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Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is often thought of as an adult disease, but children get it too. Scientists don't know what causes it, and there is no cure or approved treatment. It can be hard on children and on the people who care for them.
Image from CDC's page on ME/CFS in children.
How it differs in children
Children and teens share many symptoms with adults: symptoms can look like other illnesses, come and go, and change over time. But there are differences:
| Symptom | In children and teens |
|---|---|
| Dizziness and lightheadedness (orthostatic intolerance) | More common than in adults, especially in teens — often the most unbearable symptom, and it can worsen the others |
| Sleep problems | In young children, may show up as a loss of their usual energy. In teens, harder to spot because sleep changes in puberty; common complaints are trouble falling or staying asleep, daytime sleepiness and intense or vivid dreams |
| Pain | Muscle and joint pain is less usual than in adults, but headaches and stomach pain may be more common. Young children may not be able to describe pain well |
| Onset | More likely to start after an illness such as the flu or mononucleosis, especially in teens — though it sometimes begins gradually |
Diagnosis
There's no test for ME/CFS, and diagnosis requires at least 6 months of illness — but a sick child should see a healthcare provider right away, not wait months. The doctor may review the child's history, medicines and recent illnesses, do a thorough physical and mental status exam, and order blood, urine or other tests. Specialists such as a neurologist, rheumatologist or sleep specialist can check for treatable conditions with similar symptoms. A child can have other conditions and ME/CFS at once, and treating those may help.
Depending on the child's age, the doctor may ask the child, the parent or guardian, or both:
- What can the child do now, compared with before? How long have they been ill?
- Does sleep or rest help? What makes them worse, and what helps?
- Which symptoms stop them doing what they need or want to do?
- Do they feel dizzy or lightheaded, or fall more than before?
- Do they have trouble remembering or focusing?
- What happens when they try activities that used to be normal?
A symptom journal helps families remember details for visits and shows how flare-ups affect daily life.
Care: start with the most disruptive symptoms
Patients, families and providers should decide together which symptom causes the most trouble, and weigh the benefits and harms of each treatment.
Post-exertional malaise (PEM) — symptoms worsening after even minor physical, mental or emotional effort — is managed by pacing: finding the child's own limits and planning activity and rest to stay within them. Vigorous aerobic exercise, helpful in many chronic illnesses, is not tolerated in ME/CFS, but activities the child can tolerate still matter. Chores and schoolwork may need to be broken into smaller steps. After-school activities, as tolerated, support social development — even for a child who can't attend school.
Orthostatic intolerance — dizziness, vision changes like blurring or spots, weakness, or a racing, pounding or skipping heartbeat, all worse when standing or sitting upright. Providers will check heart rate and blood pressure and may refer to a cardiologist or neurologist.
Sleep. Good sleep habits come first; medicine may help if they aren't enough. A child who still wakes unrefreshed after a full night should consider a sleep specialist.
Concentration and memory. Taking notes while listening to a teacher can be hard. Some doctors prescribe the stimulants used for ADHD, which may help focus but can trigger a "push-and-crash" cycle: on a good day the child does more than usual, crashes, rests — and repeats.
Depression, stress and anxiety. Adjusting to any chronic illness can bring these on; in ME/CFS, anxiety comes from the changes the child must make, not from the illness itself. Counseling can ease stress and some symptoms. Antidepressants and anti-anxiety medicines may help some children but should be prescribed with caution, since some can worsen other symptoms. Deep breathing, muscle relaxation, massage, stretching, yoga and tai chi may reduce stress. Treating depression and anxiety can help a great deal — but it doesn't cure ME/CFS.
Pain. Doctors may check for food allergies and vision problems. Gentle massage and heat help some children, and a doctor may suggest acetaminophen or ibuprofen — but always ask the child's provider before trying any medicine.
Sources
Based on "ME/CFS in Children," Centers for Disease Control and Prevention; a work of the United States government in the public domain.
Lizenz: CC0 1.0 (gemeinfrei) · Bearbeitet nach www.cdc.gov
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