Fatigue in relapsingremitting multiple sclerosis patients

2006, p. 58)Fatigue is very common among patients with multiple sclerosis and yet is it a symptom that is quite poorly defined. (Flachenacher et al., 2002). This very fact makes evaluation of fatigue as a symptom of multiple sclerosis difficult. And yet, since it is such a common complaint of patients with this condition, its evaluation as part of the disease process cannot be ignored.The paper by Flachenecker and colleagues is an important one dealing with the problem of fatigue in relapsing-remitting multiple sclerosis. Of the 151 consecutive patients who entered the study and were given the standardized questionnaires, 94 had the relapsing-remitting type of multiple sclerosis which is our main interest as far as the symptom of fatigue is concerned. One of the most important aspects of this paper in the evaluation of fatigue is the fact that the authors used 4 different fatigue scales namely, Fatigue Severity Scale (FSS), MS-specific FSS, Modified Fatigue Impact Scale (MFIS) and Visual Analogue Scale (VAS). To evaluate a symptom as vague and non-specific as fatigue, it was important that the authors relied not just on one fatigue scale but on four different fatigue scales in order to reduce the incidence of errors.In order for a patient to be included in the MS-related fatigue group (MS-F) they had to have stated in the questionnaire that fatigue: 1.is one of their three most disabling symptoms. 2. occurs daily or on most days of the week. and 3. limits their activities at home or at work. Patients who fulfilled none of these criteria were labeled MS non-fatigue group (MS-NF). those who had only one or two of the criteria were labeled borderline (Flachenecker et al., 2002 p. 524). This was another way of ensuring that only those who were truly fatigued were included in the group of MS patients with fatigue.It is also significant that Flachenecker, et al. (2002) used a depression screen as part of the evaluation of fatigue in MS.