Cigarettes and the brain

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and muscles, unrefreshing sleep, tender lymph nodes, sore throat, and headache. Symptoms vary from person to person and fluctuate in severity. Specific symptoms may come and go, complicating treatment and the patient's ability to cope with the illness. Most symptoms are invisible, which makes it difficult for others to understand the vast array of debilitating symptoms.


Doctors usually diagnose the condition by excluding other illnesses with similar symptoms. As yet, there is no indicator or diagnostic test that can clearly identify the disorder. Overlapping symptoms can occur with several diseases, such as fibromyalgia, Gulf War illnesses, and multiple chemical sensitivities. Lupus, hypothyroidism, and Lyme disease also have similar symptoms and will need to be ruled out when making a diagnosis.

The Centers for Disease Control and Prevention updated the case definition for CFIDS in 1994. Although the criteria were designed to be used for research purposes, doctors use the definition as a diagnostic guideline. The case definition criteria call for four of eight symptoms to be present, along with fatigue that interferes with physical, mental, social, and educational activities. Both the fatigue and symptoms must have occurred for at least six months. The condition first received attention in the mid-1980s after reports of about 100 cases appeared in the Lake Tahoe region of California.

Initially, many physicians dismissed CFS as hypochondria or a misdiagnosed depression; it was called "yuppie flu" because most patients were professionals in their mid-30s (especially women). Because its symptoms were so similar to other diseases, it further complicated attempts to study the condition. Without a solid definition, scientists had problems identifying its cause and seeking a cure.


More recently, studies have begun to link the condition with physiological, rather than psychological, factors. In one recent study, magnetic resonance imaging scanned the brains of 259 patients in Lake Tahoe, 183 of whom were afflicted with CFS. In 78 percent of the patients, images showed tiny points of swelling on brain cells in the central nervous system; the myelin sheath on some cells was also missing. These swellings did not appear in the same section of the brain for all patients, but researchers did discover a relationship between the region affected and the patient's symptoms. For example, patients who had vision problems also had disturbances in the occipital lobe of the brain—an area that processes vision.

Evidence also suggests that most patients have an active infection with herpes virus 6 (HHV-6), although scientists emphasize this does not mean the virus causes the condition. This virus is believed to infect most people in early life without producing any symptoms.

still other studies suggest that the cause may be linked to a retrovirus in spinal fluid, known as a spumavirus or "foamy virus." Moreover, many patients suffer from irregularities in their immune systems and have abnormally low levels of hormones in the brain and endocrine glands.


There is no known cure for CFIDS. Until a treatment is developed which will improve all the symptoms of cFiDs or correct the underlying cause, therapy is based on symptoms. Medications that ease symptoms include medications for pain, sleep disturbances, nausea, depression and anxiety, and flu-like symptoms. Treatment that helps a patient relax and improve coping skills may include counseling, cognitive behavioral therapy, sleep management therapy, and massage.

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