There are a number of scoring systems used to quantify symptoms for research and diagnosis purposes. One such system devised is ‘The Clinical Working Case Definition of ME/CFS’ and it cites that:
“A patient with ME/CFs will meet the criteria for fatigue, post-exertional malaise and/or fatigue, sleep dysfunction, and pain; have two or more neurological/cognitive manifestations and one or more symptoms from two of the categories or autonomic, neuroendocrine, and immune manifestations.” Carruthers BM, Jain AK, De Meirleir KL, Petersn DL, Klimas MD, Lerner AM, Bested AC, Flor-Henry P, Joshi P, Powles ACP, Sherkey JA, van de Sande MI (2003). “Myalgic encephalomyelitis.chronic fatigue syndrome: Clinical working definition, diagnostic and treatment protocols”. Journal of Chronic Fatigue Syndrome11 (1): 7-36.
The type of fatigue described should be of new or definite onset (therefore not since birth); be unexplained by other causes; last for at least six months (from onset); and is not improved by rest .
The CDC (Centers for Disease Control) has an official list of symptoms for medical practitioners to use when diagnosing CFS. There are two criteria:
1) Clinically evaluated, unexplained, persistent, or relapsing fatigue for at least six months that is: Of new or definite onset; not the result of ongoing exertion; not substantially alleviated by rest; and results in substantial reduction in previous levels of occupational, educational, social, or personal activities
2) Four or more of the following concurrent symptoms on a persistent or recurrent basis during six or more consecutive months of illness, none of which may predate the fatigue: Self-reported impairment in short-term memory or concentration severe enough to cause substantial reduction in previous levels of occupational, educational, social, or personal activities; sore throat; tender cervical or axillary lymph nodes; muscle pain; multi-joint pain without joint swelling or redness; headaches of a new type, pattern, or severity; unrefreshing sleep; and postexertional malaise lasting more than 24 hours.
(From "Chronic Fatigue Syndrome: New Insights Into An Enigmatic Illness," by Capt. Ceabert J. Griffith, PA-C, Physician Assistant Journal, February 1996 issue)
In addition to fatigue (of the type described above) a minimum of 4 should be met:
· Cognitive impairment, manifested in short-term memory and concentration problems
· Sore throats
· Tender lymph nodes
· Muscle pain
· Joint pain
· Insomnia and/or unrefreshing sleep
· Post-exertional malaise/fatigue lasting for more than 24 hours after exertion
Anyone suffering with CFS will likely say that the symptoms used for diagnosis are only a small part of the illness - there are countless other horrendous symptoms involved. Please see My Own Dance With The Sandman to see the range of symptoms I suffer.
Other scoring systems
·Oxford criteria (1991)
· Holmes et al (1988)
· Carruthers et al (2003) Canadian Case definition for ME/CFS