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• FATIGUE AS ONLY EMOTION ?
  CELIO LEVYMAN.MD,MSc
  Published on: 4 October 2004

• Published on: 4 October 2004

  FATIGUE AS ONLY EMOTION ?

  • CELIO LEVYMAN.MD,MSc, Senior Neurologist

  Dear Editor,

  This a very interesting, but curious,paper.The novel theory presented, enhanced the CNS as the more important center regulatory of exercise fatigue, resembles all the research that occupied the minds of clinical and experimental neuroscience people in regard of pain.

  Pain is a reality, an alarm signal. Of course there are many pain syndromes as diseases by thereselfes, as migraine, cluster h...

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  Dear Editor,

  This a very interesting, but curious,paper.The novel theory presented, enhanced the CNS as the more important center regulatory of exercise fatigue, resembles all the research that occupied the minds of clinical and experimental neuroscience people in regard of pain.

  Pain is a reality, an alarm signal. Of course there are many pain syndromes as diseases by thereselfes, as migraine, cluster headache, trigeminal neuralgia, thalamic pain post-stroke, etc., and very important pain due to other diseases, especially in cancer patients.

  Nothing new about the typical pain neurosurgery, as cingullectomy, to give a better quality of life in terminal oncology people: they continue to refer pain, but without the limbic system information as these stimulus is a nociceptive one, the suffering disappear – they points and describe pain when questioned, but this symptom don’t cause any distress: the emotional aspect of this form of sensibility was removed.

  In another example, people with trigeminal neuralgia can survive many years with good control of the pain with carbamazepine and perhaps (after more controlled studies and evidence-based guidelines) gabapentin.However, the total control of the disease is based in an anatomical question, the vascular loop around the trigeminal pathway, and the definitive treatment is the surgery, first performed by Janetta, from Pittsburgh, many years ago.

  After these considerations, the theory explained could reach a danger level: fatigue is a periphery nociceptive sensation, an alarm signal. Techniques to reduces or control the CNS role are, in thesis, something like doping: the athlete could perform better marks, however could be present a potential risk of damage in the muscles, bones, peripheral nerves and even in central nervous structures.

  The whole thing resembles a different way of Pavlov’s conditioning methods, with a plausible cause of disease risk to people in good health.

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  Conflict of Interest:
  None declared.

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