Low grade fever.
+21 ;; c. Nonexudative pharyngitis.
+22 ;; d. Palpable or tender cervical or axillary lymph nodes.
+23 ;; e. Generalized muscle aches or weakness.
+24 ;; f. Fatigue lasting 24 hours or longer after exercise.
+25 ;; g. Headaches (of a type, severity or pattern that is different
+26 ;; from headaches in the premorbid state).
+27 ;; h. Migratory joint pains.
+28 ;; i. Neuropsychologic symptoms.
+29 ;; j. Sleep disturbance.
+30 ;;
+31 ;;A. Review of Medical Records:
+32 ;;
+33 ;; Comment on:
+34 ;;
+35 ;; 1. Date diagnosis established.
+36 ;; 2. Does it meet the requirements outlined above?
+37 ;; 3. History of hospitalizations or surgery, reason or type of surgery,
+38 ;; location and dates, if known.
+39 ;;
+40 ;;B. Medical History (Subjective Complaints):
+41 ;;
+42 ;; Comment on:
+43 ;;
+44 ;; 1. Estimate the percentage of restriction of routine daily activities,
+45 ;; including employment if applicable, due to CFS. State the duration
+46 ;; (in months) of this level of restriction and give specific examples
+47 ;; of activities that are restricted.
+48 ;; 2. State whether there is debilitating fatigue, whether it is constant
+49 ;; or nearly so, or if it waxes and wanes. Does fatigue last 24 hours
+50 ;; or longer after exercise?
+51 ;; 3. State the total number of days of incapacitating episodes (defined as
+52 ;; requiring bed rest and treatment by a physician) due to CFS during the
+53 ;; past 12-month period.
+54 ;; 4. Describe symptoms of cognitive impairment, such as inability to
+55 ;; concentrate, forgetfulness, and confusion, and state their frequency
+56 ;; and whether they are constant or nearly so, or if they wax and wane.
+57 ;; 5. Describe other current symptoms, such as headaches, sleep disturbance,
+58 ;; fever, sore throat, generalized muscle aches or weakness, migratory
+59 ;; joint pains, or other neuropsychologic symptoms, and state their
+60 ;; frequency and whether they are constant or nearly so, or if they wax
+61 ;; and wane. If headaches are present, are they of a type, severity, or
+62 ;; pattern that is different from headaches in the premorbid state?
+63 ;; 6. Does the patient require continuous medication for CFS?
+64 ;;
+65 ;;C. Physical Examination (Objective Findings):
+66 ;;
+67 ;; 1. General appearance.
+68 ;; 2. Describe evidence of pharyngitis and enlargement or tenderness of
+69 ;; cervical or axillary lymph nodes.
+70 ;; 3. Describe other significant abnormal physical findings.
+71 ;;
+72 ;;D. Diagnostic and Clinical Tests:
+73 ;;
+74 ;; 1. Include results of all diagnostic and clinical tests conducted
+75 ;; in the examination report.
+76 ;;
+77 ;;E. Diagnosis:
+78 ;;
+79 ;;
+80 ;;Signature: Date:
+81 ;;END
