title: Fatigue heralding multiple sclerosis.
abstract: BACKGROUND
  Fatigue is a common symptom in multiple sclerosis (MS) and is an important determinant of overall well-being and disability.
  
  
  OBJECTIVE
  To assess the frequency with which fatigue precedes the diagnosis of MS using a retrospective database analysis.
  
  
  METHODS
  Between January 1, 2003 and September 30, 2008, patients diagnosed with fatigue with and without fatigue-related medications within a 3-year period prior to newly diagnosed MS were identified from the MarketScan Databases. All statistical analysis was performed using SAS.
  
  
  RESULTS
  Of the 16,976 patients with MS in the overall population, 5305 (31.3%) were newly diagnosed with MS and had three years of continuous healthcare coverage prior to MS diagnosis. Of these patients, 1534 (28.9%) were labeled with chronic fatigue syndrome (ICD9-780.71) or malaise or fatigue (ICD9-780.79) prior to the diagnosis of MS. One-third of these patients were labeled with fatigue one to two years before the diagnosis; 30.8% were diagnosed only with fatigue and had no other MS symptoms prior to their MS diagnosis. Among the patients diagnosed with fatigue, 10.4% were also prescribed medication for fatigue.
  
  
  CONCLUSIONS
  This study demonstrates that fatigue may herald MS, often by years. A careful history for transient neurological symptoms and a physical examination is warranted in any patient presenting with fatigue.
authors: Department of Neurology, University of Kentucky College of Medicine, Lexington, KY, USA.
authors: Joseph R
authors: JR
authors: Berger
authors: Jennifer
authors: J
authors: Pocoski
authors: Ronald
authors: R
authors: Preblick
authors: Susan
authors: S
authors: Boklage
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005221:Fatigue / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications*; D012189:Retrospective Studies; D055815:Young Adult
keywords: chronic; epidemiology; fatigue; fatigue syndrome; malaise; multiple sclerosis; quality of life