chapter  17
7 Pages

Pathophysiology of fatigue in multiple sclerosis

ByUlrich Roelcke

Fatigue is a common and disabling symptom of multiple sclerosis (MS).1 In reporting fatigue, patients may describe many and varied physical as well as psychological symptoms (overwhelming sense of tiredness, lack of energy, feeling of exhaustion during or following motor or mental activity). Although test scales measuring fatigue and depression share a significant number of items related to somatic functioning,2 most authors distinguish fatigue from depression, the latter being characterized by lack of selfesteem, despair or a feeling of hopelessness. Most authors also agree that fatigue does not depend on overall or motor disability (as measured with the Expanded Disability Status Scale (EDSS)3). This is in line with the clinical observation that fatigue may be the presenting symptom of MS, occurring at a time where there is minimal or no neurological disability.1