Fatigue In Multiple Sclerosis A Current Perspective

Multiple sclerosis is a chronic and often disabling disease of the nervous system, affecting about 1 million people worldwide. Even though it has been known for over a hundred years, no cause or cure has yet been discovered-but now there is hope. New therapies have been shown to slow the disease progress in some patients, and the pace of discoveries about the cellular machinery of the brain and spinal cord has accelerated. This book presents a comprehensive overview of multiple sclerosis today, as researchers seek to understand its processes, develop therapies that will slow or halt the disease and perhaps repair damage, offer relief for specific symptoms, and improve the abilities of MS patients to function in their daily lives. The panel reviews existing knowledge and identifies key research questions, focusing on: Research strategies that have the greatest potential to understand the biological mechanisms of recovery and to translate findings into specific strategies for therapy. How people adapt to MS and the research needed to improve the lives of people with MS. Management of disease symptoms (cognitive impairment, depression, spasticity, vision problems, and others). The committee also discusses ways to build and financially support the MS research enterprise, including a look at challenges inherent in designing clinical trials. This book will be important to MS researchers, research funders, health care advocates for MS research and treatment, and interested patients and their families.

Dear Readers, If you are engaged in the treatment of patients with MS (pwMS), this e-book’s aim is to offer novel insights to improve on an understanding of one of the major problems of pwMS: fatigue. Although there is increasing research into fatigue and its impact on MS, this collection of ten articles supports a better understanding of fatigue in MS patients. It explores pathophysiological concepts, provoking mechanisms, objective measurements, personality interactions, pharmacological and non-pharmacological interventions and summarizes clinical management. It is written by neurologists, psychologists, scientists and therapists and addresses this group of people, who deal with pwMS in private, clinical, rehabilitation or scientific settings. Its aim is to communicate high-quality information, knowledge and experience on MS to healthcare professionals, while providing global support for the international MS community.

This practical guide for physicians and other health care professionals discusses the impact of fatigue on the individual with MS, the potential etiologies underlying MS-related fatigue, its work up and diagnosis, and pharmacologic and nonpharmacologic management strategies. Fatigue is perhaps the single most prevalent and disabling symptom of the multiple sclerosis, and limits patients' activity more than any other MS symptom. The identification of fatigue as a distinct clinical entity requires both art and science, and most of all, a willingness and ability to listen carefully to patients and their families. The physician's ability to obtain a comprehensive history requires a full understanding of the circumstances in which fatigue occurs (physical, cognitive, and psychosocial) and demands consideration of a large number of disorders, including anxiety, depression, excessive daytime sleepiness, pain, and spasticity, all of which may mimic or contribute to fatigue. While fatigue is almost exclusively a subjective experience, depending on the patient's ability to understand and report this symptom, there are effective methods for identifying the existence of fatigue, determining its severity, and distinguishing it from related or contributing disorders such as depression, pain, and sleep disorders. Readers will learn that fatigue need not be tolerated by the MS patient. Various therapies, support systems, and treatment of underlying affective disorders can all alleviate fatigue or reduce its impact, restoring the patient's energy levels and ability to participate in life. Virtually every MS patient with fatigue can benefit from intervention, and failing to treat the symptom of fatigue with the respect that it deserves is a serious detriment to patient care.

Myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS) are serious, debilitating conditions that affect millions of people in the United States and around the world. ME/CFS can cause significant impairment and disability. Despite substantial efforts by researchers to better understand ME/CFS, there is no known cause or effective treatment. Diagnosing the disease remains a challenge, and patients often struggle with their illness for years before an identification is made. Some health care providers have been skeptical about the serious physiological - rather than psychological - nature of the illness. Once diagnosed, patients often complain of receiving hostility from their health care provider as well as being subjected to treatment strategies that exacerbate their symptoms. Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome proposes new diagnostic clinical criteria for ME/CFS and a new term for the illness - systemic exertion intolerance disease(SEID). According to this report, the term myalgic encephalomyelitis does not accurately describe this illness, and the term chronic fatigue syndrome can result in trivialization and stigmatization for patients afflicted with this illness. Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome stresses that SEID is a medical - not a psychiatric or psychological - illness. This report lists the major symptoms of SEID and recommends a diagnostic process.One of the report's most important conclusions is that a thorough history, physical examination, and targeted work-up are necessary and often sufficient for diagnosis. The new criteria will allow a large percentage of undiagnosed patients to receive an accurate diagnosis and appropriate care. Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome will be a valuable resource to promote the prompt diagnosis of patients with this complex, multisystem, and often devastating disorder; enhance public understanding; and provide a firm foundation for future improvements in diagnosis and treatment.

This volume describes the effects and consequences of multiple sclerosis (MS) on cognition. Authors summarize the impact of MS on behavioral problems, daily living, and related neuropsychiatric disorders, and offer clinical guidance for practitioners.

This book provides cutting-edge information on the epidemiology, etiopathogenesis, clinical manifestations, diagnostic procedures and treatment approaches for the main white matter (WM) disorders of the central nervous system (CNS). WM lesions are associated with many neurological conditions, and with aging. The diagnostic work-up of neurological diseases characterized by the presence of these lesions has changed dramatically over the past few years. This is mainly due on the one hand to the discovery of specific pathogenetic factors in some of these conditions, and on the order to the optimized use of diagnostic tools. All of this has resulted in new diagnostic algorithms, and in the identification of new neurological conditions. The book offers neurologists essential guidance in the diagnosis and treatment of the most frequent WM conditions, promoting their correct and cost-saving diagnosis and management. By integrating neurological, laboratory and imaging concepts with the demands of accurate diagnosis, this reference guide provides a state-of-the-art overview of the current state of knowledge on these conditions, as well as practical guidelines for their diagnosis and treatment.