Neurological fatigue

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Thought to be unique to sufferers of multiple sclerosis,[1] neurological fatigue is a feeling of overwhelming lassitude or tiredness that can occur at any time of the day, for any duration and does not necessarily recur in a recognisable pattern for any given patient. Neurological fatigue has been described as an overwhelming feeling of weakness not associated with increased physical effort.[2] There is near universal support that the fatigue experienced by people with MS goes beyond that of people without the disease.[3] Many multiple Sclerosis patients report sleeping more than 12 hours a night on successive nights and still being too tired to complete their daily duties despite feeling physically rested. This fatigue is also highly variable and there are some with MS who do not experience neurological fatigue as a primary symptom.[4] As this fatigue is an invisible symptom, and because of the difficulty of explaining the 'tired brain' feeling of neurological fatigue, others can misinterpret the behavior of persons with MS as lack of effort[5], but it is important for those dealing with MS patients to realize that this may not be the case.

Suspected Causes

The specific causes of neurological fatigue in Multiple Sclerosis sufferers is not fully understood. The leading theory includes 'tired neurons,' whereby the patient experiences marked mental fatigue due to the overworking of demyelinated neurons within the brain and central nervous system. This is thought to be compounded by depression, which is very common in Multiple Sclerosis and many other degenerating diseases.


Treatment with modafinil has been shown to significantly improve fatigue and sleepiness and is well tolerated by patients with MS. Unlike the higher dose regimen required in narcolepsy, a low-dose regimen of modafinil is effective in MS.[6]

Other treatments include elevated doses of caffiene, cold body suits, and regular exercise.

External Information

Modafinil in treatment of fatigue in multiple sclerosis

Fatigue and Multiple Sclerosis (MS)