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British Medical Bulletin 47:815-825 (1991)
© 1991 The British Council

other

Neurophysiology of postiviral fatigue syndrome

G A Jamal and R G Miller

Glasgow University Department of Neurology, Institute of Neurological Sciences, Sothern General Hospital Glasgow, UK
Department of Neurology, University of California San Francisco, California, USA

Abstract

The exact pathophysiology of excessive fatigue in patients with postviral fatigue syndrome (PVFS) remains uncertain in spite of increasing investigation. One objective abnormality of neuromuscular function is the increased jitter on single fibre EMG studies. While this is a sensitive technique which indicates a disturbance in the peripheral part of the mottor unit, it is non-specific and its role in the pathophysiology remains unclear. Impaired muscular activation with added force in response to superimposed electrical stimulation suggests an extra-muscular and/or central component of fatigue. Conventional neurophysiological studies and those of strength and endurance have shown no objective abnormality in patients compared with controls. The previous reports of disturbed muscle metabolism on NMR spectroscopy have not been confirmed in more recent studies and no consistent abnormality of excitation- contraction coupling has so far emerged. Finally, unlike patients with depression, congnitive evoked potential studies suggest impaired attention, memory and stimulus evaluation in importance of utilising approved clinical criterial for patient inclusion cannot be overemphasised. Control groups should include sedentary or deconditioned as well as depressed subjects to help standardise these important variables.


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