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What are severe cognitive symptoms of multiple sclerosis (MS)?

Between 5 to 10 percent of people with multiple sclerosis (MS) will experience serious cognitive (thinking and knowing) problems. These can include difficulty planning and problem solving, as well as problems interpreting and remembering new information. A person with serious cognitive problems might become overwhelmed by a complex task and unable to think of alternate solutions. They could be unable to plan or organize purposeful activities.

Similar to the physical fatigue many individuals living with multiple sclerosis (MS) experience, cognitive fatigue can also be present. Research shows that persons with MS can easily experience fatigue when engaging in mentally challenging work and tasks that require focused attention. Once fatigued, individuals with MS tend to make errors in their written and verbal communication skills.

If cognitive difficulties are severe, a person may lack the ability to monitor or regulate their own behavior. They can be talkative and uninhibited, blurting out comments they would likely have kept to themselves in the past.

They might also be unresponsive to normal social cues indicating that their behavior is inappropriate or impulsive. These problems are rare but do occur.

Dr. Charles R. Smith, MD
Neurologist

In this video, I discuss how In multiple sclerosis patients, brain lesions cause cognitive impairment, which can be subtle early in the disease. More obvious cognitive impairment is a sign of progressive MS.

Dr. Louis Rosner
Neurologist

Problems with attention, information processing, memory, planning or problem solving can affect 50 to 65 percent of people with multiple sclerosis (MS). It is believed the loss of myelin, the insulating material around nerve fibers, can interrupt the transportation of memories to storage areas in the brain.

MS has the potential to affect personality, emotions and intellect through the loss of myelin, damage to the fibers or loss of brain tissue. While mild problems are common (40 percent of people with MS have mild dysfunction), severe damage to these brain functions is rare. Only 5 to 10 percent of people with MS will have moderate to severe impairment. There is no correlation between physical disability and cognitive deficits, according to several studies. Fatigue and cognitive impairment do show a correlation in some studies. Medications, sleeplessness, nutrition, menopause and depression can also add to cognitive problems and should be assessed as well.

While research shows 9 out of 10 people with MS are free of severe intellectual problems, cognitive impairment is one of the major reasons cited for unemployment among people with MS. So it's important to screen, assess and manage. Many studies have shown that lesion volume is correlated with cognitive impairment, especially in the cerebral area. Stronger correlations are shown with brain atrophy as opposed to extent of lesions. A goal for researchers should be to identify at-risk patients. Since the consequences of intellectual impairment can be great, identification and intervention are critical. Often the patient is reluctant, even unaware. Family reports may be helpful.

Multiple Sclerosis

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Multiple Sclerosis

Too often, multiple sclerosis is thought of only as "the crippler of young adults." But in fact, 75 percent of all people with MS will never need a wheelchair. In Multiple Sclerosis, Dr. Louis J....

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.