Cognition in multiple sclerosis within the modern diagnostic and treatment era

[Prot]

Foundational research conducted decades ago established the longstanding speed-centric model of cognitive dysfunction in multiple sclerosis,^{Only registered and activated users can see links., Click Here To Register...} which posits slow cognitive speed as the principal deficit that leads to difficulties with memory and other functions.^{Only registered and activated users can see links., Click Here To Register...} This model was rooted in an understanding of multiple sclerosis as a prototypical diffuse white matter disease, with cognitive dysfunction likened to subcortical dementia.^{Only registered and activated users can see links., Click Here To Register...}

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[agate]

Thanks for finding and posting this! The cognitive and memory problems are a huge concern.

I sometimes wonder if some of the information-processing problems are related to vision impairment. My vision is very slow--and a visual evoked potentials test came up with "severely abnormal" as a result. I can't follow a fast action in a movie (car chase, for example) or fast-moving games (football, hockey). I'd be a perfectly terrible eye-witness to any crime. I just wouldn't have seen what happened.

[Prot]

Although I don't have MS I do have severely impaired visual memory,moderate impairment- visual crowding,difficulty with differences in shades of a colour.

[agate]

Yes, colors are a problem for me. I'm often not sure if I'm looking at brown, red, gray, green, or navy blue. When given little squares of different colors to choose from--when considering an item to buy that comes in various colors, I often don't know what the colors are unless I hover over those color samples and have them spelled out for me.

[Prot]

Yesterday especially and today have not been good days pain wise. I get so demoralised and frustrated that 4.5 years after the falls I can still only manage 10 minutes of being upright before level 6 pain kicks in. To add to it possible arthritic neck and knees.

[agate]

I think I can understand that frustration. I don't know which fall it was that caused my back and legs to have the problems they've had for the past couple of years, or maybe it was a combination of falls that did it, but the problems have gone on for so long that I'm wondering if I should just be glad they're not getting worse, without expecting them to get better.

In a way things are a little better. I hardly ever have the level of pain I was having at times when I reached at a certain angle or tried to change positions. That is probably progress but it's been glacially slow.

I don't know if I'll ever be able to reach my feet again. It's hard to wash them, hard to put on socks and shoes. I keep up with the new PT exercises as well as the old ones no matter how inconvenient it is for me to do them--and keep hoping.

Sometimes I even mutter that old saying, "Every day in every way I am getting better and better." I understand that early psychologists told their patients to repeat that 20 times twice a day.

[Prot]

It doesn't help psychologically that the 7 week gap from the second fall to it being revealed I'd broken my femur, was idiotically judged as only likely to delay recovery by a week. On a brighter note , I managed to make a reasonably good beef casserole in the slow cooker on Friday. This Friday I may try to make a fish casserole.

[agate]

About the 7 weeks before you found out you had a broken femur, was that because it was known but not yet told to you, or was it a fracture that wasn't discovered for 7 weeks, maybe because a first Xray or other test result had been wrong?

[Prot]

I'll try explaining as best I can. Paramedics made out the pain was psychological, as did the GP. Was in 8-9 level pain but being a people pleaser agreed to do the physical therapy the congenital idiots demanded I do. After a while a slightly more intelligent one of them realised it might not be 'psychological'. There was then a sub mediocre attempt to do what was needed to get an X ray done. Eventually transport was arranged. I had to be slid down the stairs on a special sheet to get out of my flat. That was 47 days after my 2nd fall. The X ray done that day revealed the broken femur. 2 days later I had a partial hip replacement . Soon after, I don't know why, my blood pressure plummeted - and I had to go on oxygen . After a month or so I was transferred to a separate rehabilitation unit.

My daughter who was with me when the paramedics behaved like pig ignorant louts was so disgusted by their ill treatment of me, and shortly after that of the GP, that she started a negligence claim on my behalf. . Although she had done so, not me, a major line of defence by the paramedics and GP was emphasising I had autism and a severe mental illness. To cut a long story short I got nothing near the award for damages done that I should have got.

[agate]

What a nightmare! My guess is that you're probably glad to be alive at this point--to have survived medical "care."

There are all too many "congenital idiots" around. In fact, I just finished reading (listening to) a book (read by the author) by one Adam Kay, This Is Going to Hurt. It's mainly a collection of incidents that he was involved in during his several years as a doctor--in the UK but it was in ob/gyne. There are several incidents that show just how stupid human beings can be, in the medical profession as everywhere else. Maybe some are stupid because they've been overworked and are overtired. I don't know but the mistakes made are horrifying.