MS Strength

Surprisingly, the least common area for a multiple sclerosis attack (only 3% of all relapses) is the cerebrum, or the vast area of the brain. Attacks to the cerebrum can cause demyelination to its nerves as well as brain atrophy, or shrinkage. Such relapses can cause the following symptoms in multiple sclerosis patients:

Cognitive Impairments

Although not as common as spinal cord or brain stem symptoms, cognitive disabilities are thought to affect about 50 to 60% of MSers over the courses of their diseases. Such impairments include short-term memory problems, a decrease in reasoning skills, vocabulary deficits (“fishing for words”), and problems with outside overstimulation and internally processing outside situations (confusion.) Only about 5 to 10% of those with multiple sclerosis develop severe cognitive problems.

Depression

Multiple sclerosis depression can be caused by several mitigating factors such as coping with a chronic and debilitating illness, taking medications that cause depression, and non-MS outside stressors (careers, financial situations, divorce, other illnesses, death, and so on.) MS depression can also be organic, or caused by the multiple sclerosis itself. Scientists now know that depression can arise from damage to nerves within the cerebrum. These nerves send and receive messages about emotions, and faulty nerves can misfire messages. Brain atrophy might also be responsible for organic depression.

Tonic Seizures

Although rare (occurring in approximately 5 out of every 800 MS patients), brief seizures can happen when there are lesions and inflammation in the cerebrum.

• Reference:

Rosner, Louis J., MD and Shelley Ross. New Hope and Practical Advice for People with MS and Their Families. Simon & Schuster: New York, 2008.

I have to tell you about my love affair with denial. Having had MS for a bunch of years now, I’ve tackled several ongoing issues that the disease has presented: fatigue, bladder and bowel problems, loss of balance, swallowing like a geriatric, and getting out the old cane for relapses when I walk like Charlie Chaplin. These issues I’ve come to accept with a little anguish and a bit of therapy, and it has been a long journey to acceptance since these symptoms often go into remission and try to convince me that I’m living without MS. I’ve also learned in the past few years that my emotional state with MS is never static: because the disease is so unpredictable, it is never safe for me to assume that I have my emotions completely figured out and that they will remain balanced indefinitely. It has taken me about three years to get the emotional situation to a point where I can accept the unknown and live my life not waiting for the other shoe to drop. Multiple sclerosis has a tendency to do this to people and as the disease progresses and more plans are thwarted, it becomes a bigger challenge to remain emotionally balanced. So I’ve recently learned the benefits of dealing with the emotional ramifications of MS with my divine social worker. I cannot express enough how much she’s kept me balanced and grounded on the continuous, unpredictable path that is MS. Just as MS continues, so does the fight to emotionally deal with it, and the methods are never permanent and can change with the course of the disease.

So here is my most recent lesson about denial, and probably one of the hardest to accept: I am trying to come to terms with the fact that I still need some sort of career to make me satisfied, but I have to let go of a choice that will not meet my needs. Anguish! MSers all know the dilemma of wisely picking and choosing what to do and what not to do. Being in relatively good shape despite my MS, I volunteer at my local library system a few short intervals a week. I love the damned library. I’ve worked there a couple of times in the past, but the multiple sclerosis always seems to get in the way. So now I am again in remission and my denial comes creeping back to me: maybe I can still get that library science degree and be a part-time librarian in a few years. Maybe this time it will be different. But the loads of books are still there, the lengthy walks to help patrons are still there, and the Family Medical Leave Act is still a difficult hurdle. So I have come to a practical, satisfying decision and I’m sticking to it: I love science and I want to continue going to school, so I’m going to take some entry-level psychology courses FOR ME. Not for a possible career, but if I continue taking the classes and a career develops, so be it. I love helping people and my local MS Society doesn’t have enough referrals for licensed professional counselors who deal with the issues of chronic illness (I’ve already inquired.) I don’t know if I will ever counsel anyone— on an hourly basis of course— but I took an intro psychology course a few years ago and loved it, and I’ve already gotten the required statistics class out of the way. One of my life goals is to earn a master’s degree. So who knows? Either way, I walk away fulfilled and with new knowledge that I can apply to everyday life. But I have to confess that the denial still lurks in the back of my mind and this choice is not without its pain.

Optic neuritis, or the inflammation of the optic nerve that connects the eye to the brain, is the third most common type of multiple sclerosis relapse, making up approximately 17% of all attacks. 20% of all MSers experience this as their first acute attack. The optic nerve sends messages from the eye to the brain, describing visual clarity, color perception, and brightness. An attack of optic neuritis usually affects one eye. During an acute MS optic nerve attack (when the immune system attacks the myelin covering surrounding the optic nerve), the following symptoms may occur:

Blurred, murky vision: this can be intermittent or it can be a steady disruption of proper sight

Acute loss of vision: complete loss of vision in the affected eye may occur, and this too may fluctuate or remain steady during an attack

Eye pain: pain from the inflamed optic nerve can make moving the eye or even keeping the eye still very painful

Loss of or change in color vision: optic nerve inflammation can also cause a loss of or fluctuation in color clarity, making the visual field less vivid or “washed out”

• Reference: The Mayo Clinic