Case Report

MEDICAL ACUPUNCTUREVolume 20, Number 1, 2008© Mary Ann Liebert, Inc.DOI: 10.1089/acu.2007.0601

Acupuncture Treatment for an Adolescent with Chronic Fatigue Syndrome

Gouri Chaudhuri, MD

ABSTRACT

A 14-year-old girl presented with demonstrated insomnia, fatigue, depression, and inability to attend school.This case was unique because a literature search did not reveal the use of acupuncture for a young person withchronic fatigue syndrome. This patient received 6 weeks of once-weekly acupuncture treatment with excellentresults.

INTRODUCTION

ACCORDING TO THE CENTERS FOR Disease Control andPrevention, chronic fatigue syndrome (CFS) is defined

as a condition with severe fatigue of unexplained reasons ofmore than 6 months’ duration. In addition, patients with CFShave impaired short-term memory, sore throat, tender mus-cles, and joint pain without swelling.1

Acupuncture has been reported as a treatment for CFS as-sociated with multiple sclerosis.2 Another author reported acase of a 27-year-old woman who had CFS with the complaintof chest pain, shortness of breath, and dizziness; these symp-toms were alleviated after acupuncture treatment.3 In addition,electroacupuncture treatments have been reported to help fa-tigue, depression, and insomnia in end-stage renal disease.4

CASE REPORT

A 14-year old girl presented with the chief complaint ofextreme fatigue and insomnia. She had been diagnosed withinfectious mononucleosis at the age of 11. During subse-quent years, she continued to have fatigue, sore throat, in-ability to concentrate, and insomnia. During the day, shewas hypersomnolent and unable to attend school. The pa-

tient had been seen by a rheumatologist, infectious diseasespecialist, and pediatrician. All workups done were negativefor autoimmune disease and infectious disease.

On examination, the patient was a well-developed, well-nourished, and sleepy-appearing girl. Her blood pressurewas 100/60 mm Hg, heart rate was 82/min, respiratory ratewas 18/min, and her temperature was normal. All systems,including cardiovascular, neurological, musculoskeletal, en-docrine, pulmonary, gastrointestinal, and hematopoetic werenormal on examination; the only abnormal finding was mod-erately enlarged tonsils.

She was taking citalopram (5 mg/d for 2 years) for de-pression as well as daily multivitamins.

TREATMENT

Acupuncture treatment was initiated after obtaining in-formed consent from the patient’s mother (who was presentin the room during each treatment). The patient receivedtreatment once a week for 6 weeks; duration of each treat-ment was 30 minutes. De Qi was felt by the patient for somepoints, but not all. Depth of needle penetration was 1–2 mm;needles used were Seirin #5 (0.25 � 40 mm; Tokyo, Japan).Electrical stimulation (IC-1107, Tokyo, Japan) was used for

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Private Practice, Wheaton, IL.

some of the acupuncture points; low frequency (2 Hz) andlow intensity (2–3 mA) were used.

Vital signs were taken before and after acupuncture treat-ments, remained normal, and were almost identical eachtreatment. No complications were noted.

Acupuncture Points Used

The following acupuncture points were selected for theirusefulness in conditions of fatigue, insomnia, and memory/concentration problems: GV 20, not stimulated electrically;LI 4, stimulated electrically, bilaterally; LI 11, stimulatedelectrically, bilaterally; LR 3, not stimulated electrically; HT 3, not stimulated electrically; SP 6, stimulated electri-cally, bilaterally; ST 36, stimulated bilaterally.

HT 3, LR 3, GV 20 helped the patient to sleep at night,reduced anxiety and depression, and helped concentrationand memory.

SP 6 and 36 helped improve energy level. SP 6 is the in-tersection point of 3 Yin channels of the legs (Kidney,Spleen, Liver), and by stimulating this point, all the Yinchannels of the legs were stimulated, which were deficientdue to the chronic nature of the patient’s condition.

LI 4 and 11 helped in strength and endurance. LI 4 is thesource point of the Metal Meridian and it strengthens all YangMeridians and also Wei-Qi (defensive Qi). LI 11 is the Earthpoint on Metal Meridians and it harmonizes Qi and Blood. Italso energizes Yang-Ming Meridians, which helps in CFS.

RESULTS

After 2 treatments, the patient was able to sleep at night.After 3 treatments, she was able to attend daytime homeschool class without fatigue. After 5 treatments, she returnedto regular school classes and was able to resume normaldaily activities with her peers and siblings. After 6 treat-ments, she graduated from eighth grade and entered highschool. The quality of life for the patient and her family sig-nificantly improved.

DISCUSSION

A literature search revealed that electroacupuncture canimprove central and peripheral level of beta-endorphins in

CFS.3 Beta-endorphins help in the improvement of fatigue,insomnia, and myalgias.

According to some review articles, CFS is most likelydue to viral infection of the brain, which then affects the en-docrine, immune, and motor systems.4,5

Meass3 used almost identical points for the treatment ofCFS in a 27-year-old woman. McGuire2 used similaracupuncture points for treatment of fatigue associated withmultiple sclerosis. Even though these 2 cases have dissimi-lar presentations, the outcome of acupuncture treatments ap-pears to be similar.

CONCLUSIONS

Acupuncture treatment was effective in the treatment ofCFS in this patient. The quality of her life, as well as herfamily’s life, significantly improved. Further research isneeded to confirm these findings and evaluate the positiveoutcome.

REFERENCES

1. Chronic fatigue syndrome. Centers for Disease Control and Pre-vention website. http://www.cdc.gov/cfs/cfsdefinitionHCP.htm.Page updated May 5, 2006. Accessibility verified November 16,2007.

2. McGuire C. Acupuncture in the treatment of fatigue in a pa-tient with multiple sclerosis: a case study. Physiotherapy.2003;89(11):637–640.

3. Meass T. Acupuncture in the treatment of post viral fatigue syn-drome: a case report. Acupuncture Med. 2005;23(3):141–145.

4. Tsay SL, Cho YC, Chen ML. Acupressure and transcutaneouselectrical acupoint stimulation in improving fatigue, sleep qual-ity and depression in hemodialysis patients. Am J Chin Med.2004;32(3):407–416.

5. Wesley RS. Chronic fatigue syndrome and myofascial pain syn-drome. Curr Opin Rheumatol. 2000;12(2):113–123.

Address correspondence to:Gouri Chaudhuri, MD

Marianjoy Medical Group26W171 Roosevelt Road

Wheaton, IL 60187

E-mail: gchaudhuri@marianjoy.org

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