Managing Systemic Exertion Intolerance Disease (SEID)
A New Name for Chronic Fatigue Syndrome.
An article in Medscape caught my eye last week. If you suffer from Chronic Fatigue Syndrome, you may find it interesting too.
Dr Paul Auwaerter is based at the Johns Hopkins Division of Infectious Diseases, Johns Hopkins University in Baltimore, Maryland. He reports that some of his most challenging outpatient visits are with patients who describe long-standing problems that include fatigue, perhaps sleep difficulties, and brain fog.
Often they may not be functioning well, perhaps experiencing problems in school or at work. Most of these patients are quite bright; they are analytical and sophisticated. They are hoping that something can be found to explain their fatigue and symptoms.
He explains that patients want to embrace something that makes sense. In fact, science has determined that the human brain likes distinct answers, and that uncertainty seems to amplify problems.
The term “chronic fatigue syndrome” or “myalgic encephalomyelitis” was developed and the defining criteria included:
- more than 6 months of symptoms
- an inability to perform customary activities.
The term resulted in a fair amount of controversy and sometimes even stigma because many clinicians believe this could be a psychosomatic illness; while others believe it is quite real. There is also symptom overlap with other syndromic problems, including fibromyalgia and irritable bowel syndrome.
“Within this context, the Institute of Medicine (IOM) was charged by several federal agencies to come up with a new name, some subcategories, and other aspects. In sum, the IOM committee decided that it would be important to rename chronic fatigue syndrome something that captures the nature of this. They have called it “systemic exertion intolerance disease,” or SEID.”
The criteria for SEID include:
- substantial decline in functional activities for at least 6 months
- post-exertional fatigue
- non-restorative sleep.
And then at least one of the following:
- cognitive impairment or orthostatic intolerance
- gastrointestinal issues
- stimuli hypersensitivity
- sore throat
Some patients may develop SEID / chronic fatigue syndrome after having an authentic infection from which they never seem to recuperate and for others, there seems to be no precipitating factor. The condition afflicts a large number of people, children and young adults included, and the best treatment strategies -compiled by Simon Wessely and colleagues, (who did a fair amount of work on chronic fatigue syndrome and Gulf War syndrome), and others include:
- graded exercises
- conditioning to build up tolerance
- cognitive-behavioral therapy.
Once again, a graduated approach to increasing physical activity is one of the most beneficial interventions.
What are your thoughts about these recommendations?
Dr Paul Auwaerter
Medscape Infectious Diseases © 2015 WebMD, LLC
Cite this article: Managing Systemic Exertion Intolerance Disease (SEID). Medscape. Mar 03, 2015.
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