Some of the most common but
hidden symptoms of MS are the changes people may experience related to
cognition. The majority of people with MS
experience intermittent cognitive symptoms. However, a person with almost no physical limitations can have
significant cognitive impairment, while a person who is quite disabled
physically can be unaffected cognitively.
In people with MS, the
body's own immune system attacks the tissue surrounding the nerve fibers in the
brain, spinal cord, and optic nerves. This covering is made of a fatty
substance called myelin. It insulates the nerves and helps them send electrical
signals that control movement, speech, and other functions. When myelin is
destroyed, scar tissue forms (sclerosis means scarring) and nerve messages are
not transmitted properly. Depending on the extent and location of damage in the
central nervous system, patients with MS may experience a wide variety of
symptoms. MS is different in every person.
My
MS mainly affects my mobility without much influence on my cognition – although
I do have trouble with verbal fluency (word-finding); when that certain word is
on the tip of your tongue. Other people may find it takes longer to solve
problems. Some may have mild memory loss or trouble concentrating. Loss of
cognitive function can influence one’s ability to work. While I would love to
walk again, I am thankful to still think, focus, and work. I do get a
glimpse of these other symptoms when I get overheated or extremely fatigued.
Heat and high humidity may temporarily worsen symptoms. My mind and body go
“dumb” when I am hot. Weakness increases, my mind seems to shut down, and I
have trouble communicating. It is very frustrating. Thankfully, once I cool off, I return to myself.
Some
people can’t imagine life in a wheelchair. Well, it sucks, but I can still get
around. I can’t imagine a life where I can’t think, speak, or live the life I
know. I love to read and watch movies, and even work. If I couldn’t
do those things, I’d feel trapped, whereas a wheelchair gets me moving, I don’t
see an easy fix for cognitive impairment. Selfishly, since I am stuck with MS,
I am happy my MS went the way it did. I am afraid for what the future might
bring to me cognitively– just like those who are afraid of life in a
wheelchair. MS is a bitch of a disease.
Cognitive
impairment substantially impacts the lives of patients with MS and their
families. Understanding these issues and showing compassion can help patients
with MS deal with these invisible symptoms.
From the NMSS: Mood and Cognition in MS (What You Can Do)
