We report on a patient with multiple sclerosis (MS) who presented with fatigue as the only manifestation of an acute MS relapse. Fatigue was assessed by the 'Würzburg Fatigue Inventory in MS (WEIMuS)' scale and confirmed by neuropsychological testing of attention. After high-dose corticosteroid therapy, subjective symptoms were completely abolished. The improvement was corroborated by both, the WEIMuS score and neuropsychological testing. MS-related fatigue may be the only symptom of an acute MS relapse, and neuropsychological methods may be used to objectively assess and follow the time course of this common and disabling symptom.

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