Frequency and characteristics of chronic fatigue syndrome in multiple sclerosis patients at a university hospital in Eastern Saudi Arabia

Abdullah S AlAmri; Foziah J AlShamrani; Noor M AlMohish; Azra S Zafar; Saud A Alnaaim; Hatem A Alazman; Ibrahim A Al-Ghanimi; Abdullah A AlNahdi; Fahad A AlDawsari; Shahad B AlMatrafi; Ghaida R Alzahrani; Muna S Alnamlah; Rawan A Alkhalifa

doi:10.4103/jfcm.jfcm_73_23

Frequency and characteristics of chronic fatigue syndrome in multiple sclerosis patients at a university hospital in Eastern Saudi Arabia

J Family Community Med. 2024 Jan-Mar;31(1):63-70. doi: 10.4103/jfcm.jfcm_73_23. Epub 2024 Jan 8.

Affiliations

¹ Department of Neurology, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
² Department of Clinical Neurosciences, College of Medicine, King Faisal University, Al-Hofuf, Saudi Arabia.
³ Department of Radiology, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
⁴ Department of Neurology, College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia.

Abstract

Background: Multiple sclerosis (MS) is a chronic, inflammatory demyelinating disease that affects various parts of the central nervous system. Fatigue, a common symptom, transient, prolonged, or chronic experienced by individuals with MS, can significantly impact daily functioning. It can be associated with underlying pathological processes or can have an idiopathic cause, such as chronic fatigue syndrome (CFS). The study aimed to assess the presence and etiology of fatigue in MS patients and its relationship with CFS.

Materials and methods: This cross-sectional study was conducted in the Eastern Province of Saudi Arabia. Data were collected using a questionnaire from a sample of 225 MS patients receiving care at our university hospital. The questionnaire included the Centers for Disease Control and Prevention (CDC) criteria for diagnosing CFS and the Expanded Disability Status Scale to evaluate fatigue in MS patients.

Results: Of the total of 225 MS patients who participated in this study, 87.1% were diagnosed with relapsing-remitting MS, 6.7% with primary progressive MS, 3.6% with clinically isolated syndrome, and 2.7% with secondary progressive MS. About 53% had experienced fatigue that persisted for over 6 months. Analysis of CFS diagnosis revealed that 7.3% of patients met both CDC criteria and self-reported answers while 17.5% reported having CFS despite not meeting the CDC criteria. These findings highlight a significant lack of agreement between patient-reported diagnoses and established criteria, indicating poor agreement (P = 0.028).

Conclusion: The study found an association between CFS and MS, and a significant impact on daily functioning. The study revealed lack of agreement between patient-reported diagnoses and established criteria for CFS. This emphasizes the need for a standardized approach to diagnosis and evaluation of fatigue in MS patients.

Keywords: Chronic fatigue syndrome; multiple sclerosis; myalgic encephalomyelitis.