Some of you may have seen this on the Patient's voice, but I think it is worth reposting here:

Cognitive function impairment, commonly known as ‘brain fog’.

We all know that Multiple Sclerosis (MS) is a disabling set of symptoms; some of us know this better than others. People who have no experience of MS often do not realise the impact these symptoms can have on people’s lives. People with MS will either disappear from public consciousness or be mistaken for someone displaying erratic behaviour, and there is ample evidence to show how people using wheelchairs are either ignored or talked down to.

One of the difficulties for the ‘public’ to understand MS is that people display a variety of symptoms which do not manifest in all in equal measure, so some people display very few visible symptoms; others are severely disabled within a few years and the range of disabling symptoms range from physical to cognitive and emotional. It is difficult for people who do not suffer from cognitive impairment to understand the impact this can have on the life of the person afflicted by it. This article aims illustrates what it is like to live with constant ‘brain fog’, sometimes known as ‘cog fog’ but medically described as cognitive function impairment.

Loss of memory is often one of the first sign that something is wrong, but there are others and different people may have none, one or many of these problems. If you are unlucky enough to suffer a range of cognitive function impairment the impact on your life and that of those who know you, can be devastating. In spite of being an intelligent person you might lose the ability to perform complex tasks such as map reading, mathematical calculations and list making for example. You might have problems multitasking, or planning and executing a simple project such as cooking a meal. But the effects of ‘brain fog’ do not stop there: people can have difficulty expressing their thoughts and emotions, meandering around a subject, struggling to find the correct words to express themselves. They may constantly repeat themselves either through faulty memory or uncertainty about how clearly they communicated. Often repeating the same things as a way of checking their thoughts. They describe their distress at not being able to make a decision; they talk about not being able to formulate their thoughts, of living in a kind of fog that makes it difficult to ‘see’ the problem and consequently the solutions to problems. Sometimes the confounding problem might be a simple question such as: “would you like a cup of tea?”

People with ‘brain fog’ can also be hypersensitive to environmental factors such as light, heat and sound. Hypersensitivity can make it difficult to cope with irritants that others cope with easily. Bright lights and sudden noises, small irritants cause disproportionate reactions which appear irrational and unwarranted to onlookers. To understand communications, problems and propositions as well as learning new tasks takes longer and may require many repetitions of the process before it is mastered.

At the same time people suffering from ‘brain fog’ can lose visual perception which has a double effect: they can appear clumsy because they will not see obstacles, especially small ones like wires and protruding shelves for example. But poor visual perception also makes them unaware of body language and other clues that inform about other people’s responses. This collection of symptoms has a profound effect on social interaction with friends and family. Dr Bill Code tells us of his experience in his book: Who’s in Control of your Multiple Sclerosis? He recounts a car journey with his family who by the end of the trip “was almost ready to give me away. My Multiple Sclerosis had turned a happy trip into a near nightmare.” What had exasperated his family had been mostly to do with his cognitive impairment and hypersensitivity, he had got them lost because he had ‘forgotten’ how to map read, he had found oncoming headlights difficult to cope with, every bump in the road and any music unbearable which had made him very irritable and consequently difficult to be with.

People who suffer from cognitive function impairment are subject to different but as devastating disadvantages as a person with physical disabilities because employers, family and friends may perceive the sufferer as a difficult or incompetent person whereas their behaviour is something they cannot help. These hidden symptoms lead to low self-esteem, depression, and a devastated and lonely life.

Michele Findlay and Kevin Campbell.

MS: Cognitive Function

Memory is the part of cognitive function that is most often affected. Other areas of the brain that are affected include those responsible for the speed of information processing, the ability to plan and prioritize, visual perception, problem solving and decision-making, concentration, and the ability to find words. Multitasking (shifting back and forth between different tasks) and dividing attention between different tasks may also become more difficult.

Source: http://chealth.canoe.ca/channel_health_features_details.asp?health_feature_id=126&article_id=372&channel_id=2065&relation_id=58437

Another useful resource is the Dummies site:

Dr Bill Code of NCS

Who’s in Control of your Multiple Sclerosis?

www.drbillcode.com