Multiple Sclerosis/Chronic Fatigue Syndrome overlap: When two common disorders collide

NeuroRehabilitation. 2014;35(3):529-34. doi: 10.3233/NRE-141146.


Introduction: Fatigue is a major cause of disability and handicap in Multiple Sclerosis (MS) patients. The management of this common problem is often difficult. Chronic Fatigue Syndrome (CFS/ME) is another common cause of fatigue which is prevalent in the same population of middle aged females commonly affected by MS.

Aim: This report aims at examining the potential coexistence of MS and CFS/ME in the same patients.

Method: This is a retrospective study examining a cohort of MS patients referred for rehabilitation. The subjects were screened for CFS/ME symptoms.

Results: Sixty-four MS patients (43 females) were screened for CFS/ME. Nine patients (14%) with a mean age 52 (SD 9.7) who were all females fulfilled the Fukuda criteria for diagnosis of CFS/ME. Their symptoms, including muscular and joint pain, malaise and recurrent headaches, were not explained by the pattern of their MS.

Discussion: MS and CFS/ME are two common conditions with increased prevalence in middle aged females. As the diagnosis of CFS/ME is clinical with no positive clinical signs or investigations; it can be made with difficulty in the presence of another clear explanation for the disabling fatigue. Our results suggest that the two conditions may co-exist. Considering CFS/ME as a potential co-morbidity may lead to more focused and appropriate management.

Keywords: Chronic Fatigue Syndrome; Multiple Sclerosis; fatigue; myalgic encephalitis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Arthralgia / etiology
  • Arthralgia / rehabilitation
  • Cohort Studies
  • Fatigue Syndrome, Chronic / complications*
  • Fatigue Syndrome, Chronic / physiopathology
  • Fatigue Syndrome, Chronic / rehabilitation
  • Female
  • Headache / etiology
  • Headache / rehabilitation
  • Humans
  • Male
  • Middle Aged
  • Mobility Limitation
  • Multiple Sclerosis / complications*
  • Multiple Sclerosis / physiopathology
  • Multiple Sclerosis / rehabilitation
  • Myalgia / etiology
  • Myalgia / rehabilitation
  • Retrospective Studies
  • Treatment Outcome