Current problems in pediatric and adolescent health care · 2014
Adolescent fatigue, POTS, and recovery: a guide for clinicians.
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Kizilbash Sarah J, Ahrens Shelley P, Bruce Barbara K, Chelimsky Gisela, Driscoll Sherilyn W, Harbeck-Weber Cynthia, Lloyd Robin M, Mack Kenneth J, Nelson Dawn E, Ninis Nelly, Pianosi Paolo T, Stewart Julian M, Weiss Karen E, Fischer Philip R
Аннотация
Many teenagers who struggle with chronic fatigue have symptoms suggestive of autonomic dysfunction that may include lightheadedness, headaches, palpitations, nausea, and abdominal pain. Inadequate sleep habits and psychological conditions can contribute to fatigue, as can concurrent medical conditions. One type of autonomic dysfunction, postural orthostatic tachycardia syndrome, is increasingly being identified in adolescents with its constellation of fatigue, orthostatic intolerance, and excessive postural tachycardia (more than 40 beats/min). A family-based approach to care with support from a multidisciplinary team can diagnose, treat, educate, and encourage patients. Full recovery is possible with multi-faceted treatment. The daily treatment plan should consist of increased fluid and salt intake, aerobic exercise, and regular sleep and meal schedules; some medications can be helpful. Psychological support is critical and often includes biobehavioral strategies and cognitive-behavioral therapy to help with symptom management. More intensive recovery plans can be implemented when necessary.