When MS (multiple sclerosis) affects the cognitive areas of the brain, it can create lapses in thinking, planning, language skills and memory. These can be some of the most terrifying but misunderstood symptoms of Multiple Sclerosis and are often some of the most debilitating.
Multiple Sclerosis can be difficult to diagnose. But often, even after a diagnosis of MS has been confirmed, the physical symptoms are the ones most noticed and treated. Because many of our mental functions are not obvious to the eye, they can easily be overlooked. A doctor may not realize their patient is having greater difficulty at a job when doing analytical work. A spouse may not notice that their partner is suddenly struggling when helping to plan their budget or do their taxes. A policeman may take the confused speech and mental confusion as signs of inebriation, rather than a momentary flair-up of a driver’s MS symptoms. A teacher may become frustrated with a student’s ability to learn something quickly one day but then can’t seem to grasp a simple concept on the next. Then there is the patient confronted with the terrifying prospect of not recognizing things they realize full well they should know, becoming so afraid they are losing their mind they hesitate to inform anyone of the problems they are having.
Our brains are so poorly understood that the sporadic and unpredictable effects of MS often go unreported. Because the symptoms can vanish as quickly as they appear, it is also easy for the patient to deny the problem until the damage becomes severe. The most common cognitive areas you find affected by MS are in: concentration, processing, memory, and expression.
Concentration: Here the person will start to have problems focusing their attention. This can be while reading, watching television, listening to the radio or in their conversations. The more noise or distraction there is around them while trying to concentrate, the more difficulty the individual will have. They will lose their place or suddenly seem inattentive and distracted.
Processing: This is when someone tries to put the information they are receiving into some type of order. This can be planning based on receiving certain facts, making decisions based on various choices, or organizing several pieces of collected information. Processing and the previous, concentration, can greatly affect an individual’s ability to learn and retain something new. Filling out forms may become near to impossible as they try to grasp the bits of information into some coherent pattern.
Memory: This area can affect short term issues but can also be severe enough to cause a “sudden forgetting” of previously well-known places, things, actions or people.
Short term memory problems can also affect learning ability and be very frustrating for those dealing with this individual. They can forget appointments, dates, things they have to do or even lists they have their To-Do items written upon. Constant reminders may be needed into order to get through the day and follow-up calls on medicine renewals or doctor’s appointments may become critical.
The latter mentioned above, the “sudden forgetting”, is one of the most terrifying cognitive symptoms. Individuals may sporadically feel as if part of their brain has shifted or dropped out of place. They may remember what they are doing, who they are and where they are going but have no idea where they are currently at. Or, they may know where they are at and what they are currently doing but suddenly forget the face of the loved one sitting next to them. They can literally, for a few moments, not know their own partner. It is as if a hole has been punched in the page of reality people use for their mental balance. This comes on suddenly and then can vanish again within ten to thirty minutes.
Expression: This area affects all language skills. When the lesions of MS affect this area, writing, speaking and translating may be affected. The individual may mix words up, thinking of a word but saying another. They may have difficulty thinking of a word they have known very well in the past. This is the old phrase, “the word is on the tip of my tongue”, taken to the nth degree.
Once these symptoms begin to occur in a patient with Multiple Sclerosis, they can continue to come and go without warning, sometimes going months between occurrences. They can also increase in frequency and grow progressively worse until they become severely disabling. Though someone can be employed in a wheelchair, it becomes much more difficult to be employed when memory problems and processing issues are added to the mobility limitations. Much more research is needed in this area and more doctors need to look for these issues during the treatment and diagnosis of their MS patients.
If you are interested in learning more about the issues of cognitive functioning with multiple sclerosis, Jeffrey N. Gingold wrote a wonderful book titled, facing the cognitive challenges of multiple sclerosis, published by Demos Medical Publishing. I particularly recommend this book to any patient suffering from these symptoms or for their loved ones who worry about them. If you would like more information on Multiple Sclerosis in general, please see: Are you Aware? The MS (Multiple Sclerosis) FAQ.
