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Chronic pain & fatigue syndromes: overlapping clinical & neuroendocrine features & potential pathogenic mechanisms

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By Clauw DJ, Chrousos GP • www.ProHealth.com • May 20, 1998


Patients with unexplained chronic pain and/or fatigue have been
described for centuries in the medical literature, although
the terms used to describe these symptom complexes have
changed frequently. The currently preferred terms for these
syndromes are fibromyalgia and chronic fatigue syndrome, names
which describe the prominent clinical features of the illness
without any attempt to identify the cause. This review
delineates the definitions of these syndromes, and the
overlapping clinical features. A hypothesis is presented to
demonstrate how genetic and environmental factors may interact
to cause the development of these syndromes, which we
postulate are caused by central nervous system dysfunction.
Various components of the central nervous system appear to be
involved, including the hypothalamic pituitary axes,
pain-processing pathways, and autonomic nervous system. These
central nervous system changes lead to corresponding changes
in immune function, which we postulate are epiphenomena rather
than the cause of the illnesses.




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