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Fatigue heralding multiple sclerosis

Symptoms_of_MS

A scientific report in this month’s Multiple Sclerosis Journal reveals an intriguing fact – that many people are given a ‘fatigue-related’ diagnostic label long before receiving a confirmed diagnosis of multiple sclerosis (MS).

Over half of MS patients say that fatigue is one of their worst symptoms, and the researchers from University of Kentucky were particularly interested in whether fatigue had been present as an early symptom. Using retrospective databases of ICD-9 labels given to MS patients up to 3 years before a diagnosis of MS, they found that a full 1534 of 5305 patients (28.9%) had been given a fatigue-related diagnosis. Most had received the general label “other malaise or fatigue”, but 73 people (1.4% of the group) had been given the label “chronic fatigue syndrome” in the 3 years before their re-diagnosis with MS.

The researchers’ aim was to show that “fatigue may herald MS, often by years”, since awareness of this fact might help physicians to detect the initial stage of MS and start treatment earlier. However, they also point out that “careful history and physical examinations should be performed in all patients presenting with fatigue for the presence of clues to the possible diagnosis of MS. The symptom check list might include inquiries about Lhermitte’s phenomenon, enervation on heat exposure, bandlike sensation across the chest or abdomen, sphincter dysfunction, visual loss, diplopia, and transient weakness, paresthesias or numbness…A  more comprehensive neurological examination than routinely performed may also be warranted.”

[Image Credit: Wikimedia Commons, Mikael Häggström]