All three of the following must apply All three of the following must apply All three of the following must apply Our patient
1 A substantial reduction or impairment in the ability to engage in preillness levels of occupational, educational, social or personal activities that persists for more than 6 months and is accompanied by fatigue, which is often profound, is of new or definite onset (not lifelong), is not the result of ongoing excessive exertion, and is not substantially alleviated by rest. A substantial reduction or impairment in the ability to engage in preillness levels of occupational, educational, social or personal activities that persists for more than 6 months and is accompanied by fatigue, which is often profound, is of new or definite onset (not lifelong), is not the result of ongoing excessive exertion, and is not substantially alleviated by rest.
2 Post-exertional malaise (PEM). Post-exertional malaise (PEM).
3 Unrefreshing sleep. Unrefreshing sleep.
In addition, at least one of the following two symptoms must apply In addition, at least one of the following two symptoms must apply In addition, at least one of the following two symptoms must apply In addition, at least one of the following two symptoms must apply
4 Cognitive impairment. Cognitive impairment.
5 Orthostatic intolerance. Orthostatic intolerance.