MEDICAL ACUPUNCTURE

Volume 20, Number 1, 2008

© Mary Ann Liebert, Inc.
DOI: 10.1089/acu.2007.0601

Case Report

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 with
chronic fatigue syndrome. This patient received 6 weeks of once-weekly acupuncture treatment with excellent
results.

INTRODUCTION tient had been seen by a rheumatologist, infectious disease

A CCORDING TO THE CENTERS FOR Disease Control and
Prevention, chronic fatigue syndrome (CFS) is defined
as a condition with severe fatigue of unexplained reasons of
more than 6 months’ duration. In addition, patients with CFS
have 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 a
case of a 27-year-old woman who had CFS with the complaint
of 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
specialist, and pediatrician. All workups done were negative
for autoimmune disease and infectious disease.
On examination, the patient was a well-developed, well-
nourished, and sleepy-appearing girl. Her blood pressure
was 100/60 mm Hg, heart rate was 82/min, respiratory rate
was 18/min, and her temperature was normal. All systems,
including cardiovascular, neurological, musculoskeletal, en-
docrine, pulmonary, gastrointestinal, and hematopoetic were
normal 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

CASE REPORT Acupuncture treatment was initiated after obtaining in-

A 14-year old girl presented with the chief complaint of
extreme fatigue and insomnia. She had been diagnosed with
infectious 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, she
was hypersomnolent and unable to attend school. The pa-
formed consent from the patient’s mother (who was present
in the room during each treatment). The patient received
treatment once a week for 6 weeks; duration of each treat-
ment was 30 minutes. De Qi was felt by the patient for some
points, 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

Private Practice, Wheaton, IL.

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some of the acupuncture points; low frequency (2 Hz) and
low intensity (2–3 mA) were used.
Vital signs were taken before and after acupuncture treat-
ments, remained normal, and were almost identical each
treatment. No complications were noted.
Acupuncture Points Used
The following acupuncture points were selected for their
usefulness in conditions of fatigue, insomnia, and memory/
concentration problems: GV 20, not stimulated electrically;
LI 4, stimulated electrically, bilaterally; LI 11, stimulated
electrically, 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 concentration
and 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 Yin
channels of the legs were stimulated, which were deficient
due to the chronic nature of the patient’s condition.
LI 4 and 11 helped in strength and endurance. LI 4 is the
source point of the Metal Meridian and it strengthens all Yang
Meridians and also Wei-Qi (defensive Qi). LI 11 is the Earth
point on Metal Meridians and it harmonizes Qi and Blood. It
also 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 home
school class without fatigue. After 5 treatments, she returned
to regular school classes and was able to resume normal
daily activities with her peers and siblings. After 6 treat-
ments, she graduated from eighth grade and entered high
school. The quality of life for the patient and her family sig-
nificantly improved.
DISCUSSION
A literature search revealed that electroacupuncture can
improve central and peripheral level of beta-endorphins in
CHAUDHURI
CFS.3 Beta-endorphins help in the improvement of fatigue,
insomnia, and myalgias.
According to some review articles, CFS is most likely
due 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 of
CFS in a 27-year-old woman. McGuire2 used similar
acupuncture points for treatment of fatigue associated with
multiple 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 of
CFS in this patient. The quality of her life, as well as her
family’s life, significantly improved. Further research is
needed to confirm these findings and evaluate the positive
outcome.
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 transcutaneous
electrical 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 Group
26W171 Roosevelt Road
Wheaton, IL 60187
E-mail: gchaudhuri@marianjoy.org