- unrefreshing sleep and vague feelings of illness or depression after exerting oneself, lasting more than 24 hours following exertion

- tiredness that lasts longer than 24 hours

In addition, any of the above symptoms associated with the fatigue must have occurred for at least 6 or more months in a row. Also, continuous fatigue should have been the first noticeable symptom of illness.

Other symptoms of CFS can include mild fever, blurry vision, chills, night sweats, diarrhea, and fluctuations in appetite and weight.

Diagnosing Chronic Fatigue Syndrome
Chronic fatigue syndrome is hard to diagnose because a single diagnostic test does not exist and there is no identifiable cause of the illness. Another problem is that symptoms of CFS often mimic other disorders such as viral infections, kidney disease, cardiac disease, depression, and neurological illnesses. Doctors first have to make sure that a person's fatigue and other symptoms are not caused by another illness, a sleep disorder, or hormone problems such as hypothyroidism.

We all get tired, depressed, and run down. But CFS is different from normal feelings of fatigue and low energy. Symptoms of CFS often develop suddenly and include a strong, noticeable fatigue that comes and goes or remains for months.

When examining your child, a doctor will be looking to first rule out diseases that appear similar to CFS, such as multiple sclerosis and systemic lupus. In addition to doing a physical examination, the doctor will ask you about any concerns and symptoms you have, your past health, your family's health, any medications your child is taking, any allergies your child may have, and other issues. This is called the medical history. Blood and urine tests will be given to identify any other possible causes of illness.

Your child also will probably meet with a psychologist or therapist who can help assess the symptoms in relation to his or her cognitive skills, concentration, memory, personality, and overall psychological state. This is helpful because CFS is often seen in people who also have depression or anxiety. In fact, it's because many people with CFS have also been diagnosed with depression or anxiety that some health professionals mistake CFS for a psychiatric condition.

During subsequent office visits, you and your child's doctor should discuss any new symptoms, which might suggest that the problem is something other than CFS. If other diseases are ruled out and if your child's illness meets the criteria of the case definition, a diagnosis of CFS can be made.

Because kids and teens often feel tired for many reasons, CFS is a potentially misused or abused diagnosis. Children sometimes use fatigue as an excuse to avoid school or other activities. Many teens are overly active in a number of sports, which can cause fatigue. For these reasons, doctors are careful when making a diagnosis of CFS.

Treatment for Chronic Fatigue Syndrome

Regular, carefully planned exercise, which helps by providing healing movement, increased energy, and feelings of well being. Exercise should not be extreme - people with CFS should always pace themselves while doing any physical activity that requires exertion.
Stress management and reduction techniques, which teach strategies for taking control over certain aspects of the illness.
A healthy diet, which can minimize symptoms and general discomfort. Doctors agree that people with CFS should avoid heavy meals, alcohol, caffeine, and large quantities of junk food.
Acupuncture, massage, stretching, yoga, and tai chi have been helpful for many people with CFS.
In addition to lifestyle changes, to change negative or unrealistic thoughts or feelings into positive, realistic ones. It also can help children with CFS and their families learn to deal with academic or social problems brought on by the illness, such as missed school, poor performance, or withdrawal from friends and social situations.

All the patients need to be tested for IgG level and subclass level if any is low then immunoglobulin or IVIg should be given for complete relief of symptoms.

For most people, the symptoms of CFS are most severe in the beginning, and later they may come and go. Some people recover completely from CFS, although it's not clear why this happens. According to the CDC, almost 50% of CFS patients experience partial or full recovery within 5 years after the CFS symptoms began.