A patient may develop significant fatigue following a stroke. It is often necessary to distinguish primary from secondary fatigue.


Features of a stroke that may increase the risk of post-stroke fatigue:

(1) subcortical ischemia

(2) ischemia of the thalamus and/or basal ganglia

(3) brainstem ischemia


Right hemispheric strokes are associated with a greater risk of fatigue and loss of energy.


Patients with post-stroke fatigue:

(1) tend to be older

(2) may have significant comorbidity prior to the stroke

(3) are at increased risk for impaired activities of daily living (ADL)

(4) have increased mortality

Causes of Secondary Fatigue

Distinguishing Features


fatigue reduced by effective therapy

disordered sleep, including sleep apnea

fatigue improves with improved sleep


fatigue improves once the drug is stopped


It is important to ask a patient about fatigue and loss of energy following a stroke, since it may be associated with significant impairment for the patient.


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