Gulf War syndrome is a group of symptoms experienced by > 100,000 American, British, and Canadian veterans of the 1991 Persian Gulf War.
Within a few months of returning from the Persian Gulf, veterans from different military units in the US, Britain, and Canada began reporting various unexplained symptoms, including headache, fatigue, difficulty sleeping, joint pain, chest pain, rashes, and diarrhea. However, in most cases, objective evidence of abnormalities was lacking. Even when symptoms, such as a rash, could be confirmed, no specific cause could be identified.
The cause of Gulf War syndrome is unknown. Gulf War veterans often have 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 irritant petroleum products, decontamination solutions, and a variety of airborne substances that may have caused allergies. Vaccination with the anthrax vaccine, which was given to US 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 pyridostigmine 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 linked convincingly to Gulf War syndrome; many exposed people have been asymptomatic, and many symptomatic people have had no identifiable exposure.
Symptoms predominantly involve the nervous system. They include problems with memory, reasoning, concentration, and attention; difficulty falling asleep; depression; fatigue; and headache. Other symptoms may include disorientation, dizziness, erectile dysfunction (impotence), myalgias, fatigue, weakness, paresthesias, diarrhea, rashes, cough, and chest pain.
Diagnosis and treatment have not been established; therefore, the aim is to relieve 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