Disorders Of Alertness

Fatigue is a deficit in alertness, which is a normal response following physical or mental exertion and instructs the body to rest and repair. Fatigue is a symptom of many illnesses, which reflects in part the importance of rest in recuperation from illness. However, there are occasions, such as after resting, when fatigue is inappropriate and, when alertness is required, debilitating. If such unexplained fatigue is persistent and is accompanied by other symptoms (such as sleeping problems, depression, concentration or memory problems, headache, sore throat, swelling of the lymph nodes, and muscle or joint pain) it is likely to be diagnosed as chronic fatigue syndrome.

Alertness is generally considered a good thing, but it is worth considering whether there are conditions in which a patient might complain of hyperalertness. Insomnia is the most obvious candidate; however, this is better thought of as a condition of inability to sleep rather than inability to be ''not alert.'' Typically, the insomniac will complain that he or she is drowsy and fatigued and, in fact, suffers from a lack of alertness when awake because of an inability to sleep. The best example of hyperalertness is perhaps mania.

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