[Therapy of fatigue in multiple sclerosis : A treatment algorithm]

Area of Science:

• Neurology
• Sleep Medicine

Background:

• Fatigue is a primary symptom of multiple sclerosis (MS), significantly impacting patients' quality of life and employment.
• The underlying mechanisms of MS-related fatigue remain unclear, with comorbid conditions playing a crucial role.

Purpose of the Study:

• To present current treatment strategies for MS-related fatigue.
• To specifically focus on managing fatigue secondary to sleep disorders in MS patients.

Main Methods:

• A comprehensive literature review was conducted to synthesize existing research on MS fatigue treatments.

Main Results:

• Excessive daytime sleepiness (EDS) must be assessed in MS patients with fatigue, as sleep disorders are common causes.
• Medications (e.g., antihistamines), anemia, iron deficiency, diabetes, and hypothyroidism can exacerbate MS fatigue.
• Cognitive behavioral therapy, exercise, physiotherapy, and fatigue management interventions show promise in improving MS fatigue.

Conclusions:

• Thorough evaluation for sleep disorders, including EDS, is essential for MS patients experiencing fatigue.
• Excluding comorbid conditions and optimizing medication regimens are critical steps in managing MS fatigue.
• While pharmacological options are scarce, non-pharmacological interventions offer significant potential for improving fatigue in multiple sclerosis.