Magdi Eid Nasr Al-Osali, Salim Said Abdulla Al Qassabi and Saud Mohammed Al-Harthi
Fatigue and weakness are terms that are often used as if the same thing, but in fact they describe tw o different sensations, both are nonspecific and in c ontrast to, weakness which usually indicates a medi cal disorder, fatigue may result from medical, psychia tric, or physiologic causes. Most patients with fat igue and weakness have self-limited conditions and do not se ek medical care, nevertheless, patients who present with either of them as the sole or major complaint may r epresent a more difficult diagnostic and therapeuti c problem. People suffering from certain medical cond itions may describe feelings of total body weakness , referring to feelings of tiredness, even though n o detectable loss of muscle strength is present. A precise understanding of the patient's description of fatig ue or weakness is imperative because this help the clinician to narrow down the possible causes and help better management. The clinician should rely upon open-end ed questions, encouraging the patient to describe the fatigue in his or her own words. Questions and comm ents such as "What do you mean by fatigue?" or "Please d escribe what you mean" may elicit responses that he lp distinguish fatigue from true weakness, asthenia, somnolence, shortness of breath, joint pain, limita tion of motion or orthostatic hypotension. Extensive labora tory evaluations in the absence of a positive histo ry or physical examination are of little diagnostic utili ty in the evaluation of the fatigued patient.
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