Fatigue in A sample of Egyptian Multiple Sclerosis Patients: A Cross Sectional Study

Abstract

Background: Multiple sclerosis [MS] is an inflammatory demyelinating disease of the central nervous system, which is the second-most common cause of physical handicap in young individuals. Fatigue is the most prevalent [50%–90%] symptom of MS interfering with everyday life with at least one mild symptom of fatigue even in the early stages of the disease [36.5%] when clinical symptoms are still negligible. The Aim of The Work: To evaluate the prevalence and relation of fatigue in MS patients with sleep disorders and other clinical factors in an attempt to understand the underlying mechanisms of this symptom which might be of help in easing its evaluation and optimizing patient care. Patients and Methods: A cross-sectional study was performed on patients recruited from MS unit at Al-Azhar University Hospitals in Cairo. Fifty patients were investigated and submitted to clinical evaluation as well as fatigue severity assessment using fatigue severity scale and sleep scales: Epworth sleepiness scale for assessment of daytime sleepiness, Pittsburgh sleep scale for assessment of sleep quality, and polysomnography. Results: Fatigue was present in 60% of MS patients. Decreased sleep efficiency, pain and progressive types were significantly higher among MS patients with fatigue. Male patients with fatigue were significantly more than those without fatigue. About 84% of patients with MS were complaining from sleep disorder symptoms, 72% had insomnia, pain and nocturia ranged from 54%-60% while leg spasm and narcolepsy were present in 30% and 20% respectively. Conclusion: The present study emphasized the prevalence of fatigue in MS patients and its relation with sleep disorders and disease progression denoting wide variety of pathological mechanisms and the necessity of multimodal management.

Keywords

• sleep disorders
• polysomnography
• fatigue scales
• sleep scales