Q. Are there medications that help to improve cognitive problems in MS? Thanks, Daniel
A. No medications have yet demonstrated long-term success in large clinical trials in reducing cognitive problems. During recent years, there have been studies of ways to stabilise or improve cognitive dysfunction. Some have focused on whether MS disease-modifying drugs, which have all been shown to reduce the accumulation of new demyelinating lesions, can also slow the progression of cognitive problems. In theory, this should be the case, although results, thus far, have been varied.
Q. Why do I frequently use words that are inappropriate? For example, the other day I said “gloves” in a sentence when I meant to say “pockets”. Regards, Barbara
A. Studies show that difficulty in naming objects is a fairly common problem in MS. Some researchers believe that this difficulty is related to myelin damage in the brain preventing people from retrieving language information stored in the brain. Unfortunately neither cognitive rehabilitation nor compensatory strategies seem to help in managing this type of problem. What can help is for you to inform others around you (family, friends, work colleagues) that you occasionally experience this difficulty and encourage them to communicate their concerns in order to avoid misunderstandings.
Q. I am concerned about the control of emotions. I find that I can become tearful at the strangest and most inappropriate times, and in any situation. It has started to become a concern and very embarrassing! Is this a common thing for people with MS? Is it part of the condition? Do you have any tips on dealing with this? Thank you, Gerry
A. These emotional changes that you describe sound like a term referred to as “emotional instability” (also called “emotional lability” or “emotional release”). It seems that about 10 per cent of people with MS have similar experiences as a result of demyelination in the part of the brain that controls emotions. If you feel that this tearfulness is disrupting your life in some way now or may cause problems (for instance with family life, work or social interactions), you should talk to your neurologist or psychologist. Some MS centres have specialised nurses who are skilled in helping to manage these types of problems. There are even some self-management strategies that you can learn from a healthcare professional to apply in everyday life. It's really worth discussing this problem in order to manage it better.
Q. Is it possible that MS has influenced my terrible mood swings? I'm a teacher and children's worker. One time I think I can take activities with kids and another time it drives me to despair to even think of the responsibility. One day I'm all gung-ho and another day I couldn't even think of it – or even the next hour. It can literally change by the hour. Please help me manage this if possible. Linda
A. It is important that the people around you are aware that you are having this difficulty. This serves mostly to avoid misunderstandings. Some people are prescribed mood-stabilising medication or anti-depressants, which do help in some cases. For others, counselling is an excellent solution, giving the person the chance to explore her feelings with a professional and learn ways to manage unpredictable mood changes better. In all of these cases, the first step is to talk to your healthcare provider – neurologist, MS nurse or psychologist.
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