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Neurasthenia

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Copyright 1991, 1998, 2005

Synonyms of Neurasthenia

Disorder Subdivisions

General Discussion

The word "neurasthenia" is a term that has fallen into disuse among psychiatrists in the United States and Australia. It remains in use in the United Kingdom. Where it is used, it covers a wide spectrum of symptoms including the sensation of pain or of numbness in various parts of the body, chronic fatigue, weakness, anxiety, and fainting. Additional findings associated with this term may include rapid intense heartbeat that may be irregular (palpitations, tachycardia); cold, clammy hands and feet; abnormally rapid breathing (hyperventilating); dizziness or faintness; periodic sighing; and/or sweating for no apparent reason.

Symptoms

Major symptoms of neurasthenia include a feeling of weakness or fatigue, which may be accompanied by chest pain. A rapid intense heartbeat, which may be irregular (palpitations, tachycardia) can occur. The individual may have cold, clammy hands and feet. Hyperventilation causes a dizzy or faint feeling. Sighing periodically, or sweating for no reason are other symptoms associated with neurasthenia. This condition may occur along with, or after, depression or other psychological disorders.

Angiopathic neurasthenia (also called angioparalytic neurasthenia, or pulsating neurasthenia) refers to a mild form of Neurasthenia in which the patient feels a pulsing or throbbing sensation throughout the entire body. Gastric neurasthenia is a mild form of neurasthenia accompanied by digestive dysfunction and stomach enlargement (distention), and by indigestion (dyspepsia). Neurasthenia gravis refers to an extreme and persistent form of neurasthenia. Neurasthenia precox (or primary neurasthenia) tends to occur most often in adolescents and is characterized by nervous exhaustion.

Causes

Neurasthenia is a mental disorder caused by emotional stress or anxiety. It is not caused by any underlying physical (organic) problems even though physical discomfort can be present.

Affected Populations

Neurasthenia is a fairly common disorder which may occur in childhood, adolescence or adulthood. It affects males and females in equal numbers.

Related Disorders

Symptoms of the following disorders can be similar to those of neurasthenia. Comparisons may be useful for a differential diagnosis:

In hyperthyroidism, the thyroid gland is overactive and produces an excessive amount of thyroid hormones. Symptoms may include sweating, nervousness, emotional instability, fatigue, insomnia, increased appetite, weight loss, or diarrhea. A rapid heartbeat (tachycardia) or rapid twitching of the muscle of the heart's upper chambers (atrial fibrillation) may occur. Other symptoms may include sensitivity to heat (heat intolerance), trembling of the hands, or muscle weakness. A slight swelling in the neck just below the Adam's apple (due to thyroid gland enlargement), warm smooth skin, or bulging of the eyes (exophthalmos) may be present. In older people depression or heart failure may occur. A blood test for hyperthyroidism can rule it out as a cause for neurasthenia. (For more information on disorders of the thyroid, choose "thyroid" as your search term in the Rare Disease Database.)

Myalgic encephalomyelitis is thought to be an infectious disorder affecting the central, peripheral and autonomic nervous systems and the muscles. Major symptoms may include general exhaustion, headache, muscle pain, weakness, and possible mental changes. The exact cause of this disorder is unknown, but researchers believe a virus associated with an immune system abnormality may be responsible. Adults are most commonly affected, with more cases seen in females than in males. (For more information on this disorder, choose "Myalgic Encephalomyelitis" as your search term in the Rare Disease Database.)

Myasthenia gravis (MG) is a chronic neuromuscular disease characterized by weakness and abnormally rapid fatigue of the voluntary muscles, with improvement following rest. Any group of muscles may be affected, but those around the eyes and the muscles used for swallowing are the most commonly involved. In the majority of cases, the course of the disease is punctuated with periods of greater and lesser weakness. Short-term aggravation of symptoms can be provoked by a host of factors, including excessive physical activity, emotional upset, menstruation, and pregnancy. Complete spontaneous disappearance of symptoms has been reported in rare instances. (For more information on this disorder, choose "Myasthenia Gravis" as your search term in the Rare Disease Database.)

The main feature of panic-anxiety syndrome is the recurrence of panic attacks. Psychological symptoms may include intense apprehension, unreasonable fear of dying or impending doom, fear of becoming insane, or dread of losing control of the self. Physical manifestations are generally those commonly associated with panic or anxiety such as difficulty in breathing, irregular heartbeat, sweating, trembling and faintness. In addition, patients may experience chest pain, feelings of unreality, abnormal sensations (burning or pricking), dizziness, or hot and cold flashes. The symptoms usually become apparent in late adolescence or early adulthood. Attacks, which can occur at any time, usually last only minutes, though in rare cases they may last hours. (For more information on this disorder, choose "Panic-Anxiety" as your search term in the Rare Disease Database.)

Standard Therapies

Testing can be done to rule out any underlying physical (organic) causes that might lead to the symptoms of neurasthenia. Treatment includes reassuring the patient that the symptoms are not due to any physical (organic) causes. Counseling will be of benefit to the patient in learning how to control feelings of stress and anxiety. If necessary, biofeedback, sedatives or tranquilizers may be prescribed.

Investigational Therapies

Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government website.

For information about clinical trials being conducted at the National Institutes of Health (NIH) in Bethesda, MD, contact the NIH Patient Recruitment Office:

Tollfree: (800) 411-1222
TTY: (866) 411-1010
Email: prpl@cc.nih.gov

For information about clinical trials sponsored by private sources, contact:
www.centerwatch.com

Organizations related to Neurasthenia

References

TEXTBOOKS
Cecil Textbook of Medicine, 18th Ed.: James B. Wyngaarden, and Lloyd H. Smith, Jr., Editors; W.B. Saunders Co., 1988. Pp. 1322, 1324, 2124-2125, 2286.

Internal Medicine, 2nd Ed.: Jay H. Stein, ed.-in-chief; Little, Brown and Co., 1987. Pp. 374-375.

The Merck Manual, Volume 1, 15th Ed.: Robert Berkow, M.D., ed.-in-chief; Merck, Sharp, and Dohme Laboratories, 1987. Pp. 345.

JOURNAL ARTICLES
Feelings of Fatigue and Psychopathology: A Conceptual History. G.E. Berrios; Compr Psychiatry (Mar-Apr 1990; issue 31 (2)). Pp. 140-151.

Old Wine in New Bottles: Neurasthenia and 'Me'. S. Wessely; Psychol Med (Feb 1990; issue 20 (1)). Pp. 35-53.

Neurasthenia in the 1980's: Chronic Mononucleosis, Chronic Fatigue Syndrome and Anxiety and Depressive Disorders. D. B. Greenberg; Psychosomatics (Spring 1990; issue 31 (2)). Pp. 129-137.

Report last updated: 2008/04/25 00:00:00 GMT+0