September 2007 - Number 5 & 6 (7 صفحه - از 40 تا 46)
Multiple Sclerosis (M.S) is one of the prevalent diseases of the central nervous system which cause disability in young adults. This appears as neural signs in different parts and various times. The main defect is local deterioration or destruction of myelin tissue in the brain and spinal cord. Profound fatigue is one the most common symptoms of this disease. Because MS is prevalent in middle ages, so the presence of this symptom affects the life and activity of the patient In these ages people have high amount of activities and this functional disorder creates many difficulties for daily works in patient. For this reason, fatigue problem in patients, always, have caught the attention of researchers. Despite numerous studies, still the exact reason for producing fatigue have not been mentioned But several mechanisms have been discussed, such as: autoimmune mechanism of the disease, Involvement and disorder of endocrine system, involvement of central nervous system and de-synchronization of autonom system. Among these, autoimmune mechanism is considered as a main role in producing fatigue. Lack of proper knowledge regarding exact fatigue mechanism several problems in its treatment. Evaluation is the first step for controlling fatigue, which is done through various tests. Clear and proper evaluation can be obtained by these tests. After evaluation, non-drug and finally drug procedures are helpful. In non-drug treatment the focus is on: sport exercises, suitable diet program, identification and improvement of the patient psychotic disorders, energy conservation methods. Finally, the use of drugs such as Amantadine, Pemoline and Modafini is recommended for fatigue treatment.خلاصه ماشینی:
"Despite numerous studies, still the exact reason for producing fatigue have not been mentioned; But several mechanisms have been discussed, such as: autoimmune mechanism of the disease, Involvement and disorder of endocrine system , involvement of central nervous system and de-synchronization of autonom system. In non-drug treatment the focus is on: sport exercises, suitable diet program, identification and improvement of the patient psychotic disorders, energy conservation methods. Keywords: multiple sclerosis, fatigue, diagnosis, treatment Introduction: Profound fatigue has different meaning for doctors and patients. Different mechanisms explain the appearance of fatigue in MS patients, such as: 1) Autoimmune nature of this disease , 2) Disorder in damaged neurons , 3) Change in response of endocrine system , 4) dys- synchronization of autonomous nervous system and consequently lack of energy conservation(9. In some other studies , damage of neural myelin and as a result, deficit in muscles innervations have been explained as a reason of fatigue , in a way that for doing one movement or act , motor center must produce further impulses(19)& consequently consume more energy. Factors like drug consumption, psychological disorders & sleep problems are the other reasons of fatigue in MS patients. On the other hand, doing tests to determine the mental and psychological status of patient and for different reasons can help MS patients; such as: prevention of cardiovascular disease, decrease of obesity, weight control, treatment of psychological signs(42). Reduced glucose metabolism in the frontal cortex and basal ganglia of multiple sclerosis patients with fatigue ; an 18F-Fluoro deoxyglucose positron emission tomography study Neurology . Amantadine treatment of fatigue associated with multiple sclerosis Arch Neurol ."
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