Gulf War syndrome consists of a group of symptoms experienced by more than 100,000 American, British, and Canadian veterans of the 1992 Persian Gulf War.

• Some Gulf War veterans have developed various symptoms.
• Although the veterans have been exposed to many different possibly harmful agents, the cause is unknown.
• Most symptoms involve the nervous system.
• The syndrome does not seem to increase the need for hospitalization or lead to earlier death.

Gulf War syndrome is poorly understood. Within a few months of returning from the Persian Gulf, veterans from different military units in the United States, Britain, and Canada began reporting a variety of symptoms, including headache, fatigue, difficulty sleeping, joint pain, chest pain, skin rashes, and diarrhea. In most cases, however, the symptoms reported by the person, such as headache and nausea, could not be objectively confirmed by a doctor. Even when symptoms, such as a skin rash, could be confirmed, no specific cause could be identified.

The cause of Gulf War syndrome is unknown. Gulf War veterans have often been exposed to a number of potentially toxic substances, including chemical weapons, depleted uranium weapons, insecticides, and smoke from burning oil wells. Veterans may also have been exposed to irritating petroleum products, decontamination solutions, and a variety of airborne substances that may have caused allergies. Vaccination with the anthrax vaccine, which was given to U.S. military personnel involved in the Gulf War as protection against biological warfare, has also been proposed as a cause, although this vaccine has not caused symptoms in other recipients. The use of pyridostigmineSome Trade Names
MESTINON
tablets to help prevent the lethal effects of chemical weapons has been suggested as a possible cause as well. However, none of these agents has been convincingly linked to Gulf War syndrome. Many exposed people have not developed symptoms, and many people with symptoms have had no identifiable exposure.

Symptoms

Symptoms predominantly involve the nervous system. They include problems with memory, reasoning, concentration, and attention and difficulty falling asleep, depression, fatigue, and headache. Other symptoms may include disorientation, dizziness, erectile dysfunction (impotence), muscle pains, muscle fatigue, weakness, pins-and-needles sensations, diarrhea, skin rashes, cough, and chest pain.

Diagnosis, Prognosis, and Treatment

Diagnosis and treatment have not been established. Therefore, doctors focus on relieving the symptoms.

Veterans who have Gulf War syndrome do not have a higher hospitalization or death rate than anyone else of the same age.

Last full review/revision December 2008 by Margaret-Mary G. Wilson, MD