7 msfocusmagazine.org Have Your Say We welcome your questions, suggestions, opinions and feedback. Reach us at editor@msfocus.org, call 800-225-6495, or use the contact form on www.msfocus.org. year, I'd have a day when I was really “on” and was amazed that many folks likely live their life with that degree of clarity, and think howdifferent mylifewould have beenwithout this malady. The problem is, despite being “cared for” at one of the top institutions in the U.S., I feel essentially ignored because my physical exam is normal. Other than falling from time to time, losing my “presence of space”, I have no physical symptoms that can be seen or measured. I have what has been referred to as “slow MS” presenting with only two episodes of spinal cord demyelination. I was told I did not need further MRIs unless I developed new symptoms, so I have not been seen for about a decade, and no discussion regardingmyvaguesymptoms.Noexplanation except, “well, it’s a physiological disease.” I have a doctorate, and will be retiring earlier thanexpectedduetothis–itseemslikeawaste. Can these types of vague, but debilitating symptoms really be due to MS without brain lesions? I have been worried sick I’m developing Alzheimer’s and the specialists really don't have much to say to me. Sick and tired of feeling sick and tired without an explanation. Thanks for your work, Susan Dear Susan, We ran your question past our senior medical advisor, Dr. Ben Thrower. Here’s what he had to say: “I’m so sorry to hear about the difficulties you’re going through. MS can certainly cause cognitive dysfunction and this particular symptom is a leading cause of vocational disability in MS. There are several parts of your presentation that make me think you need to explore other diagnostic possibilities though. While some people with MS do have unremarkable brain MRIs, it is unusual – especially in the setting of having cognitive symptoms. The extreme episodic nature of the cognitive symptomswould also be unusual for MS. People with MS clearly have good days and bad days, but not typically to the degree you are describing. If you’ve not had a neuropsychologist do a full battery of cognitive tests, this may be helpful. In addition, MRI technology has advanced over the past 10 years and it may be worth getting an updated brain MRI. I hope this is of some help.” If your medical team is unwilling to order a new MRI or neuropsychological testing, you may want to get another opinion. Please feel free to call our helpline at 888-673-6287 for information on the nearest MS centers to you.