"Mary Schweitzer" 29. august 2007 As if we did not have too many CFS definitions already (Holmes, Oxford, Lloyd-Hickey, Fukuda, and Reeves), the NICE report from the UK has now added two new ones. >From the following website: (Section 1.2.1, beginning on page 14): "1.2.1.2. Healthcare professionals should consider the possibility of CFS/ME if a person has: * fatigue with all of the following features: - new or had a specific onset (hat is, it is not lifelong) - persistent and/or recurrent - unexplained by other conditions - has resulted in a substantial reduction in activity level - characterised by post-exertional malaise and/or fatigue (typically delayed, for example, by at least 24 hours, with slow recovery over several days) and * one or more of the following symptoms: - difficulty with sleeping, such as insomnia, hypersomnia, unrefreshing sleep, a disturbed sleep-wake cycle - muscle and/or joint pain that is multi-site and witout evidence of inflammation - headaches - painful lymph nodes without pathological enlargement - sore throat - cognitive dysfunction, such as difficulty thinking, inability to concentrate, impairment of short-term memory, and difficulties with word-finding, planning/organising thoughts and information processing - physical or mental exertion makes symptoms worse - general malaise or 'flu-like' symptoms - dizziness and/or nausea - palpitations in the absence of identified cardiac pathology." The SECOND effective definition in the NICE guidelines follows: P. 16: "1.3.1.3. The diagnosis of CFS/ME should be reconsidered if none of the following key features are present: * post-exertional fatigue or malaise * cognitive difficulties * sleep disturbance * chronic pain." The definitions are different from Oxford, which admitted to no physical symptoms and included all forms of depression, but it is also much broader than either Holmes or Fukuda. A personal who is "tired" and has headaches could be diagnosed with "CFS" this way. A person with no cognitive difficulties and no post-exertional fatigue or malaise - but with chronic pain - could be diagnosed with "CFS". With so many definitions of CFS now in play in the international medical community, we have to ask yet again is there meaning left for the phrase "chronic fatigue syndrome"? Mary Schweitzer