Fatigue and neuromuscular diseases

[Guest guest]

Ann Readapt Med Phys. 2006 Jul;49(6):375-384.

Fatigue and neuromuscular diseases.

Feasson L, Camdessanche JP, El Mhandi L, Calmels P, Millet GY.

Unite de Recherche PPEH-EA 3062, Faculte de Medecine Jacques-

Lisfranc, Universite Jean-Monnet, Saint-Etienne, France; Unite de

Myologie, Service de Physiologie Clinique et de L'exercice, Hopital

Bellevue, CHU de Saint-Etienne, 42055 Saint-Etienne cedex 02, France.

PURPOSE: To identify the role of fatigue, its evaluation and its

causes in the pathophysiology context of acquired or hereditary

neuromuscular diseases of the spinal anterior horn cell, peripheral

nerve, neuromuscular junction and muscle.

MATERIAL AND METHODS: A literature review has been done on Medline

with the following keywords: neuromuscular disease, peripheral

neuropathy, myopathy, fatigue assessment, exercise intolerance, force

assessment, fatigue scale and questionnaire, then with the terms:

Fatigue Severity Scale, Chalder Fatigue Scale, Fatigue Questionnaire,

Piper Fatigue Scale, electromyography and the combination of the word

Fatigue with the following terms: Amyotrophic Lateral Sclerosis

(ALS), Post-Polio Syndrome (PPS), Guillain-Barre Syndrome, Immune

Neuropathy, Charcot-Marie-Tooth Disease, Myasthenia Gravis (MG),

Metabolic Myopathy, Mitochondrial Myopathy, Muscular Dystrophy,

Facioscapulohumeral Dystrophy, Myotonic Dystrophy.

RESULTS: Fatigue is a symptom very frequently reported by patients.

Fatigue is mainly evaluated by strength loss after an exercise, by

change in electromyographic activity during a given exercise and by

questionnaires that takes into account the subjective (psychological)

part of fatigue. Due to the large diversity of motor disorders, there

are multiple clinical expressions of fatigue that differ in their

presentation, consequences and therapeutic approach.

CONCLUSION: This review shows that fatigue has to be taken into

account in patients with neuromuscular diseases. In this context,

pathophysiology of fatigue often implies the motor component but the

disease evolution and the physical obligates of daily life also

induce an important psychological component.