Physiopathology and treatment of fatigue in multiple sclerosis

摘要: Fatigue is a common symptom of patients with multiple sclerosis (MS). It reported by about one-third patients, and for many fatigue the most disabling symptom. may be associated motor disturbances and/or mood disorders, which makes it very difficult to determine whether an aspect these features or result per se disease. Although peripheral mechanisms have some role in pathogenesis fatigue, MS there are clear indications that more important played “central” abnormalities. Neurophysiological studies shown does not depend on involvement pyramidal tracts implicate impairment volitional drive descending pathways as physiopathological mechanism. Metabolic abnormalities frontal cortex basal ganglia revealed positronemission tomography correlations between magnetic resonance imaging lesion burden support this hypothesis. Some recent also suggest pro-inflammatory cytokines contribute sense tiredness. No specific treatments available. Management strategies include medications, exercise, behavioural therapy; cases combined approach appropritate.