Why is fatigue commonly seen in cases of multiple sclerosis (MS)?

Fatigue is a symptom of multiple sclerosis (MS) that's in a category of its own since it cannot be traced to any one spot in the nervous system. While it is the single most common complaint of patients, it is also the one symptom to which others are least sympathetic. Especially in the absence of other symptoms, others can easily regard it as laziness, depression, or copping out.

This is unfortunate because, although fatigue is invisible, it can often be the most debilitating of symptoms. There is not yet a good anatomical explanation for the fatigue of MS. Sometimes it is due to subtle weakness in the legs.

Sometimes it is the result of the extra work required to stay active in spite of a balance or coordination problem. Sometimes it is related just to the frustration of having MS. In any case, fatigue often occurs in isolation, unassociated with other symptoms, when the MS has gone into remission.

Fatigue commonly strikes in the late afternoon, when the body temperature normally rises. Frequently fatigue is relieved by cooling off and resting. By early evening, when the body temperature starts to fall again, fatigue will subside.

Fatigue, though very real and sometimes very debilitating, is one of the more deceptive complaints of MS. Patients can look terrific but feel exhausted. This is one reason why collecting disability insurance for fatigue has been a controversial issue.

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