Differential Diagnosis and Management of Fatigue in Multiple Sclerosis: Considerations for the Nurse

Fatigue is one of the most disabling aspects of multiple sclerosis (MS), affecting an estimated 70%-90% of patients. Yet, despite its prevalence, it is also one of the most difficult MS symptoms to accurately diagnose and effectively treat. This is because of numerous factors, including the subjecti...

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Bibliographic Details
Published in:The Journal of neuroscience nursing Vol. 35; no. 3; pp. 139 - 148
Main Authors: Costello, Kathleen, Harris, Colleen
Format: Journal Article
Language:English
Published: United States Lippincott Williams & Wilkins, WK Health 01.06.2003
American Association of Neurosurgical Nurses
Subjects:
Acute Disease
Algorithms
Care and treatment
Chronic Disease
Diagnosis, Differential
Fatigue
Fatigue - diagnosis
Fatigue - etiology
Fatigue - nursing
Humans
Multiple sclerosis
Multiple Sclerosis - complications
Multiple Sclerosis - nursing
Neurology
Neurosciences
Patient Education as Topic
ISSN:0888-0395, 1945-2810
Online Access:Get full text
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Summary:Fatigue is one of the most disabling aspects of multiple sclerosis (MS), affecting an estimated 70%-90% of patients. Yet, despite its prevalence, it is also one of the most difficult MS symptoms to accurately diagnose and effectively treat. This is because of numerous factors, including the subjective and nonspecific nature of fatigue; its variable manifestations; its similarity to psychological, motor, cognitive, respiratory, and non-MS-related disturbances and conditions; and a lack of understanding of its precise etiology. In contrast to fatigue experienced by people without MS, MS fatigue is characterized by its persistence and sensitivity to core and ambient temperatures. Differential diagnosis of MS fatigue is largely dependent on delineating chronic versus acute onset and determining whether fatigue is a symptom in and of itself (primary MS fatigue) or an aspect of an MS-related or non-MS-related etiology (secondary MS fatigue). Once the presence of fatigue is established, a through medical history, physical examination, and fatigue assessments can guide effective management, which includes education, self-care strategies, and pharmacological treatment. As patient advocates and gatekeepers, MS nurses are in an optimal position to establish and evaluate fatigue as a symptom in and of itself and effectively guide this process.
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ISSN:0888-0395
1945-2810
DOI:10.1097/01376517-200306000-00003