Asthenia (fatigue) is one of the most common reasons for consultations. The term encompasses a variety of subjective sensations (tiredness, lack of energy, etc.). Many diseases are manifested initially by asthenia. We distinguish organic asthenia, psychiatric (depression, anxiety, PTSD) and reactive (isolated).
Clinical signs:
Clinical examination should include:
– The fact of occurrence: progressive or brutal, old or new, isolated or associated with other signs or special circumstances (work, intense activity, travel, illness).
– The nature of the fatigue: physical, intellectual, sexual; its occurrence in the morning (usually of psychological origin) or evening, which focuses more towards an organic cause.
– The associated clinical signs:
• the existence of general signs associated (loss of appetite, weight loss, fever) attests to a probable organic origin;
• the association of clinical signs corresponding to a particular organ precise etiology: cough and hemoptysis in tuberculosis, dyspnea in heart failure or anemia, abdominal pain parasites, jaundice hepatitis, etc;
• the association of sleep disorders, anorexia, behavior disorders, sad, slow, should suggest a depressive episode.
– Clinical examination will review:
• nutritional status: weight, signs of vitamin deficiency, anemia, etc. ;
• cardiopulmonary device: blood pressure, pulse, auscultation;
• the digestive tract;
• spleen, liver, lymph nodes;
• the state of the mucous membranes and skin;
• psychological state (anxiety, depression).
Treatment:
– Weakness is associated with a syndrome responds to a question that must be treated as such (that it is organic or psychiatric).
– Asthenia is isolated. She often reflects personal difficulties, relationship, etc. A listening time can relieve these patients.
