Fatigue in Multiple Sclerosis: A Guide to Diagnosis and Management / Edition 1

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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.

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Editorial Reviews

Doody's Review Service
Reviewer: Elliot Frohman, MD, PhD, FAAN (University of Texas Southwestern Medical Center at Dallas)
Description: This book presents a primer on the definition, pathophysiology, diagnosis and treatment of fatigue in Multiple sclerosis (MS) patients.
Purpose: The purpose of the book is to provide a cogent outline on how to approach the identification and management of fatigue in MS. The book emphasizes important practical tips recognizing the mutifactorial nature of this highly disabling symptom of MS. The author has succeeded in advancing these important concepts in a rather small, yet complete primer on the topic.
Audience: This book will have great value to patients and families with MS struggling to understand this difficult obstacle to quality of life, and to those who care for the MS community including physicians, physician assistants, nurses, physical and occupational therapists, and social workers. I believe that this short yet substantive book should be a mandatory read for all of us who struggle and search to understand and mitigate the suffering that is a byproduct of fatigue in MS. Dr. Krupp is an authority in the field whose work has added great practical value to our understanding of management principles for these very challenging patients.
Features: MS is the most common disabling neurological disorder of young people. While physical limitations secondary to the disease process can be substantial, the most common reasons why MS patients apply for disability include cognitive dysfunction and fatigue. In fact, fatigue constitutes the most common symptom complaint communicated to physicians. The underpinnings of fatigue in MS are manifold and are often multifactorial within the same patient. Many MS patients are afflicted with disease-related fatigue, but also are impacted by derangements in sleep, chronic pain, medication effects, depression, exercise and temperature intolerance, deconditioning, nutritional deficiencies, and superimposed medical illnesses. Effective management strategies for the treatment of fatigue can yield improvements in the a patient's ability to complete their activities of daily living, maintain gainful employment, experience an improved sense of well being and ultimately find new hope for today and the future. This is a delightful primer on an often very enigmatic subject. Lauren Krupp has succeeded in writing an invaluable resource on fatigue in MS. While the book covers a broad landscape of topics, it is remarkably telescoped on practical 'pearls' and 'pitfalls' that are germane to the understanding of how fatigue can be identified, analyzed, and effectively managed. Each chapter is tightly crafted and to the point. The references are extensive and provide the basis for more in-depth exploration of this challenging subject.
Assessment: While there have been other publishing products on the subject, this small book will eclipse the others by virtue of its economy of style, focused approach, and user-friendly structure.

4 Stars! from Doody
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Product Details

  • ISBN-13: 9781888799811
  • Publisher: Demos Medical Publishing, LLC
  • Publication date: 3/28/2004
  • Edition description: Subsequent
  • Edition number: 1
  • Pages: 92
  • Product dimensions: 6.00 (w) x 9.00 (h) x 0.40 (d)

Meet the Author

Dr. Lauren B. Krupp is Professor of Neurology at the State University of New Yorks Stony Brook Multiple Sclerosis Center. She lectures widely on the management of multiple sclerosis.
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Table of Contents

Introduction; What is Multiple Sclerosis-related fatigue?; The Measurement of Fatigue; The Pathophysiology of Multiple Sclerosis-Related Fatigue; Depression and Fatigue; The Examination and Diagnosis of Fatigue; Nonpharmacologic Approaches to Fatigue Management; The Pharmacologic Management of Fatigue; Appendix. Ensuring Patient Adherence to an Exercise Program.

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