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Holmes criteria
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====Symptom Criteria==== To fulfill a symptom criterion, a symptom must have begun at or after the time of onset of increased fatigability, and must have persisted or recurred over a period of at least 6 months (individual symptoms may or may not have occurred simultaneously). Symptoms include: # [[Mild fever]] - oral temperature between 37.5 degrees C and 38.6 degrees C, if measured by the patient - or [[chills]]. (Note: oral temperatures of greater than 38.6 degrees C are less compatible with chronic fatigue syndrome and should prompt studies for other causes of illness.) # [[Sore throat]]. # [[Painful lymph nodes]] in the anterior or posterior cervical or axillary distribution. # Unexplained generalized [[muscle weakness]]. # Muscle discomfort or [[myalgia]]. # Prolonged (24 hours or greater) [[post-exertional malaise|generalized fatigue after levels of exercise]] that would have been easily tolerated in the patient's premorbid state. # Generalized [[headache]]s (of a type, severity, or pattern that is different from headaches the patient may have had in the premorbid state). # Migratory [[arthralgia]] without joint swelling or redness. # Neuropsychologic complaints (one or more of the following: [[photophobia]], transient visual [[scotomata]], [[forgetfulness]], [[excessive irritability]], [[confusion]], [[difficulty thinking]], [[attention deficit|inability to concentrate]], [[depression]]). # [[Sleep disturbance]] ([[hypersomnia]] or [[insomnia]]). # Description of the main symptom complex as initially developing over a few hours to a few days (this is not a true symptom, but may be considered as equivalent to the above symptoms in meeting the requirements of the case definition).
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