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Lawley A, Abbas A, Seri S, Rajabally YA. Peripheral nerve electrophysiology studies in relation to fatigue in patients with chronic inflammatory demyelinating polyneuropathy. Clin Neurophysiol 2020; 131:2926-2931. [PMID: 32928696 DOI: 10.1016/j.clinph.2020.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 07/07/2020] [Accepted: 08/03/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To explore the relationship between fatigue, standard electrophysiological parameters and number and size of functioning motor units in patients with chronic inflammatory demyelinating polyneuropathy (CIDP). METHODS Experienced fatigue was assessed using the linearly-weighted, modified Rasch-built fatigue severity scale (R-FSS) and the multidimensional Checklist of Individual Strength (CIS). Averaged electrophysiology values were calculated from multiple nerves. Motor Unit Number Index (MUNIX) technique was utilised to assess motor unit function. Assessments were repeated in 15 patients receiving regular intravenous immunoglobulin therapy, with changes in parameters calculated. RESULTS R-FSS and CIS scores did not correlate MUNIX or MUSIX sum scores from 3 different muscles. Inverse correlation was observed only between distal CMAP area and R-FSS but not CIS scores. However, changes in distal CMAP area and R-FSS scores on repeat assessment were not correlated. CONCLUSIONS Experienced fatigue does not appear to correlate with loss of functioning motor units in patients with CIDP. Changes in experienced fatigue on repeat assessment did not correlate with changes in any of the electrophysiological parameters, suggesting fatigue experienced in CIDP is not strongly correlated with peripheral nerve dysfunction. SIGNIFICANCE Nerve conduction studies and MUNIX values do not appear to be useful surrogate markers for fatigue in CIDP.
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Affiliation(s)
- Andrew Lawley
- School of Life and Health Sciences, Aston Brain Centre, Aston University, Birmingham, UK; Department of Clinical Neurophysiology, The Birmingham Women's and Children's Hospital NHS Foundation Trust, UK
| | - Ahmed Abbas
- Inflammatory Neuropathy Clinic, University Hospitals Birmingham, Birmingham, UK
| | - Stefano Seri
- School of Life and Health Sciences, Aston Brain Centre, Aston University, Birmingham, UK; Department of Clinical Neurophysiology, The Birmingham Women's and Children's Hospital NHS Foundation Trust, UK
| | - Yusuf A Rajabally
- Inflammatory Neuropathy Clinic, University Hospitals Birmingham, Birmingham, UK; Aston Medical School, Aston University, Birmingham, UK.
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Lawley A, Abbas A, Seri S, Rajabally YA. Clinical correlates of fatigue in chronic inflammatory demyelinating polyneuropathy. Muscle Nerve 2020; 62:226-232. [DOI: 10.1002/mus.26913] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 05/01/2020] [Accepted: 05/03/2020] [Indexed: 11/11/2022]
Affiliation(s)
- Andrew Lawley
- School of Life and Health Sciences, Aston Brain CentreAston University Birmingham United Kingdom
| | - Ahmed Abbas
- Inflammatory Neuropathy Clinic, Department of NeurologyUniversity Hospitals Birmingham Birmingham United Kingdom
| | - Stefano Seri
- School of Life and Health Sciences, Aston Brain CentreAston University Birmingham United Kingdom
| | - Yusuf A. Rajabally
- Inflammatory Neuropathy Clinic, Department of NeurologyUniversity Hospitals Birmingham Birmingham United Kingdom
- Aston Medical SchoolAston University Birmingham United Kingdom
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Kacar A, Bjelica B, Bozovic I, Peric S, Nikolic A, Cobeljic M, Petrovic M, Stojanov A, Djordjevic G, Vukojevic Z, Dominovic-Kovacevic A, Stojanovic M, Stevic Z, Rakocevic-Stojanovic V, Lavrnic D, Basta I. Neuromuscular disease-specific questionnaire to assess quality of life in patients with chronic inflammatory demyelinating polyradiculoneuropathy. J Peripher Nerv Syst 2018; 23:11-16. [PMID: 29360221 DOI: 10.1111/jns.12251] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 01/13/2018] [Accepted: 01/18/2018] [Indexed: 11/28/2022]
Abstract
To date, generic questionnaires have been used to investigate quality of life (QoL) in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) patients. Although these measures are very useful, they are not usually precise enough to measure all specific characteristics of the disease. Our aim was to investigate QoL using the neuromuscular disease-specific questionnaire (individualized neuromuscular quality of life, INQoL) in a large cohort of patients with CIDP. Our study comprised 106 patients diagnosed with CIDP. INQoL questionnaire, Medical Research Council (MRC) sum score, Inflammatory Neuropathy Cause and Treatment (INCAT) disability score, Visual Analogue Pain Scale, Beck Depression Inventory, and Krupp's Fatigue Severity Scale were used in our study. Physical domains of INQoL were more affected than mental, and the overall score was 57 ± 25. Significant predictors of higher INQoL score in our patients with CIDP were severe fatigue (β = 0.35, p < 0.01), higher INCAT disability score at time of testing (β = 0.29, p < 0.01), and being unemployed/retired (β = 0.22, p < 0.05). QoL was reduced in our cohort of CIDP patients, which was more pronounced in physical segments. Patients with fatigue, more severe disability, and unemployed/retired need special attention of neurologists because they could be at greater risk to have worse QoL.
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Affiliation(s)
- Aleksandra Kacar
- Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Bogdan Bjelica
- Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ivo Bozovic
- Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Stojan Peric
- Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ana Nikolic
- Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Mina Cobeljic
- Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milutin Petrovic
- Neurology Clinic, Clinical Center Kragujevac, Kragujevac, Serbia
| | | | | | - Zoran Vukojevic
- Neurology Clinic, Clinical Center Banja Luka, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
| | | | | | - Zorica Stevic
- Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Dragana Lavrnic
- Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ivana Basta
- Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
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Simatos Arsenault N, Vincent PO, Yu BHS, Bastien R, Sweeney A. Influence of Exercise on Patients with Guillain-Barré Syndrome: A Systematic Review. Physiother Can 2016; 68:367-376. [PMID: 27904236 DOI: 10.3138/ptc.2015-58] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: To evaluate the effects of exercise interventions on improving physical outcomes in patients with Guillain-Barré syndrome (GBS). Methods: The PubMed database was searched for articles published up to and including February 2015. Randomized controlled trials (RCTs), case reports, and quasi-experimental and single-subject designs published in English-language, peer-reviewed journals that assessed the impact of physical exercise on patients with GBS were included; study quality was assessed using Sackett's rules of evidence. Data are presented qualitatively and quantitatively using numerical values and percentages. Results: Seven articles were included in the systematic review. One RCT showed that high-intensity relative to lower intensity exercise significantly reduced disability in patients with GBS, as measured with the FIM (p<0.005, r=0.71). Overall, various types of exercise programmes improve physical outcomes such as functional mobility, cardiopulmonary function, isokinetic muscle strength, and work rate and reduce fatigue in patients with GBS. Conclusion: Because of insufficient high-quality literature, making confident conclusions about the effects of exercise interventions on physical outcomes in patients with GBS is not possible. Future research should consider using higher quality study designs to confirm the results outlined in this article.
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Affiliation(s)
- Nicholas Simatos Arsenault
- Rehabilitation Science in Physical Therapy Program, School of Physical and Occupational Therapy, McGill University, Montreal
| | - Pierre-Olivier Vincent
- Rehabilitation Science in Physical Therapy Program, School of Physical and Occupational Therapy, McGill University, Montreal
| | - Bai He Shen Yu
- Rehabilitation Science in Physical Therapy Program, School of Physical and Occupational Therapy, McGill University, Montreal
| | - Robin Bastien
- Rehabilitation Science in Physical Therapy Program, School of Physical and Occupational Therapy, McGill University, Montreal
| | - Aaron Sweeney
- Rehabilitation Science in Physical Therapy Program, School of Physical and Occupational Therapy, McGill University, Montreal
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Merkies ISJ, Kieseier BC. Fatigue, Pain, Anxiety and Depression in Guillain-Barré Syndrome and Chronic Inflammatory Demyelinating Polyradiculoneuropathy. Eur Neurol 2016; 75:199-206. [PMID: 27077919 DOI: 10.1159/000445347] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 03/08/2016] [Indexed: 01/13/2023]
Abstract
BACKGROUND In the clinical evaluation of patients with Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), scant attention is paid to symptoms such as fatigue, pain and anxiety/depression. We aimed at addressing seminal studies that focused on the burden of these symptoms and their impact on quality of life (QoL) in these conditions. SUMMARY Fatigue, pain, and anxiety/depression are increasingly being recognized in patients with GBS and CIDP, although their pathophysiological provenance remains unknown. Fatigue and pain are significant in terms of prevalence and intensity, may be a presenting symptom, and can persist for years after apparent functional recovery, suggesting residual injury. Anxiety/depression has also been examined although studies are limited. Despite their negative impact on QoL, the long-term dynamics of these symptoms in patients with GBS and particularly CIDP receiving therapy in routine clinical practice have not been systematically evaluated. Such observations formed the basis for the ongoing (GAMEDIS) studies evaluating the effect of Gamunex on fatigue and depression in patients with CIDP, of which some preliminary data are presented. KEY MESSAGES Strength and sensory deficits are the main areas of focus in patients with GBS and CIDP, but they do not explain the total reduction in QoL, suggesting the possible role of other complaints. A more comprehensive approach to patient care demands that factors such as pain, fatigue and anxiety/depression receive greater attention. The non-interventional GAMEDIS studies are expected to provide valuable insight into the long-term effectiveness of Gamunex in everyday practice.
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Affiliation(s)
- Ingemar S J Merkies
- Department of Neurology, Maastricht University Medical Centre, Maastricht, The Netherlands
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Van Eijk JJJ, Groothuis JT, Van Alfen N. Neuralgic amyotrophy: An update on diagnosis, pathophysiology, and treatment. Muscle Nerve 2016; 53:337-50. [PMID: 26662794 DOI: 10.1002/mus.25008] [Citation(s) in RCA: 160] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2015] [Indexed: 12/21/2022]
Abstract
In this review we provide a current overview of the clinical features, pathophysiology, epidemiology, and diagnostic and therapeutic strategies in neuralgic amyotrophy (NA). The disorder has several phenotypic variations, with a classic form in 70% of the patients. It is not rare, with an incidence of 1 per 1,000 individuals, but it is still often missed. Recurrences are common, yet the proposed multifactorial etiology, which includes genetic, biomechanical, and immunologic factors, limits our capacity to predict or prevent them. NA is a clinical diagnosis, and ancillary studies serve to exclude infectious or malignant causes or to assess a differential diagnosis. If patients are seen early and are still in pain, a short trial of high-dose oral corticosteroids is advised, and adequate analgesia may require opioids and non-steroidal anti-inflammatory drugs. Persistent complaints are common, and a multidisciplinary rehabilitation approach focusing on scapular coordination, energy distribution strategies, and self-management is indicated.
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Affiliation(s)
- Jeroen J J Van Eijk
- Department of Neurology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.,Department of Neurology and Clinical Neurophysiology, Donders Centre for Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jan T Groothuis
- Department of Rehabilitation, Donders Centre for Neuroscience, Radboud University Medical Center, P.O. Box 9101, 6500, HB Nijmegen, The Netherlands
| | - Nens Van Alfen
- Department of Neurology and Clinical Neurophysiology, Donders Centre for Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
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White CM, van Doorn PA, Garssen MPJ, Stockley RC. Interventions for fatigue in peripheral neuropathy. Cochrane Database Syst Rev 2014; 2014:CD008146. [PMID: 25519471 DOI: 10.1002/14651858.cd008146.pub2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Persistent feelings of fatigue (or subjective fatigue), which may be experienced in the absence of physiological factors, affect many people with peripheral neuropathy. A variety of interventions for subjective fatigue are available, but little is known about their efficacy or the likelihood of any adverse effects for people with peripheral neuropathy. OBJECTIVES To assess the effects of drugs and physical, psychological or behavioural interventions for fatigue in adults or children with peripheral neuropathy. SEARCH METHODS On 5 November 2013, we searched the Cochrane Neuromuscular Disease Group Specialized Register, CENTRAL, MEDLINE, EMBASE, CINAHL Plus, LILACS and AMED. We also searched reference lists of all studies identified for inclusion and relevant reviews, and contacted the authors of included studies and known experts in the field to identify additional published or unpublished data. We also searched trials registries for ongoing studies. SELECTION CRITERIA We considered for inclusion randomised controlled trials (RCTs) and quasi-RCTs comparing any form of intervention for fatigue management in adults with peripheral neuropathy with placebo, no intervention or an alternative form of intervention for fatigue. Interventions considered included drugs, pacing and grading of physical activity, general or specific exercise, compensatory strategies such as orthotics, relaxation, counselling, cognitive and educational strategies. DATA COLLECTION AND ANALYSIS Two review authors independently assessed risk of bias and extracted study data. We contacted study authors for additional information. We collected information on adverse events from the included trials. MAIN RESULTS The review includes three trials, which were all at low risk of bias, involving 530 people with peripheral neuropathy. The effects of amantadine from one randomised, double-blind, placebo-controlled, cross-over trial comparing amantadine with placebo for the treatment of fatigue in 80 people with Guillain-Barré syndrome (GBS) were uncertain for the proportion of people achieving a favourable outcome six weeks post-intervention (odds ratio (OR) 0.56 (95% confidence interval (CI) 0.22 to 1.35, N = 74, P = 0.16). We assessed the quality of this evidence as low. Two parallel-group randomised double-blind, placebo-controlled trials comparing the effects of two doses of ascorbic acid with placebo for reducing fatigue in adults with Charcot-Marie-Tooth disease type 1A (CMT1A) showed that the effects of ascorbic acid at either dose are probably small (standardised mean difference (SMD) -0.12 (95% CI -0.32 to 0.08, n = 404, P = 0.25)) for change in fatigue after 12 to 24 months (moderate quality evidence). Neither ascorbic acid study measured fatigue at four to 12 weeks, which was our primary outcome measure. No serious adverse events were reported with amantadine. Serious adverse events were reported in the trials of ascorbic acid. However,risk of serious adverse events was similar with ascorbic acid and placebo. AUTHORS' CONCLUSIONS One small imprecise study in people with GBS showed uncertain effects of amantadine on fatigue. In two studies in people with CMT1A there is moderate-quality evidence that ascorbic acid has little meaningful benefit on fatigue. Information about adverse effects was limited, although both treatments appear to be well tolerated and safe in these conditions.There was no evidence available from RCTs to evaluate the effect of other drugs or other interventions for fatigue in either GBS, CMT1A or other causes of peripheral neuropathy. The cost effectiveness of different interventions should also be considered in future randomised clinical trials.
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Affiliation(s)
- Claire M White
- Health & Social Care Research, Faculty of Life Sciences &Medicine, King’s College London, Room 3.22, Shepherd’s House, Guy’s Campus, London, SE1 1UL, UK.
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Aritake S, Kaneita Y, Ohtsu T, Uchiyama M, Mishima K, Akashiba T, Uchimura N, Nakaji S, Munezawa T, Ohida T. Prevalence of fatigue symptoms and correlations in the general adult population. Sleep Biol Rhythms 2014. [DOI: 10.1111/sbr.12099] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Sayaka Aritake
- Department of Psychophysiology; National Institute of Mental Health; National Center of Neurology and Psychiatry; Tokyo Japan
- Division of Sports Psychiatry and Neuroscience; Faculty of Sport Sciences; Waseda University; Tokyo Japan
| | - Yoshitaka Kaneita
- Department of Public Health; Nihon University School of Medicine; Tokyo Japan
- Department of Public Health and Epidemiology; Faculty of Medicine; Oita University; Oita Japan
| | - Tadahiro Ohtsu
- Department of Public Health; Showa University School of Medicine; Tokyo Japan
| | - Makoto Uchiyama
- Department of Psychiatry; Nihon University School of Medicine; Tokyo Japan
| | - Kazuo Mishima
- Department of Psychophysiology; National Institute of Mental Health; National Center of Neurology and Psychiatry; Tokyo Japan
| | - Tsuneto Akashiba
- Department of Sleep and Respiratory Medicine; Nihon University School of Medicine; Tokyo Japan
| | - Naohisa Uchimura
- Department of Neuropsychiatry; Kurume University School of Medicine; Kurume Japan
| | - Shigeyuki Nakaji
- Department of Social Medicine; Hirosaki University Graduate School of Medicine; Hirosaki Japan
| | - Takeshi Munezawa
- Department of Public Health; Nihon University School of Medicine; Tokyo Japan
| | - Takashi Ohida
- Department of Public Health; Nihon University School of Medicine; Tokyo Japan
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Campbell R, Gordon P, Ward K, Reilly C, Scott DL, Rafferty GF. Nonvolitional assessment of muscle endurance in idiopathic inflammatory myopathies: There is no relationship between patient-reported fatigue and muscle fatigability. Muscle Nerve 2014; 50:401-6. [DOI: 10.1002/mus.24148] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 11/10/2013] [Accepted: 12/02/2013] [Indexed: 11/08/2022]
Affiliation(s)
- Richard Campbell
- Department of Academic Rheumatology; King's College London, Weston Education Centre; Cutcombe Road, London SE5 9RJ UK
| | - Patrick Gordon
- Department of Academic Rheumatology; King's College London, Weston Education Centre; Cutcombe Road, London SE5 9RJ UK
| | - Katie Ward
- Department of Respiratory Medicine; Kings College; London UK
| | - Charles Reilly
- Department of Respiratory Medicine; Kings College; London UK
| | - David L. Scott
- Department of Academic Rheumatology; King's College London, Weston Education Centre; Cutcombe Road, London SE5 9RJ UK
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Abstract
Skeletal muscle fatigue is defined as the fall of force or power in response to contractile activity. Both the mechanisms of fatigue and the modes used to elicit it vary tremendously. Conceptual and technological advances allow the examination of fatigue from the level of the single molecule to the intact organism. Evaluation of muscle fatigue in a wide range of disease states builds on our understanding of basic function by revealing the sources of dysfunction in response to disease.
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Affiliation(s)
- Jane A Kent-Braun
- Department of Kinesiology, University of Massachusetts-Amherst, Amherst, Massachusetts, USA.
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12
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Drory VE, Bronipolsky T, Bluvshtein V, Catz A, Korczyn AD. Occurrence of fatigue over 20 years after recovery from Guillain–Barré syndrome. J Neurol Sci 2012; 316:72-5. [DOI: 10.1016/j.jns.2012.01.024] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2011] [Revised: 01/18/2012] [Accepted: 01/24/2012] [Indexed: 11/26/2022]
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Voermans N, Knoop H, Bleijenberg G, van Engelen B. Fatigue is associated with muscle weakness in Ehlers-Danlos syndrome: an explorative study. Physiotherapy 2011; 97:170-4. [DOI: 10.1016/j.physio.2010.06.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2009] [Accepted: 06/04/2010] [Indexed: 12/14/2022]
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de Vries JM, Hagemans MLC, Bussmann JBJ, van der Ploeg AT, van Doorn PA. Fatigue in neuromuscular disorders: focus on Guillain-Barré syndrome and Pompe disease. Cell Mol Life Sci 2010; 67:701-13. [PMID: 20196238 PMCID: PMC2824125 DOI: 10.1007/s00018-009-0184-2] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Revised: 10/12/2009] [Accepted: 10/13/2009] [Indexed: 12/03/2022]
Abstract
Fatigue accounts for an important part of the burden experienced by patients with neuromuscular disorders. Substantial high prevalence rates of fatigue are reported in a wide range of neuromuscular disorders, such as Guillain-Barré syndrome and Pompe disease. Fatigue can be subdivided into experienced fatigue and physiological fatigue. Physiological fatigue in turn can be of central or peripheral origin. Peripheral fatigue is an important contributor to fatigue in neuromuscular disorders, but in reaction to neuromuscular disease fatigue of central origin can be an important protective mechanism to restrict further damage. In most cases, severity of fatigue seems to be related with disease severity, possibly with the exception of fatigue occurring in a monophasic disorder like Guillain-Barré syndrome. Treatment of fatigue in neuromuscular disease starts with symptomatic treatment of the underlying disease. When symptoms of fatigue persist, non-pharmacological interventions, such as exercise and cognitive behavioral therapy, can be initiated.
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Affiliation(s)
- J M de Vries
- Department of Neurology, Erasmus MC, University Medical Centre, Room Number EE 22-30, Dr. Molenwaterplein 50-60, Postbus 2040, 3000 CA Rotterdam, The Netherlands.
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White CM, van Doorn PA, Garssen MPJ, Stockley RC. Interventions for fatigue in peripheral neuropathy. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2009. [DOI: 10.1002/14651858.cd008146] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Rekand T, Gramstad A, Vedeler CA. Fatigue, pain and muscle weakness are frequent after Guillain-Barré syndrome and poliomyelitis. J Neurol 2009; 256:349-54. [DOI: 10.1007/s00415-009-0018-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2007] [Revised: 04/23/2008] [Accepted: 05/29/2008] [Indexed: 10/21/2022]
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van Doorn PA, Ruts L, Jacobs BC. Clinical features, pathogenesis, and treatment of Guillain-Barré syndrome. Lancet Neurol 2008; 7:939-50. [PMID: 18848313 DOI: 10.1016/s1474-4422(08)70215-1] [Citation(s) in RCA: 492] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Guillain-Barré syndrome (GBS) is an important cause of acute neuromuscular paralysis. Molecular mimicry and a cross-reactive immune response play a crucial part in its pathogenesis, at least in those cases with a preceding Campylobacter jejuni infection and with antibodies to gangliosides. The type of preceding infection and patient-related host factors seem to determine the form and severity of the disease. Intravenous immunoglobulin (IVIg) and plasma exchange are effective treatments in GBS; mainly for practical reasons, IVIg is the preferred treatment. Whether mildly affected patients or patients with Miller Fisher syndrome also benefit from IVIg is unclear. Despite medical treatment, GBS often remains a severe disease; 3-10% of patients die and 20% are still unable to walk after 6 months. In addition, many patients have pain and fatigue that can persist for months or years. Advances in prognostic modelling have resulted in the development of a new and simple prognostic outcome scale that might also help to guide new treatment options, particularly in patients with GBS who have a poor prognosis.
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Affiliation(s)
- Pieter A van Doorn
- Department of Neurology, Erasmus Medical Centre, Rotterdam, Netherlands.
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18
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Zwarts M, Bleijenberg G, van Engelen B. Clinical neurophysiology of fatigue. Clin Neurophysiol 2008; 119:2-10. [DOI: 10.1016/j.clinph.2007.09.126] [Citation(s) in RCA: 119] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2007] [Revised: 09/07/2007] [Accepted: 09/23/2007] [Indexed: 10/22/2022]
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Orsini M, De Freitas MRG, Presto B, Mello MP, Reis CHM, Silveira V, Silva JG, Nascimento OJM, Leite MAA, Pulier S, Sohler MP. Guideline for Neuromuscular Rehabilitation in Guillain-Barré Syndrome. ACTA ACUST UNITED AC 2001. [DOI: 10.34024/rnc.2010.v18.8443] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Introduction. Originally described by Landry in 1859 and Guillain, Barré and Strohl in 1916, Guillain-Barré Syndrome (GBS) is the most common cause of acute neuromuscular paralysis selflimited in developed countries. The annual incidence of GBS is 1.5 per 100,000. Although it had a favorable prognosis (“maladie bénigne et spontanément curable”) it’s mortality rate is about 5% and 10% of patients remaining severely disabled one year after neurological onset. Specialist teams, intensive care and rehabilitation are essential for patient management and should be provided in appropriate hospital units. Objective. To guide the health professionals about the utilization of the physical and respiratory techniques in patients with GBS, as well as it’s indication. Method. Update of articles about GBS and Rehabilitation, on the last years of the data bases Bireme, ScienceDirect, PubMed and SciELO. Conclusion. There is currently no consensus on the management of these patients in the acute, sub-acute and chronic settings. Many of them are being discharged without access to rehabilitation services. Our results suggest that the rehabilitation makes a measurable and significant difference and should be available to all patients with GBS.
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