Fatigue is a commonly reported symptom of many neurological diseases, including multiple sclerosis, stroke, Parkinson’s and traumatic brain injury. This type of fatigue is known as neurological fatigue.
Neurological fatigue can have a huge impact on quality of life and disability. People who live with this type of fatigue can experience shortness of breath, slower speech, forgetfulness, irritability and withdrawal.
Despite its huge impact on a person’s well being, fatigue is still not well understood. In this article, we will look at the prevalence, triggers and effects of neurological fatigue and discuss management options.
What is Neurological Fatigue
Fatigue is often defined as an overwhelming feeling of tiredness and exhaustion. Research distinguishes fatigue from other symptoms such as sleepiness, depression, and apathy. It is important to recognize that fatigue is the primary symptom and not secondary to medications, mood or lack of sleep.[i]
In neurological illnesses the prevalence of fatigue is higher than would be expected based on disability and age.[ii] The prevalence of fatigue varies with the type of neurological condition. In traumatic brain injury the prevalence of fatigue ranges from 45-73 percent while in stroke this range is between 36-77 percent.[iii]
Neurological fatigue can result from both physical and mental tasks. With neurological fatigue tasks that may have been easy beforehand such as walking the dog or having a conversation with a friend can become both physically and cognitively fatiguing.
It is also common in many chronic illnesses including cardiovascular disease, arthritis, and cancer that can accompany neurological diseases.
The Effects of Fatigue
- Physical symptoms: a pale or greyish pallor, glazed eyes, headaches, tension in muscles, shortness of breath, slower movement and speech, decreased coordination, or difficulty staying awake.
- Cognitive symptoms: increased forgetfulness, distractibility, decreased ability to follow directions, making an increased number of mistakes, decreased awareness of surroundings, or increased response time or lack of response.
- Social/Emotional symptoms: decreased ability to communicate effectively, decreased ability to engage in social activities, irritability, restlessness, emotional lability, increased negative thoughts, withdrawal, short answers, dull tone of voice, lack of motivation and interest, or difficulty engaging in activities of daily living.[iv]
What Causes Neurological Fatigue?
We use many different pathways and areas of the brain to coordinate and carry out our daily activities. When an area of the brain or peripheral nervous system is damaged, this can lead to an overtaxing of other neural systems or pathways to carry out these normal activities.