# disautonomia in cfs



## poet (Nov 17, 2003)

Dysautonomia in chronic fatigue syndrome: facts, hypotheses,implications.Journal: Med Hypotheses. 2004 Feb;62(2):203-6.Authors: Jochanan E. Naschitz, [*, a], Daniel Yeshurun [a] and ItzhakRosner *Affiliations:[a] Department of Internal Medicine A, Bnai Zion Medical Center and BruceRappaport Faculty of Medicine, Technion - Israel Institute of Technology,P.O. Box 4940, Haifa 31048, Israel Department of Rheumatology, Bnai Zion Medical Center and BruceRappaport Faculty of Medicine, Technion - Israel Institute of Technology,P.O. Box 4940, Haifa 31048, Israel[*] Corresponding author; E-mail: mailto:naschitz###tx.technion.ac.ilReceived 14 February 2003; accepted 20 October 2003. ; Available online19 December 2003.NLM Citation: PMID: 14962627The diagnosis of chronic fatigue syndrome (CFS) is based on patienthistory and treatment on cognitive behavior therapy and graded exercise.There is increasing evidence that dysautonomia occurs in CFS manifestprimarily as disordered regulation of cardiovascular responses to stress.We impart our experience relating to diagnosis, monitoring, and treatmentof CFS based on identification and management of dysautonomia. Recentlyproposed methods for assessment of the cardiovascular reactivity, the'hemodynamic instability score' (HIS) and the 'Fractal and RecurrenceAnalysis-based Score' (FRAS), served for this purpose.On HUTT, a particular dysautonomia is revealed in CFS patients thatdiffer from dysautonomia in several other disorders. This distinctabnormality in CFS can be identified by HIS [Formula: see text] -0.98(sensitivity 84.5% and specificity 85.1%) and FRAS [Formula: see text]+0.22 (sensitivity 70% and specificity 88%). Therefore, the HIS and FRASmay be used, in the appropriate clinical context, to support thediagnosis of CFS, which until now, could only be subjectively inferred.A pilot study suggested that midodrine treatment, directed at theautonomic nervous system in CFS, results first in correction ofdysautonomia followed by improvement of fatigue. This finding impliesthat dysautonomia is pivotal in the pathophysiology CFS, at least in alarge part of the patients, and that manipulating the autonomic nervoussystem may be effective in the treatment of CFS. --------------------------------------------- Send posts to mailto:CO-CURE###listserv.nodak.edu Join or leave the list at http://www.co-cure.org/sub.htm Select list topic options at http://www.co-cure.org/topics.htm Co-Cure Archives: http://listserv.nodak.edu/archives/co-cure.html ---------------------------------------------tom*


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