[The appraisal of fatigue in multiple sclerosis]

A particular problem is premature tiredness and elevated exhaustion in persons suffering from multiple sclerosis. The problem of fatigue in multiple sclerosis has received increasing attention in recent years not only from attending physicians but also from patients and self-help groups. Many patients cite fatigue as a reason for their inability to work and they apply for disability benefit on this basis. Objective proof is not possible. The decision regarding disability must be supported by a very detailed examination of the patient's medical history, including a precise description of routine and everyday activities and, if possible, behavioural observation and work testing. The scales currently used to determine the severity of MS fatigue are questionnaires that offer a subjective self-assessment but are of little use for an appraisal. The appraisal essentially depends on the plausibility of the complaints, which have to be critically assessed by the expert.