Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Dantrolene sodium or dantrolene1 is 1([5-(nitrophenyl)furfurylidend] amino) hydantoin sodium hydrate. It is indicated for use in chronic disorders characterised by skeletal muscle spasticity, such as spinal cord injury, stroke, cerebral palsy and multiple sclerosis. Dantrolene is believed to act directly on the contractile mechanism of skeletal muscle to decrease the force of contraction in the absence of any demonstrated effects on neural pathways, on the neuromuscular junction, or on the excitable properties of the muscle fibre membranes. Controlled trials have demonstrated that dantrolene is superior to placebo in adults or children with spasticity from various causes, as evidenced by clinical assessments of disability and daily activities, and by muscle and reflex responses to mechanical and electrical stimulation. It is somewhat less effective in patients with multiple sclerosis than in those with spasticity from other causes. There has been a general clinical impression in controlled trials that dantrolene caused less sedation than would have been expected from therapeutically comparable doses of diazepam. In 2 controlled trials, there was no significant difference between dantrolene and diazepam in terms of reductions in spasticity, clonus, and hyperreflexia, but side-effects such as drowsiness and inco-ordination occurred significantly more frequently on diazepam. Long-term studies have indicated continuing benefit for patients taking dantrolene, though the incidence of side-effects has often been high and there has been a suggestion of exacerbation of seizures in children with cerebral palsy. Dantrolene may be of value in the medical treatment of spasm of the external urethral sphincter due to neurological and non-neurological disease, and animal studies suggest a potential use in the management of malignant hyperpyrexia. Chemical evidence of liver dysfunction may occur in 0.7 to 1% of patients on long-term treatment with dantrolene, with symptomatic hepatitis in 0.35 to 0.5% and fatal hepatitis in 0.1 to 0.2%. The drug commonly causes transient drowsiness, dizziness, weakness, general malaise, fatigue and diarrhoea at the start of therapy. Muscle weakness may be the principal limiting side-effect in ambulant patients, particularly in those with multiple sclerosis, and therapy could be hazardous in patients with pre-existing bulbar or respiratory weakness. The dosage of dantrolene has been fixed in most controlled trials, though long-term studies have indicated the need for individualisation of dosage. The initial dose is usually 25mg once daily, increasing to 25mg two, three or four times daily, and then by increments of 25mg up to as high as 100mg two, three or four times daily. The lowest dose compatible with optimal response is recommended.
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PMID:Dantrolene sodium: a review of its pharmacological properties and therapeutic efficacy in spasticity. 31 89

The first autopsy of a case of multiple sclerosis from the District of Hokuriku was reported. The patient, a 50-year-old house-wife, born in Toyama Prefecture, had noticed a paresthesia of her face, fatigue, numbness and weakness in the right limbs, dimness of vision and gait disturbance at ave 44. Furthermore, in the course of the disease, she had suffered from visual disorder, tetraplegia, hyperreflexia, pyramidal signs and cerebellar syndroms such as dysarthria, nystagmus, intention tremor and ataxia. She also showed symptoms of euphoria and dementia. After a course of six years she died of bronchopneumonia. Remissions and exacerbations were noted four times during her clinical history. Histopathologically, there were many recent and old demyelinating lesions of varying sizes and shapes in all parts of the central nervous system, namely the cerebrum, brainstem, spinal cord and optic nerve. In contrast to the clinical symptoms, the cerebellum itself revealed less plaques than the other areas of the brain. According to the observed distributions of the lesions, our case can be classified as belonging to the optico-cerebro-spinal type in the Ikuta and Zimmerman classification. The demyelinated lesions were characterized by a perivenular distribution of the plaques, lack of tissue necrosis, paucity of inflammatory reaction and marked fibrous gliosis of varying degrees.
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PMID:First autopsy report of a multiple sclerosis case in Hokuriku District of Japan. 53 38

A rapid visual resolution test conducted on available equipment reveals the presence of rapid falloff in acuity in a case of probable multiple sclerosis. Intense large field illumination was used, and grating acuity was tested using laser red light. The effect is so large that minor anomalies (not subjectively appreciated) or the residuum of earlier minor attacks of retrobulbar optic neuritis can be readily detected. A related "visual fatigue or saturation-like syndrome" was described earlier. In bright environments these patients' vision fades. Briefly closing the eyes restores visual sensitivity. Providing filters or lowering the light level tends to maintain vision. This test must be studied intensively. It offers a noninvasive simple means of showing underlying anomalies in neural conduction of the visual signal. Such anomalies can be prognostic and previously have been revealed only with sophisticated electrophysiological techniques.
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PMID:Visual resolution in a patient exhibiting a visual fatigue or saturation-like effect: probable multiple sclerosis. 75 95

For the past decade, our group of neurologists, biomedical engineers and statisticians has developed objective tests to quantify apropos neurological functions (cognition, strength, steadiness, reactions, speed, coordination, sensations, fatigue, gait, station and selected skills of daily living). Instrumented tests have been extensively evaluated and used in several randomized double-blind trials in multiple sclerosis and Parkinson's disease. Our long-term goal is to bring to clinical neurology a type of quantification of the nervous system which does not exist. In this report, a brief overview of test development, personnel training, test administration and selected situations for using the clinical quantitative neurological examination (CQNE) are discussed. In addition, 57 tests are illustrated and described.
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PMID:The neurological examination: advancements in its quantification. 119 Sep 96

The clinical eye signs of 31 myasthenic patients are presented and those signs important for an early diagnosis are then discussed: lid symptoms caused by fatigue (Simpson-test), characteristic lid twitches as well as alternating asymmetrical eye muscle pareses. The importance of an investigation with the tangent scale in the course of which tensilon is injected is pointed out. False diagnosis and differential diagnostic signs are then considered (disseminated sclerosis, aneeurysm, encephalitis, pseudopulbarparalysis). - Our electronystagmographical investigations of saccadic eye movements showed hypometric, alternating saccades with occasional nystagmuslike jerks. After Tensilon injection hypermetric saccades (overshoots) were observed which depended on a disproportion of the supranuclear oculomotor centers and the eye muscles. The "muscleparetic" nystagmus is a pathologically increased endposition nystagmus. The hypometric nystagmuslike jerks during a saccadic eye movement are caused by insufficient phasic innervation.
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PMID:[Diagnosis of myasthenic eye signs. Clinical signs and electronystagmographical findings of saccadic eye movements (author's transl)]. 120 48

Recently, the author has identified 19 patients who have complained of marked fatigue that had abnormal responses to copper test bracelets or necklaces. At this time, 8 have been shown to have at least one enzyme deficiency in the heme pathway. These patients have been diagnosed with multiple sclerosis, chronic fatigue syndrome and other non-specific diagnoses. A lengthy but still limited review of the literature was performed regarding the following conditions: multiple sclerosis (MS), hepatic porphyria (HP), chronic fatigue syndrome (CFS) and paralytic polio (PP). The text will focus on similar epidemiologies, laboratory findings and clinical courses. Copper as a common but not unique etiologic agent will be discussed; as will the heme pathway, a biologic process that may be disordered in all.
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PMID:Fatigue syndromes: new thoughts and reinterpretation of previous data. 146 Nov 85

Pharmacotherapy plays an important part in the overall management of patients with multiple sclerosis. Most therapies directed at altering the natural history of the underlying disease process are only partially effective or are controversial or experimental. However, many effective symptomatic therapies are available to the clinician. The action and uses of corticosteroids in multiple sclerosis are discussed, and approaches to the treatment of spasticity, paroxysmal disorders, bladder dysfunction, cerebellar ataxia, neurobehavioral manifestations, fatigue, and acute and chronic pain in patients with multiple sclerosis are examined.
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PMID:Pharmacotherapy of multiple sclerosis: current status. 151 15

Multiple sclerosis (MS), an unpredictable neurologic disease, is sometimes called the crippler of young adults. This crippling effect often involves sexual functioning. Sexuality is an issue that is frequently difficult for clients, their partners and health care providers to discuss. To address this difficulty, a teaching pamphlet entitled, MS ... Will it Come Between Us? was produced. Open communication and creativity are helpful in dealing with problems frequently encountered by clients with MS: fatigue, impotence, decreased vaginal lubrication, bladder and bowel dysfunction. The pamphlet helps clients with these issues as well as the basics of sexuality as a whole.
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PMID:Multiple sclerosis: will it come between us? Sexual concerns of clients and their partners. 151 64

Ten patients with a definite diagnosis of multiple sclerosis and complaints of "fatigue" were studied using (1) reaction times and event-related potentials accompanying the performance of auditory memory tasks (target detection, verbal short-term memory) and (2) motor conduction velocities of the pyramidal tract elicited by cerebral and cervical magnetic stimulation. Patients were studied when "rested" and when fatigued. Reaction times of the patients when rested were significantly delayed in the short-term memory but not the target-detection tasks when compared with normal controls. When patients were fatigued, their reaction times became significantly longer in all tasks compared with when they were rested. Event-related potentials in these tasks consist of N1/P2 sensory components and P3a and P3b cognitive components. The N1 component latency was longer and P3a and P3b amplitudes were reduced in patients compared with controls. Fatigue in patients with multiple sclerosis was accompanied by a shortening of P3a latency and an increase in P3a and P3b amplitudes compared with these measures when patients were rested. Pyramidal tract conduction velocities did not differ between rested and fatigued conditions. Thus, fatigue in patients with multiple sclerosis was associated with a slowing of performance (reaction time) on memory tasks, whereas brain potentials reflecting neural events of stimulus encoding and classification were either unchanged or paradoxically speeded up in latency in the fatigued compared with the rested conditions. We postulate that, in patients with multiple sclerosis, fatigue affects neural processes acting after stimulus evaluation but before activation of the primary motor pathways.
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PMID:'Fatigue' in patients with multiple sclerosis. Motor pathway conduction and event-related potentials. 158 Aug 15

Fatigue is a common chronic symptom of multiple sclerosis (MS) that can have disabling effects on the patient's quality of life. The cause of this fatigue is unknown, and there is no specific treatment for it. This article presents the major problem areas and manifestations associated with fatigue and incorporates suggested guidelines for the rehabilitation nurse to use in helping patients with MS manage this symptom. Major symptom areas include (a) physiological problems, (b) affective/behavioral/cognitive problems, and (c) environmental problems. Comprehensive intervention is addressed and the concept of fatigue as a nursing diagnosis is presented.
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PMID:Fatigue in multiple sclerosis: guidelines for nursing care. 163 94


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