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Pseudo-fatigue 21 Sep 1998 The very last article from last year's symposium on Cell Death And Neuroprotection In PD* which I reviewed in yesterday's 3-page message, contains a casual but most fascinating mention of "pseudo-fatigue" as a component of the PD syndrome. That must be exactly the same as what I have called "quick exhaustion", as distinguished from "chronic fatigue" which is a very frequent complaint of PWP, in my personal notes summarizing the various symptoms of PD, as seen below: "Chronic Fatigue: PWP often complain of constant tiredness or lack of energy, even in the morning after a restful night. "Chronic Fatigue Syndrome" is a recognized clinical condition, but I think it is unrelated to PD because it affects others as well. Ordinary fatigue or exhaustion follows prolonged strenuous exertion, such as an athletic contest or a difficult mountain climb, as muscles are depleted of chemicals that enable them to function, for example blood sugars and oxygen. Ordinary fatigue abates upon prolonged rest, which permits weary muscles to recover their normal chemical state. Quick Exhaustion: What some PWP call "Chronic Fatigue", I prefer to call "Quick Exhaustion". It is not due to running out of blood sugar or oxygen, but mimics the real thing with labored breath and rapid pulse, even in moderate exertion such as climbing a flight of stairs, or doing a tedious manual task. Ignoring this kind of fatigue may trigger pain in an unrelated area, such as the upper back. Its sudden onset and equally quick recovery, after a brief rest or an extra dose of levodopa, shows the connection with PD. In a treadmill test, the technician may notice the unusually rapid "cooling off" of pulse and breathing rates." *Marsden C, Olanow C; Ann Neur 1998;44S1:189-196 The mention is fascinating, because although I have observed this "quick exhaustion" in myself and heard it described by other PWP, I've never seen it mentioned in all the scientific literature about PD, and until now I have assumed it was simply overlooked by the scientific and medical community. A quick check of Medline turned up only 4 mentions of "pseudo-fatigue" in the past year, of which none were connected to PD. It would certainly be interesting to hear more about this. Cheers, Joe -- J. R. Bruman (818) 789-3694 3527 Cody Road Sherman Oaks, CA 91403-5013