Pediatric Case Definition for Chronic Fatigue Syndrome

The researchers at DePaul University have developed a pediatric case definition for Chronic Fatigue Syndrome for children and adolescents. Because the criteria put in place by the CDC is for adults with CFS, researchers were finding that children were not properly being diagnosed with the illness.

In order for a diagnosis of CFS/ME to be made in a child, the child must report fatigue as well as classic CFS/ME symptoms in each of the following categories. They must have experienced these symptoms for at least 3 months. In addition to frequency, their severity rating must be a 4 or above. You can read the complete report on the pediatric case definition of CFS and severity ratings by clicking here.

The severity scale is as follows for symptoms (you can read the questionnaire with all of the symptoms on page 6 at the above link).

1 – 3 = Hardly ever, or no problem, little problem

4 – 6 = Half the time, or moderate problem

7 = Always, or big problem

Criteria:

Fatigue: –

– Fatigue that causes child to reduce activities to avoid feeling even more tired and a rating of half the time, or moderate problem for fatigue/extreme tiredness.

Post-exertional Malaise:

– Feeling worse after doing activities that require physical or mental effort.
– Being physically active, such as using stairs, walking, playing sports, doing chores, getting dressed, makes the child much more tired than usual or more tired than usual by the end of the day.

Sleep:

– At least one of the following:

– Feeling tired after waking up in the morning
– Need to nap daily
– Problems falling asleep
– Problems staying asleep

Pain:

– At least one symptom from Myofascial pain, Joint pain, Abdominal pain, or Head pain

– Pain or aching in muscles
– Muscle twitches
– Pain/stiffness/tenderness in more than one joint without redness and/or swelling
– Eye pain
– Vomiting
– Nausea
– Chest pain or heartburn
– Upset stomach
– Abdomen/stomach pain
– Ringing in ears
– Headaches

Neurocognition:

– At least two of the following:

– Problems remembering things
– Difficulty paying attention for long time periods
– Difficulty finding the right words to say
– Difficulty understanding things
– Can only focus on one thing at a time
– Frequently lose train of thought
– Slowness of thought
– Forgetfulness or absent-mindedness
– Recent trouble with math or numbers

At least one symptom from two of the following three categories:

– Autonomic Manifestations:

– Feel unsteady on feet, like you may fall
– Shortness of breath, trouble catching breath
– Dizziness
– Irregular heart beats

– Neuroendocrine Manifestations:

– Losing or gaining weight
– Not wanting to eat
– Sweating hands
– Night sweats
– Feel chills or shivers
– Feeling hot or cold
– Feeling like you have a high temperature
– Feeling that your temperature is low

– Immune Manifestations:

– Sore throat
– Tender/sore lymph nodes
– Fever and sweats
– Some smells, foods, chemicals makes you feel sick