['Fatigue' in multiple sclerosis].

Fatigue is a common symptom in patients with multiple sclerosis. Rapid exhaustion and reduced exercise tolerance leads to difficulties in maintaining a normal daily life for many patients. Regular resting and short breaks can help to compensate this to a certain degree. The pathophysiology of fatigue is currently unknown. Damage of specific neuroanatomic regions or a more generalized effect of inflammatory mediators in the central nervous system could be the causes of fatigue. Some drugs (e.g. amantadine) have proven effective in therapy of fatigue. Recent therapeutic approaches have begun using aminopyridines (4-aminopyridine, 3,4-diaminopyridine). These two substances are thought to improve nerve conduction, but there might be a central stimulatory effect as well. Overdosage leads to an elevated risk of epileptic seizures and confusion.