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Multiple Sclerosis Health Center

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How to Handle MS “Brain Fog”

By Nancy Fitzgerald
WebMD Feature
Reviewed by Neil Lava, MD

Have you noticed that simple things you used to do on auto-pilot, like making a pot of coffee, seem more complicated than they used to?

It happens to a lot of people with MS. Often called “brain fog,” it can include forgetfulness, trouble concentrating, and confusion. The disease can affect your thinking as well as your body.

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“There are lots of physical issues that people with MS struggle with,” says Bart Rypma, associate professor of behavioral and brain science at the University of Texas, Dallas. “But it’s the cognitive changes -- slowing of thought -- that they experience most immediately.”

You may notice that you:

  • Solve problems more slowly
  • Forget appointments
  • Lose track of conversations
  • Can’t follow directions
  • Need constant reminders about daily tasks

There are ways to get around these problems and make it easier to do what you need, and want, to do.

Why It Happens

The problem, Rypma says, is that communication breaks down between your brain cells and the blood vessels that provide the nutrients that help them work. That makes it harder for your brain to do its job.

Remember that pot of coffee? “Filling up the water, scooping the coffee into the filter, flipping on the switch -- that’s a set of skills that resides in your short-term memory,” Rypma says. “It may seem like you’re doing it by rote, but that’s just the brain working efficiently on its own.”

When you have MS and find that you have to repeatedly talk yourself through each step before going on to the next one, it may be a sign that the guidance systems in your brain have been slowed down by MS. Those brain cells don’t talk to each other as well as they should.

“It’s not that you won’t be able to do all your normal tasks,” Rypma says. “But it could take you longer.”

How to Clear Away the Fog

“Just because cognitive changes are common doesn’t mean there’s nothing you can do about them,” says Sylvia Klineova, MD, of the Corinne Goldsmith Dickinson Center for Multiple Sclerosis at Mount Sinai Hospital in New York. “After all, your brain can be trained.”

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