Onset, diagnosis, treatment ... five things to know about chronic fatigue

DECRYPTION

In the fall, many of us suddenly feel tired and have to let our bodies get used to the change of seasons.

But there are those for whom fatigue keeps coming back and presents more worrying characteristics.

It may then be a chronic fatigue syndrome, which has nothing to do with the classic fatigue that we feel in case of overwork or lack of sleep.

A syndrome in which Professor François Authier, neurologist at Henri-Mondor hospital in Créteil, is a specialist.

He was the guest on Friday of the program

with Aline Richard, editor-in-chief of

, partner of

.

What is chronic fatigue syndrome?

Chronic fatigue syndrome, by definition, differs from classic fatigue in that it is chronic.

It can start as a result of an infection, but it can also emerge for no reason.

The person then develops fatigue which gives him the impression of having the flu, but instead of getting better in a few days or weeks, this condition sets in for a long time.

"We can't get out of it, we manage to do less and less, whether it be physical activities, intellectual activities, we sleep badly, we wake up tired ...", lists Professor François Authier.

"In short, we have a life which is being reduced dramatically".

Also, although it is recognized by the World Health Organization (WHO), chronic fatigue syndrome remains very little known in France.

"It is very painful because the patients who have this disease, which is very organic, are people who, however, are doing very well", explains Professor François Authier.

"They have a normal life, kids, an active life, a job, and they have no reason to be or depressed or anything."

Yet one day, suddenly, "they get sick and we can't find anything for them."

It is moreover 'one of the characteristics of this chronic fatigue syndrome, that it cannot be easily diagnosed via conventional examinations. 

How to diagnose it?

The best way to get diagnosed is to go to a specialist and perform a fatigue and sleep assessment, as offered by the service of Professor Isabelle Arnulf at the Pitié-Salpêtrière hospital in Paris.

But it is possible, upstream, to answer a self-questionnaire on the internet.

The problem, Aline Richard recalls, is that fatigue, whether chronic or not, cannot be quantified.

No marker can be used to calculate fatigue during a blood test, for example.

If one uses these self-questionnaires available online, it is therefore important to go to a specialist with the results so that he can analyze them, rather than attempting an interpretation oneself, insists the editor-in-chief. of

.

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Why do some people develop this syndrome?

According to Professor Authier, there are a lot of hypotheses on the subject.

"We are not yet very familiar with all the mechanisms, but what is certain is that there are probably different chronic fatigue syndrome," he explains, adding that the work of doctors here is to try to "stratify, isolate" cases relating to specific mechanisms.

"Schematically, we can say that probably, we have an excessive immune reaction, it is difficult to defuse the immune reaction," he continues, referring to what happens, for example, when a person has a post-infectious syndrome .

But "we have, in the long term, a state which is much more apathetic, where people develop cognitive disorders, difficulties ... It's a kind of phase where we really have a degenerative aspect, and it is this evolution of chronic fatigue syndrome which is extremely characteristic ".

How many people are affected?

This syndrome can affect all age groups, but being little recognized in France, it is difficult to obtain statistics.

"It's a huge problem, because how do you organize a fight against a pathology without having a good idea of ​​what it is?" Asks Aline Richard, according to whom there could be hundreds of thousands of people affected. of this symptom.

"It was estimated that it was between 0.3 and 1% of the general population," said Professor Authier, referring to studies carried out in the United Kingdom.

"Which means it's still much more common than you think."

What support ?

In the event of chronic fatigue, is it necessary, as is advised for classic fatigue states, to practice certain physical activities?

"It's much more complicated," warns Professor François Authier, explaining that chronic fatigue syndrome is characterized by "post-exercise discomfort" which contributes to the accentuation of symptoms when the subject makes too much effort. .

On the contrary, too intense efforts are avoided, according to the neurologist.

In the case of chronic fatigue syndrome, he continues, it is better to favor a fragmented and diversified activity.

"You have to be able to change the type of activity in small sequences, with breaks between each, so that you can manage to do a certain number of things without having too much damage".