Fatigue in neurological disorders

Chronic fatigue is a typical symptom of neurological diseases, and is most disabling in multiple sclerosis, postpoliomyelitis, poststroke, and in chronic fatigue syndrome. Disorders of neuromuscular junction transmission and metabolic diseases cause muscle fatigability, which is characterised by fai...

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Bibliographic Details
Published in:The Lancet (British edition) 2004-03, Vol.363 (9413), p.978-988
Main Authors: Chaudhuri, Abhijit, Behan, Peter O
Format: Article
Language:English
Subjects:
Autonomic nervous system
Basal ganglia
Biological and medical sciences
Central nervous system
Chronic fatigue syndrome
Chronic illnesses
Cognition & reasoning
Cognitive ability
Crack propagation
Disease transmission
Disorders
Exercise
Fatigue
Fatigue - diagnosis
Fatigue - etiology
Fatigue - therapy
Fatigue failure
Fatigue limit
Ganglia
Humans
Hypothalamic-pituitary-adrenal axis
Hypothalamus
Lesions
Limbic system
Medical sciences
Metabolic disorders
Metabolism
Multiple sclerosis
Muscle contraction
Muscles
Muscular fatigue
Nervous system
Nervous System Diseases - complications
Nervous System Diseases - diagnosis
Nervous system involvement in other diseases. Miscellaneous
Neurological diseases
Neurological disorders
Neurology
Pathology
Patients
Perceptions
Physical fitness
Physiology
Pituitary
Poliomyelitis
Primary care
Thalamus
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Summary:Chronic fatigue is a typical symptom of neurological diseases, and is most disabling in multiple sclerosis, postpoliomyelitis, poststroke, and in chronic fatigue syndrome. Disorders of neuromuscular junction transmission and metabolic diseases cause muscle fatigability, which is characterised by failure to sustain the force of muscle contraction (peripheral fatigue). Fatigue is also seen in diseases that affect the central, peripheral, and autonomic nervous systems (central fatigue). Enhanced perception of effort and limited endurance of sustained physical and mental activities are the main characteristics of central fatigue. Metabolic and structural lesions that disrupt the usual process of activation in pathways interconnecting the basal ganglia, thalamus, limbic system, and higher cortical centre are implicated in the pathophysiological process of central fatigue. A state of pre-existing relative hypocortisolaemia might sensitise the hypothalamic-pituitary-adrenal axis to development of persistent central fatigue after stress. The contributions of physiological, cognitive, and affective changes underlying fatigue are variable, and treatment is largely symptomatic and rehabilitative.
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(04)15794-2