{"id":683807,"date":"2026-05-31T20:48:56","date_gmt":"2026-05-31T18:48:56","guid":{"rendered":"https:\/\/www.dynseo.com\/fatigue-et-troubles-cognitifs-dans-la-sep-ce-que-les-familles-peuvent-faire-2\/"},"modified":"2026-05-31T20:54:23","modified_gmt":"2026-05-31T18:54:23","slug":"fatigue-and-cognitive-disorders-in-ms-what-families-can-do","status":"publish","type":"post","link":"https:\/\/www.dynseo.com\/en\/fatigue-and-cognitive-disorders-in-ms-what-families-can-do\/","title":{"rendered":"Fatigue and Cognitive Disorders in MS: What Families Can Do"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; admin_label=&#8221;Article HTML&#8221; _builder_version=&#8221;4.16&#8243; custom_padding=&#8221;0px||0px||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row admin_label=&#8221;Contenu&#8221; _builder_version=&#8221;4.16&#8243; width=&#8221;100%&#8221; max_width=&#8221;100%&#8221; custom_padding=&#8221;0px||0px||false|false&#8221; 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solid rgba(255,255,255,.3);border-radius:50px;transition:background .2s}\n.dbi-art-d635af .footer-links a:hover {background:rgba(255,255,255,.15)}\n@media(max-width:640px) {\n.dbi-art-d635af .cta-formation, .dbi-art-d635af .cta-outil {flex-direction:column}\n.dbi-art-d635af .cards-grid {grid-template-columns:1fr}\n}<\/p>\n<\/style>\n<div class=\"dbi-art-d635af\">\n<header class=\"hero\">\n<div class=\"hero-tag\">\ud83e\udde0 Multiple sclerosis \u00b7 Fatigue \u00b7 Support<\/div>\n<h1>Fatigue and cognitive disorders in MS:<!\u2013- [et_pb_br_holder] -\u2013>what families can do<\/h1>\n<pee class=\"hero-sub\">Understanding mental fog, identifying types of fatigue, adapting daily life, and supporting a loved one with multiple sclerosis \u2014 the complete practical guide for families and caregivers<\/pee>\n<div class=\"hero-meta\">\n    <span>\ud83d\udcd6 Reading: ~24 min<\/span><span>\u2705 Updated 2026<\/span><span>\ud83d\udc68\u200d\ud83d\udc69\u200d\ud83d\udc67 Families &amp; professionals<\/span>\n  <\/div>\n<\/header>\n<div class=\"stats-bar\">\n<div class=\"stats-grid\">\n<div class=\"stat-item\"><span class=\"stat-num\">110,000<\/span><span class=\"stat-label\">people with MS in France, of which 3 out of 4 are women<\/span><\/div>\n<div class=\"stat-item\"><span class=\"stat-num\">80 %<\/span><span class=\"stat-label\">of MS patients suffer from fatigue \u2014 the most common and disabling symptom<\/span><\/div>\n<div class=\"stat-item\"><span class=\"stat-num\">65 %<\/span><span class=\"stat-label\">of patients experience cognitive disorders at some point in their illness<\/span><\/div>\n<div class=\"stat-item\"><span class=\"stat-num\">30 years<\/span><span class=\"stat-label\">average age at diagnosis of MS \u2014 a disease that primarily affects young adults<\/span><\/div>\n<\/p><\/div>\n<\/div>\n<p><main class=\"container\"><\/p>\n<div class=\"intro-block\">\n    <pee>Multiple sclerosis (MS) is a chronic neurological disease that is not limited to its visible motor symptoms. Fatigue and cognitive disorders \u2014 often invisible to others \u2014 are among the most challenging manifestations to live with daily, both for the person affected and their loved ones. &#8220;She looks fine though,&#8221; &#8220;you just need to motivate yourself,&#8221; &#8220;you just have to rest&#8221; \u2014 these phrases, heard too often, reflect a deep misunderstanding of what patients and their families actually experience. This guide provides you with the keys to understand, recognize, and act in the face of neurological fatigue and mental fog of MS.<\/pee>\n  <\/div>\n<h2>1. MS in a few words: a complex and variable disease<\/h2>\n<pee>Multiple sclerosis is an autoimmune disease of the central nervous system in which the immune system attacks the myelin, the protective sheath of nerve fibers. This demyelination disrupts the transmission of nerve signals, leading to a wide variety of symptoms depending on the areas of the brain and spinal cord affected.<\/pee>\n<h3>1.1 Forms of MS<\/h3>\n<div class=\"cards-grid\">\n<div class=\"card\">\n<div class=\"card-icon blue\">\ud83d\udd04<\/div>\n<h4>Relapsing-remitting MS (RRMS)<\/h4>\n<pee>The most common form (85 % of cases at diagnosis). Alternating between relapses \u2014 sudden onset or worsening of symptoms \u2014 and phases of remission. Recovery after each relapse is variable and often incomplete.<\/pee>\n    <\/div>\n<div class=\"card\">\n<div class=\"card-icon teal\">\ud83d\udcc8<\/div>\n<h4>Primary progressive MS (PPMS)<\/h4>\n<pee>Continuous progression of symptoms from the onset, without identifiable relapses. Represents 15 % of cases at diagnosis. Often diagnosed later (around 40\u201350 years) and with a predominance of motor impairment.<\/pee>\n    <\/div>\n<div class=\"card\">\n<div class=\"card-icon yellow\">\ud83d\udcca<\/div>\n<h4>Secondary progressive MS (SPMS)<\/h4>\n<pee>Natural evolution of uncontrolled RRMS: after a relapsing phase, the disease enters a continuous progressive phase. Modern disease-modifying treatments aim to delay or prevent this conversion.<\/pee>\n    <\/div>\n<div class=\"card\">\n<div class=\"card-icon pink\">\u26a1<\/div>\n<h4>Clinically isolated syndrome (CIS)<\/h4>\n<pee>First neurological episode that may evolve into MS. Monitoring and early treatment can prevent conversion to defined MS. Rapid diagnosis is essential to act at the first signs.<\/pee>\n    <\/div>\n<\/p><\/div>\n<div class=\"highlight-box\">\n<h4>\ud83c\udf21\ufe0f The Uhthoff effect: when heat worsens everything<\/h4>\n<pee>In about 60% of patients with MS, an increase in body temperature \u2014 due to ambient heat, fever, physical exertion, or even a hot bath \u2014 temporarily worsens all symptoms, including fatigue and cognitive disorders. This phenomenon, called the Uhthoff effect, rarely lasts more than 24 hours but can be very debilitating. It does not correspond to a true relapse and does not leave additional sequelae \u2014 but it is often misunderstood by those around who do not comprehend these abrupt variations in condition.<\/pee>\n<\/div>\n<h2>2. Fatigue in MS: a symptom in its own right<\/h2>\n<pee>Fatigue related to MS is radically different from ordinary fatigue. It does not disappear with rest, it does not correspond to an effort made, and it can occur in the middle of an otherwise calm day. Understanding its neurological nature is essential to discuss it accurately with those around and to adapt support.<\/pee>\n<h3>2.1 Primary fatigue vs secondary fatigue<\/h3>\n<div class=\"table-wrap\">\n<table>\n<thead>\n<tr>\n<th>Type of fatigue<\/th>\n<th>Origin<\/th>\n<th>Characteristics<\/th>\n<th>Approach<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td><strong>Primary fatigue (neurological)<\/strong><\/td>\n<td>Demyelination \u2014 nerve transmission requires more energy<\/td>\n<td>Occurs without effort, worsens during the day, resists rest, worsened by heat<\/td>\n<td>Energy management, planning, specific treatments<\/td>\n<\/tr>\n<tr>\n<td><strong>Secondary fatigue (reactive)<\/strong><\/td>\n<td>Depression, sleep disorders, chronic pain, medications, infections, sedentariness<\/td>\n<td>Variable, linked to triggering factors, potentially improvable<\/td>\n<td>Treat the underlying cause: depression, pain, sleep disorder<\/td>\n<\/tr>\n<tr>\n<td><strong>Muscle fatigue (spasticity)<\/strong><\/td>\n<td>Affecting motor pathways \u2014 muscles work harder to function<\/td>\n<td>Worsened by activity, localized to affected limbs, relieved by rest<\/td>\n<td>Physiotherapy, antispastic treatments, occupational therapy<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<h3>2.2 The spoon theory: explaining fatigue to those around<\/h3>\n<pee>Christine Miserandino, who has lupus, created the spoon metaphor in 2003, which has become universal for explaining fatigue in chronic illnesses. Each day starts with a limited number of &#8220;spoons&#8221; (units of energy). Each activity \u2014 getting up, showering, preparing breakfast, going out \u2014 costs one or more spoons. Unlike a healthy person who has an almost unlimited reserve, a person with MS starts with a reduced number of spoons and cannot &#8220;borrow&#8221; from the next day without paying the price.<\/pee>\n<div class=\"quote-box\">\n    <pee>This morning, I had ten spoons. Showering cost me two. Preparing lunch, two more. Responding to your messages, one. I have five left for the rest of the day. No, I can&#8217;t go out tonight \u2014 I have nothing left.<\/pee>\n    <cite>\u2014 Anonymous testimony from an MS patient, adapted from the spoon theory<\/cite>\n<\/div>\n<div class=\"tip-box\">\n<div class=\"icon\">\ud83d\udca1<\/div>\n<pee><strong>For families:<\/strong> Visualizing the day of a loved one with MS as a finite energy budget profoundly changes the way we interpret their refusals, silences, and renunciations. It is not bad will \u2014 it is a rigorous management of a rare resource. Your role may be to help prioritize energy expenditures, not to deny them.<\/pee>\n  <\/div>\n<h3>2.3 The envelope theory: planning for longevity<\/h3>\n<pee>Complementary to the spoon theory, the envelope theory recommends never using more than 70% of one&#8217;s available energy in a day \u2014 even on good days. Using the &#8220;bonus&#8221; from easy days creates an energy debt that must be paid back on subsequent days. Learning to stop before becoming exhausted is a skill that patients and their families must cultivate together, sometimes against the natural instinct to &#8220;make the most of good days.&#8221;<\/pee>\n<h2>3. Mental fog in MS: understanding cognitive disorders<\/h2>\n<pee>The &#8220;mental fog&#8221; or &#8220;brain fog&#8221; of MS refers to a set of cognitive difficulties that affect 45 to 65% of patients at some point in their illness. It can be present from the onset of MS, even in patients whose motor symptoms are limited. Long underestimated, it is now recognized as one of the main causes of job loss and relational difficulties.<\/pee>\n<h3>3.1 Cognitive domains affected by MS<\/h3>\n<div class=\"risque-card\">\n<div class=\"risque-icon\">\u26a1<\/div>\n<div class=\"risque-body\">\n<h4>Information processing speed<\/h4>\n<pee>The most frequently affected domain in MS. The person needs more time to process information, respond to a question, make a decision, or react to a situation. This can create the false impression of being &#8220;slow&#8221; or &#8220;less intelligent,&#8221; which is incorrect \u2014 only the speed is affected, not the ability.<\/pee>\n    <\/div>\n<\/p><\/div>\n<div class=\"risque-card blue\">\n<div class=\"risque-icon\">\ud83d\uddc2\ufe0f<\/div>\n<div class=\"risque-body\">\n<h4>Working memory<\/h4>\n<pee>Working memory is what allows us to keep information in mind while using it \u2014 remembering a phone number long enough to dial it, following a conversation while preparing a response. Its impairment in MS leads to many relational misunderstandings (&#8220;you&#8217;re not listening,&#8221; &#8220;you forget everything I say&#8221;).<\/pee>\n    <\/div>\n<\/p><\/div>\n<div class=\"risque-card yellow\">\n<div class=\"risque-icon\">\ud83c\udfaf<\/div>\n<div class=\"risque-body\">\n<h4>Executive functions<\/h4>\n<pee>Planning, organization, mental flexibility, inhibition of distractions \u2014 executive functions allow us to manage complex, multi-step tasks. Their impairment makes it difficult to handle daily life (shopping, administrative tasks, elaborate meals) and explains why patients may feel &#8220;overwhelmed&#8221; by things that seemed simple before.<\/pee>\n    <\/div>\n<\/p><\/div>\n<div class=\"risque-card\">\n<div class=\"risque-icon\">\ud83d\udd24<\/div>\n<div class=\"risque-body\">\n<h4>Word-finding difficulties and verbal fluency<\/h4>\n<pee>Searching for words, making unusual pauses in conversation, losing the thread of a sentence \u2014 these difficulties with verbal fluency are often very socially embarrassing. They can lead the patient to avoid conversation situations, deepening isolation.<\/pee>\n    <\/div>\n<\/p><\/div>\n<div class=\"risque-card pink\">\n<div class=\"risque-icon\">\ud83d\uddd3\ufe0f<\/div>\n<div class=\"risque-body\">\n<h4>Episodic and prospective memory<\/h4>\n<pee>Episodic memory (memories of lived events) and prospective memory (remembering to do something in the future \u2014 taking medication, calling someone) can be affected. Repeated forgetfulness of appointments or tasks does not reflect a lack of importance given, but a real neurological difficulty.<\/pee>\n    <\/div>\n<\/p><\/div>\n<p>  <!-- CTA TRAINING ENVIRONMENT --><\/p>\n<div class=\"cta-formation\">\n    <a href=\"https:\/\/www.dynseo.com\/en\/courses\/fatigue-and-cognitive-disorders-in-ms-what-families-can-do-en\/\" target=\"_blank\"><br \/>\n      <img decoding=\"async\" src=\"https:\/\/www.dynseo.com\/wp-content\/uploads\/2026\/03\/Fatigue-et-troubles-cognitifs-dans-la-sep.png\" alt=\"DYNSEO Training SEP Fatigue and cognitive disorders\" class=\"cta-img\"><br \/>\n    <\/a><\/p>\n<div class=\"cta-content\">\n<h4>\ud83c\udf93 DYNSEO Training \u2014 Fatigue and cognitive disorders in MS<\/h4>\n<pee>This certified online training (Qualiopi) has been specifically designed for families and professionals who support a person with multiple sclerosis. It teaches you to understand neurological fatigue, recognize cognitive disorders, adapt your communication, and implement concrete strategies in daily life. 100% online, at your own pace, fundable through your OPCO.<\/pee>\n      <a href=\"https:\/\/www.dynseo.com\/en\/courses\/fatigue-and-cognitive-disorders-in-ms-what-families-can-do-en\/\" class=\"btn-white\" target=\"_blank\">Access the training \u2192<\/a>\n    <\/div>\n<\/p><\/div>\n<h2>4. How to communicate with a loved one with MS<\/h2>\n<pee>The cognitive disorders of MS profoundly change communication within the family. Simple but consistent adjustments in the way you address the person can significantly reduce their cognitive load and improve the quality of exchanges.<\/pee>\n<h3>4.1 Adapting your speech: practical rules<\/h3>\n<div class=\"numbered-card\">\n<div class=\"num-badge\">1<\/div>\n<div class=\"num-content\">\n<h4>Speak slowly and allow time<\/h4>\n<pee>Slow down your own speech rate, pause between sentences, and wait for the response without completing it for the person. The slowness of processing does not mean that the response will not come \u2014 it will come if given time.<\/pee>\n    <\/div>\n<\/p><\/div>\n<div class=\"numbered-card\">\n<div class=\"num-badge\">2<\/div>\n<div class=\"num-content\">\n<h4>One piece of information at a time<\/h4>\n<pee>Avoid complex sentences with multiple instructions or simultaneous information. &#8220;We&#8217;re leaving at 2 PM, remember to take your coat and your medication, and don&#8217;t forget to call the doctor this morning&#8221;: this guarantees cognitive overload. Break down the information and ensure that the first part is well understood before adding the next.<\/pee>\n    <\/div>\n<\/p><\/div>\n<div class=\"numbered-card\">\n<div class=\"num-badge\">3<\/div>\n<div class=\"num-content\">\n<h4>Rephrase without interpreting<\/h4>\n<pee>When the person seems to be searching for their words or loses the thread, gently suggest: &#8220;Are you talking about the meeting on Tuesday?&#8221; rather than guessing and finishing the sentence. Rephrasing validates what the person is trying to say without depriving them of their expression.<\/pee>\n    <\/div>\n<\/p><\/div>\n<div class=\"numbered-card\">\n<div class=\"num-badge\">4<\/div>\n<div class=\"num-content\">\n<h4>Choose favorable moments<\/h4>\n<pee>Cognitive functions in MS fluctuate throughout the day and according to the level of fatigue. Observe when during the day your loved one is most alert and reserve important conversations, decision-making, and complex tasks for those times. Never bring up a sensitive topic at the end of the day or after physical exertion.<\/pee>\n    <\/div>\n<\/p><\/div>\n<div class=\"numbered-card\">\n<div class=\"num-badge\">5<\/div>\n<div class=\"num-content\">\n<h4>Write down important information<\/h4>\n<pee>A visible wall calendar, strategically placed post-its, a shared notebook, reminders on the phone \u2014 written or visual supports compensate for prospective memory failures and reduce anxiety related to the fear of forgetting.<\/pee>\n    <\/div>\n<\/p><\/div>\n<div class=\"two-cols\">\n<div class=\"col-block\">\n<h4>\u274c What hurts (and why)<\/h4>\n<ul>\n<li>&#8220;You&#8217;re forgetting on purpose&#8221; \u2192 denies neurological reality<\/li>\n<li>&#8220;Make an effort, you can do it!&#8221; \u2192 disregards primary fatigue<\/li>\n<li>&#8220;Yesterday you were fine, why not today?&#8221; \u2192 ignores fluctuations<\/li>\n<li>Finishing sentences for them \u2192 deprives of expressive autonomy<\/li>\n<li>&#8220;You&#8217;re exaggerating, it&#8217;s all in your head&#8221; \u2192 completely invalidates<\/li>\n<li>Talking about her in her presence as if she weren&#8217;t there<\/li>\n<\/ul><\/div>\n<div class=\"col-block\">\n<h4>\u2705 What helps (and how to say it)<\/h4>\n<ul>\n<li>&#8220;I&#8217;m writing this so we don&#8217;t forget&#8221; \u2192 compensate without judging<\/li>\n<li>&#8220;You look tired, can we postpone to tomorrow?&#8221; \u2192 respect the limits<\/li>\n<li>&#8220;Take your time, I&#8217;m here&#8221; \u2192 secure communication<\/li>\n<li>&#8220;How can I help you now?&#8221; \u2192 let the person define their need<\/li>\n<li>&#8220;It&#8217;s normal for it to fluctuate&#8221; \u2192 validate the variations<\/li>\n<li>Maintain simple and regular rituals \u2192 reduce cognitive load<\/li>\n<\/ul><\/div>\n<\/p><\/div>\n<h2>5. Structuring the environment to compensate for cognitive disorders<\/h2>\n<pee>The environment in which a person with MS lives can significantly lighten or worsen the daily cognitive load. Simple and systematic adjustments reduce the number of decisions to be made, limit the risk of forgetfulness, and preserve autonomy.<\/pee>\n<h3>5.1 Routine: the first cognitive compensation<\/h3>\n<pee>A stable and predictable routine radically reduces cognitive load: if the same sequence of actions occurs every morning, the brain does not need to &#8220;decide&#8221; \u2014 it executes a known program. Building morning, evening, and recurring task routines (medications, medical appointments, shopping) together is one of the most effective interventions.<\/pee>\n<div class=\"cta-outil\">\n<div class=\"cta-icon\">\ud83c\udf21\ufe0f<\/div>\n<div>\n<h4>DYNSEO Emotion Thermometer<\/h4>\n<pee>Emotional fluctuations are common in MS \u2014 related to the disease itself, fatigue, treatments, and the psychological burden of caregiving. The emotion thermometer is a simple visual tool that helps the person with MS and their loved ones identify and communicate their current emotional state \u2014 a starting point for adapting interaction and preventing misunderstandings.<\/pee>\n      <a href=\"https:\/\/www.dynseo.com\/en\/our-tools\/emotion-thermometer\/\" class=\"btn-blue\">Access the tool<\/a>\n    <\/div>\n<\/p><\/div>\n<h3>5.2 Practical adjustments to the environment<\/h3>\n<div class=\"energie-grid\">\n<div class=\"energie-item\">\n      <span class=\"e-icon\">\ud83d\udccb<\/span><\/p>\n<h4>Visual lists<\/h4>\n<pee>Check-lists for routines, shopping, weekly tasks \u2014 displayed visibly and consistently in the relevant areas.<\/pee>\n    <\/div>\n<div class=\"energie-item teal\">\n      <span class=\"e-icon\">\ud83d\uddd3\ufe0f<\/span><\/p>\n<h4>Shared calendar<\/h4>\n<pee>Digital calendar (Google, Apple) or wall-mounted with automatic reminders for appointments, medications, and important commitments.<\/pee>\n    <\/div>\n<div class=\"energie-item yellow\">\n      <span class=\"e-icon\">\ud83d\udccd<\/span><\/p>\n<h4>Fixed locations<\/h4>\n<pee>Each object (keys, medications, phone, glasses) has a defined and unchanging place \u2014 eliminates the burden of &#8220;looking for&#8221;.<\/pee>\n    <\/div>\n<div class=\"energie-item pink\">\n      <span class=\"e-icon\">\ud83d\udd15<\/span><\/p>\n<h4>Reducing distractions<\/h4>\n<pee>Turn off the television during an important conversation, choose quiet times for demanding cognitive tasks.<\/pee>\n    <\/div>\n<\/p><\/div>\n<div class=\"cta-outil\">\n<div class=\"cta-icon\">\ud83c\udfaf<\/div>\n<div>\n<h4>DYNSEO Choice Wheel<\/h4>\n<pee>Faced with the multitude of possible adaptations, it can be difficult to know where to start. The DYNSEO Choice Wheel is a decision-making tool that allows the person with MS and their family to identify priority adjustments, set concrete goals, and distribute responsibilities in a balanced way.<\/pee>\n      <a href=\"https:\/\/www.dynseo.com\/en\/our-tools\/choice-wheel-outils-formation-dynseo\/\" class=\"btn-blue\">Access the tool<\/a>\n    <\/div>\n<\/p><\/div>\n<h2>6. Cognitive Stimulation in MS: Why and How<\/h2>\n<pee>Cognitive stimulation in MS does not aim to &#8220;cure&#8221; cognitive disorders \u2014 there is currently no curative treatment for cognitive impairment in MS. Its goal is to maintain and strengthen preserved functions, develop compensation strategies, and preserve quality of life by maximizing cognitive autonomy.<\/pee>\n<h3>6.1 What Research Says About Cognitive Rehabilitation in MS<\/h3>\n<pee>Well-conducted clinical studies show benefits of cognitive rehabilitation on information processing speed and working memory in MS patients. Structured, regular, and sufficiently intense programs (several sessions per week) produce the most significant effects. The important thing is to adjust the intensity to the level of fatigue \u2014 a session that is too long or too difficult can temporarily worsen symptoms.<\/pee>\n<div class=\"sep-band\">\n<h3>\ud83c\udfae CLINT, the DYNSEO app adapted for MS patients<\/h3>\n<pee>The <a href=\"https:\/\/www.dynseo.com\/en\/brain-games-apps\/clint-brain-games-for-adults\/\" style=\"color:var(--blue);font-weight:600;\">CLINT<\/a> app from DYNSEO offers cognitive stimulation exercises specifically designed for adults with cognitive disorders of neurological origin \u2014 including MS. It covers working memory, processing speed, selective and divided attention, executive functions, and language.<\/pee>\n    <pee>Its short and adaptable sessions (10 to 20 minutes) are particularly suited for individuals whose cognitive endurance is reduced by neurological fatigue. The difficulty level automatically adjusts based on performance, and progress is visualized to maintain motivation.<\/pee>\n    <pee>CLINT can be used independently by the patient or with the support of a caregiver or health professional (neuropsychologist, speech therapist, occupational therapist).<\/pee>\n  <\/div>\n<h3>6.2 Principles of a Cognitive Stimulation Session Adapted for MS<\/h3>\n<div class=\"numbered-card\">\n<div class=\"num-badge\">1<\/div>\n<div class=\"num-content\">\n<h4>Assess Energy Level Before Starting<\/h4>\n<pee>Never schedule a cognitive stimulation session after physical exertion, at the end of the day, or during an episode of intense fatigue. Prefer mornings or early afternoons, after a period of relative rest.<\/pee>\n    <\/div>\n<\/p><\/div>\n<div class=\"numbered-card\">\n<div class=\"num-badge\">2<\/div>\n<div class=\"num-content\">\n<h4>Start Slowly and Gradually Increase<\/h4>\n<pee>10 to 15 minutes to start, 3 to 4 times a week. Increase duration and frequency only if the level of fatigue remains acceptable after sessions. The goal is long-term regularity, not immediate performance.<\/pee>\n    <\/div>\n<\/p><\/div>\n<div class=\"numbered-card\">\n<div class=\"num-badge\">3<\/div>\n<div class=\"num-content\">\n<h4>Vary Exercises and Domains<\/h4>\n<pee>Memory, attention, language, executive functions \u2014 varying the types of exercises avoids monotony and stimulates different neural networks. Apps like CLINT offer varied catalogs that prevent identical repetition.<\/pee>\n    <\/div>\n<\/p><\/div>\n<div class=\"numbered-card\">\n<div class=\"num-badge\">4<\/div>\n<div class=\"num-content\">\n<h4>Stop at the first signs of cognitive fatigue<\/h4>\n<pee>Difficulty concentrating, irritability, accumulating errors, feeling &#8220;in a fog&#8221; \u2014 these are the stop signals. Pushing beyond does not provide additional benefit and increases the risk of temporary worsening of fatigue.<\/pee>\n    <\/div>\n<\/p><\/div>\n<div class=\"cta-outil\">\n<div class=\"cta-icon\">\ud83c\udfad<\/div>\n<div>\n<h4>DYNSEO Facial Expression Decoder<\/h4>\n<pee>Social cognition disorders \u2014 difficulty recognizing emotions on faces \u2014 are present in a significant proportion of MS patients and contribute to relational misunderstandings. The DYNSEO facial expression decoder is an interactive exercise for training emotion recognition, usable in individual or group sessions with a professional.<\/pee>\n      <a href=\"https:\/\/www.dynseo.com\/en\/our-tools\/facial-expression-decoder\/\" class=\"btn-blue\">Discover the tool<\/a>\n    <\/div>\n<\/p><\/div>\n<h2>7. Taking care of the caregiver: family health matters too<\/h2>\n<pee>Supporting a loved one with MS is a deep commitment that exposes the caregiver to their own form of exhaustion. Caregivers of people with MS have significantly higher rates of depression and anxiety than the general population. Taking care of oneself is not a luxury \u2014 it is a condition for the sustainability of support.<\/pee>\n<h3>7.1 Recognizing caregiver exhaustion<\/h3>\n<div class=\"warning-box\">\n    <pee>\u26a0\ufe0f <strong>Signs of caregiver burnout:<\/strong> increasing irritability towards the sick loved one, constant feelings of guilt, neglecting one&#8217;s own health (postponed medical appointments, poor diet), loss of pleasure in usual activities, feeling &#8220;trapped,&#8221; sleep disturbances, gradual isolation. If you recognize yourself in this description, seeking support is a priority \u2014 not a weakness.<\/pee>\n  <\/div>\n<h3>7.2 Resources for caregivers<\/h3>\n<pee>The AFSEP (French Association of Multiple Sclerosis Patients) offers support groups for caregivers, information, and a helpline. The LFSEP (French League Against Multiple Sclerosis) provides similar resources. Many hospitals and health networks offer therapeutic education programs that include caregivers. The caregiver&#8217;s primary care physician should be informed of their role to monitor and support them.<\/pee>\n<pee>Taking time for oneself \u2014 even a few hours a week, through respite solutions (day care, home help, volunteer work) \u2014 is not abandoning one&#8217;s loved one. It is preserving the quality of the relationship over time and one&#8217;s own health.<\/pee>\n<h2>8. MS, professional life, and job retention<\/h2>\n<pee>Multiple sclerosis primarily affects young adults in full professional activity. Fatigue and cognitive disorders \u2014 slowed processing speed, organizational difficulties, working memory problems \u2014 have a direct impact on the ability to hold a job. However, many adjustments allow for a fulfilling professional life, often much longer than one fears at the time of diagnosis.<\/pee>\n<h3>8.1 Rights and professional adjustments<\/h3>\n<pee>MS is a chronic illness that grants the right to Recognition of the Quality of Disabled Worker (RQTH), issued by the MDPH. This recognition is confidential (the employer is informed only if the person wishes) and provides access to several provisions: workplace adjustments (adapted hours, telecommuting, ergonomic equipment), assistance from AGEFIPH for private companies or FIPHFP for the public sector, support from Cap Emploi for job retention or retraining, and enhanced protection against dismissal.<\/pee>\n<div class=\"tip-box\">\n<div class=\"icon\">\ud83d\udcbc<\/div>\n<pee><strong>Telecommuting and MS:<\/strong> Telecommuting is one of the most beneficial adjustments for people with MS. It eliminates transportation fatigue, allows work at the best times of the day, permits recovery breaks without colleagues&#8217; scrutiny, and removes exposure to heat and temperature variations that worsen symptoms. Since the 2020 law, the occupational physician can recommend telecommuting for medical reasons.<\/pee>\n  <\/div>\n<h3>8.2 Managing fatigue and cognitive disorders at work<\/h3>\n<div class=\"numbered-card\">\n<div class=\"num-badge\">1<\/div>\n<div class=\"num-content\">\n<h4>Plan complex tasks at the best times<\/h4>\n<pee>Identify your &#8220;cognitive peak&#8221; of the day (often in the morning for people with MS) and reserve this time slot for tasks that require concentration and thought. Schedule meetings, decision-making, and important writing during these windows of maximum efficiency.<\/pee>\n    <\/div>\n<\/p><\/div>\n<div class=\"numbered-card\">\n<div class=\"num-badge\">2<\/div>\n<div class=\"num-content\">\n<h4>Systematically use compensatory tools<\/h4>\n<pee>Digital agenda with automatic reminders, systematic note-taking in meetings (dedicated app or simple notebook), deferred proofreading of emails before sending, creation of templates for recurring tasks \u2014 these habits compensate for deficiencies in working memory and prospective memory without colleagues necessarily perceiving the reason.<\/pee>\n    <\/div>\n<\/p><\/div>\n<div class=\"numbered-card\">\n<div class=\"num-badge\">3<\/div>\n<div class=\"num-content\">\n<h4>Establish restorative micro-breaks<\/h4>\n<pee>5 to 10 minutes of recovery every 90 minutes of intense cognitive work \u2014 not on social media (which do not help recover), but in passive rest, a short walk, or conscious breathing. These breaks preserve the ability to concentrate throughout the day.<\/pee>\n    <\/div>\n<\/p><\/div>\n<div class=\"numbered-card\">\n<div class=\"num-badge\">4<\/div>\n<div class=\"num-content\">\n<h4>Communicate with your supervisor: how far?<\/h4>\n<pee>There is no obligation to disclose your diagnosis to your employer. However, communicating about functional needs (&#8220;I need adjusted hours&#8221;, &#8220;I prefer meetings in the morning&#8221;) without necessarily explaining why often allows for adaptations. The occupational physician is a key contact: confidential, they can prescribe adjustments without the diagnosis being communicated to the employer.<\/pee>\n    <\/div>\n<\/p><\/div>\n<h2>9. Care pathway in MS: who to contact and when<\/h2>\n<pee>The management of MS is multidisciplinary. Each professional plays a specific role in supporting fatigue and cognitive disorders, and coordination among them is crucial for the patient&#8217;s quality of life.<\/pee>\n<div class=\"cards-grid\">\n<div class=\"card\">\n<div class=\"card-icon blue\">\ud83e\udde0<\/div>\n<h4>Referent neurologist for MS<\/h4>\n<pee>Global follow-up of the disease, adjustment of baseline treatments, prescription of MRI exams, referral to specialists. The frequency of consultations is generally quarterly to annually depending on the stability of the disease.<\/pee>\n    <\/div>\n<div class=\"card\">\n<div class=\"card-icon teal\">\ud83e\udde9<\/div>\n<h4>Neuropsychologist<\/h4>\n<pee>In-depth neuropsychological assessment every 1 to 2 years to map preserved and altered cognitive functions. Implementation of an individualized cognitive rehabilitation program. Psychological support in facing the impacts of the disease on identity and life project.<\/pee>\n    <\/div>\n<div class=\"card\">\n<div class=\"card-icon yellow\">\ud83d\udcac<\/div>\n<h4>Speech therapist<\/h4>\n<pee>Rehabilitation of language, verbal fluency, and swallowing. Working on verbal working memory and executive functions in a structured setting. Guidance for relatives on adapted communication strategies.<\/pee>\n    <\/div>\n<div class=\"card\">\n<div class=\"card-icon pink\">\ud83d\udee0\ufe0f<\/div>\n<h4>Occupational therapist<\/h4>\n<pee>Assessment of difficulties in daily living activities, prescription of technical aids, adaptation of home and work environment. Implementation of practical compensatory strategies for cognitive and motor disorders.<\/pee>\n    <\/div>\n<div class=\"card\">\n<div class=\"card-icon blue\">\ud83c\udfcb\ufe0f<\/div>\n<h4>Physiotherapist \/ APA<\/h4>\n<pee>Exercise program adapted to fatigue and motor symptoms. Prevention of sarcopenia and maintenance of balance. Adapted physical activity reduces neurological fatigue in the long term, contrary to intuition.<\/pee>\n    <\/div>\n<div class=\"card\">\n<div class=\"card-icon teal\">\u2764\ufe0f<\/div>\n<h4>Psychologist \/ Psychiatrist<\/h4>\n<pee>Depression (present in 50% of MS patients), anxiety, mourning for the &#8220;previous self&#8221; \u2014 the psychological dimension of MS is significant and often insufficiently addressed. Cognitive-behavioral therapy (CBT) shows particular effectiveness in MS.<\/pee>\n    <\/div>\n<\/p><\/div>\n<h3>9.1 Reference networks and associations<\/h3>\n<pee>In France, several dedicated organizations support MS patients and their families: the French Society of Neurology (SFN) coordinates the OFSEP reference centers (French Observatory of Multiple Sclerosis); the LFSEP (French League Against Multiple Sclerosis) offers information, support, and research funding; the AFSEP (French Association of People with Multiple Sclerosis) provides psychological support and support groups; and the MS Resource Centers (CR-SEP) present in major cities coordinate access to specialized multidisciplinary care.<\/pee>\n<div class=\"highlight-box\">\n<h4>\ud83d\udcf1 DYNSEO cognitive tests: a first home assessment<\/h4>\n<pee>If you or your loved one with MS want to explore your current cognitive profile before a neuropsychological consultation, or track changes between two formal assessments, DYNSEO offers online cognitive tests covering different areas \u2014 memory, attention, processing speed, executive functions. Find all the tests at <a href=\"https:\/\/www.dynseo.com\/en\/our-tests\/\" style=\"color:var(--blue);font-weight:600;\">dynseo.com\/nos-tests\/<\/a>. These tests do not replace a professional evaluation but serve as a useful complementary tracking tool.<\/pee>\n  <\/div>\n<h2>10. MS and family life: preserving relationships when illness invades daily life<\/h2>\n<pee>MS does not only affect the diagnosed person \u2014 it profoundly restructures family dynamics. Roles may reverse (a spouse becomes a caregiver), life projects adapt, and children develop an early awareness of fragility and illness. Addressing these relational realities with honesty and tools is essential to preserve the quality of bonds.<\/pee>\n<h3>10.1 Couple life when one partner has MS<\/h3>\n<pee>MS introduces an asymmetry into the couple that can destabilize a previously balanced relationship. The healthy partner may find themselves in a caregiver role \u2014 managing household tasks, finances, family logistics \u2014 while continuing to pursue their professional activity. This burden, if not named and shared, creates resentment. Conversely, the person with MS may feel guilty for &#8220;not contributing anymore,&#8221; which generates their own spiral of discouragement.<\/pee>\n<pee>Couple consultations with a psychologist or a therapist trained in chronic illnesses can help renegotiate roles, verbalize needs and frustrations, and preserve the space of complicity and intimacy that the illness can gradually invade. Associations like LFSEP provide references for therapists sensitized to MS.<\/pee>\n<h3>10.2 Explaining MS to children according to their age<\/h3>\n<div class=\"table-wrap\">\n<table>\n<thead>\n<tr>\n<th>Age group<\/th>\n<th>How to explain MS<\/th>\n<th>What children need<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td><strong>3\u20136 years<\/strong><\/td>\n<td>&#8220;Sometimes dad\/mom is very tired and can&#8217;t play. It&#8217;s not your fault and you can&#8217;t catch it.&#8221;<\/td>\n<td>Reassurance about the continuity of love, maintaining daily rituals<\/td>\n<\/tr>\n<tr>\n<td><strong>7\u201311 years<\/strong><\/td>\n<td>Explain myelin, nerve messages, variable symptoms. Show illustrated books about MS for children.<\/td>\n<td>Understanding why symptoms fluctuate, not feeling responsible for &#8220;bad days&#8221;<\/td>\n<\/tr>\n<tr>\n<td><strong>12\u201315 years<\/strong><\/td>\n<td>Direct conversation about the illness, its possible evolution, treatments. Invite questions.<\/td>\n<td>To be included in family reality without being turned into a caregiver, maintaining their own social life<\/td>\n<\/tr>\n<tr>\n<td><strong>16 years and older<\/strong><\/td>\n<td>Open discussion about family impact, adaptations, long-term projects.<\/td>\n<td>Not feeling alone as the bearer of information, access to psychological support if needed<\/td>\n<\/tr>\n<\/tbody>\n<\/table><\/div>\n<h3>10.3 Preventing social isolation of MS patients<\/h3>\n<pee>The fatigue and cognitive disorders of MS lead many patients to gradually give up their social activities \u2014 too tiring, too unpredictable, too anxiety-inducing around visible symptoms. This isolation worsens depression, accelerates cognitive decline, and impoverishes quality of life. Proactive strategies allow for maintaining social connections adapted to the new reality of the illness: choosing shorter and more predictable formats (a coffee rather than a dinner), using digital tools (video conferencing) for distant friends, joining an MS support group where the illness does not have to be explained or minimized.<\/pee>\n<p><\/main><\/p>\n<div class=\"faq-section\">\n<div class=\"container\">\n<h2>Frequently Asked Questions \u2014 MS, Fatigue, and Cognitive Disorders<\/h2>\n<div class=\"faq-item\">\n<h4><span>Q1<\/span> Is fatigue in MS really that different from normal fatigue?<\/h4>\n<pee>Yes, radically. Neurological fatigue in MS is a primary fatigue related to demyelination \u2014 nerve transmission requires much more energy than in a healthy person. It can occur after minimal effort, or even without apparent effort. It does not go away with a good night&#8217;s sleep. It can be debilitating in the middle of a seemingly calm day. It worsens with heat (Uhthoff&#8217;s effect). It is not laziness, it is not psychological \u2014 it is a real neurological symptom, documented and recognized by the medical community.<\/pee>\n    <\/div>\n<div class=\"faq-item\">\n<h4><span>Q2<\/span> Do all MS patients have cognitive disorders?<\/h4>\n<pee>No, not all \u2014 but the proportion is higher than one might think. About 45 to 65% of patients experience cognitive disorders at some point in their illness. They can be present from the beginning, even in patients with little physical disability. The most commonly affected area is the speed of information processing, followed by working memory and executive functions. A neuropsychological assessment by a professional trained in MS can accurately map cognitive strengths and weaknesses.<\/pee>\n    <\/div>\n<div class=\"faq-item\">\n<h4><span>Q3<\/span> How to explain to children that their parent with MS &#8220;forgets things&#8221;?<\/h4>\n<pee>Adapting the explanation to the age is essential. For young children (3-8 years): &#8220;Mommy&#8217;s\/Daddy&#8217;s brain sometimes sends messages a little slowly or that get lost \u2014 like when the internet is slow. That doesn&#8217;t mean she\/he loves you less.&#8221; For older children (9-14 years): explain myelin, its function as an insulating cable, and what happens when it is damaged. For teenagers: a more direct conversation about the disease, its fluctuations, and how they can help without becoming full-time caregivers. Age-appropriate transparency protects children better than silence.<\/pee>\n    <\/div>\n<div class=\"faq-item\">\n<h4><span>Q4<\/span> Do MS disease-modifying treatments also affect cognitive disorders?<\/h4>\n<pee>Disease-modifying treatments (interferons, glatiramer acetate, natalizumab, ocrelizumab, etc.) primarily work by reducing inflammation and new brain lesions, which can indirectly slow the progression of cognitive disorders. Some studies suggest that high-efficacy treatments, started early, could better preserve cognition in the long term. But no treatment repairs already impaired cognitive functions \u2014 which is why cognitive rehabilitation and compensatory strategies remain essential as a complement.<\/pee>\n    <\/div>\n<div class=\"faq-item\">\n<h4><span>Q5<\/span> Is the DYNSEO training on MS also aimed at healthcare professionals?<\/h4>\n<pee>Yes, fully. The training &#8220;Fatigue and Cognitive Disorders in MS: What Families Can Do&#8221; is designed to be accessible to families while providing added value to professionals \u2014 nurses, caregivers, occupational therapists, speech therapists, psychologists, social workers \u2014 who support MS patients. It is Qualiopi certified and eligible for OPCO funding for employees or independent professionals in the medico-social sector.<\/pee>\n    <\/div>\n<\/p><\/div>\n<\/div>\n<p><main class=\"container\"><\/p>\n<div class=\"conclusion\">\n<h2>Understanding to Better Support<\/h2>\n<pee>Neurological fatigue and mental fog in MS are not excuses or exaggerations \u2014 they are real, documented, and debilitating symptoms. Families who understand these mechanisms can transform their perspective, adapt their communication, and implement strategies that preserve both their loved one&#8217;s autonomy and their own balance. DYNSEO supports you with practical tools, a tailored cognitive stimulation app, and certified training to make this support an informed and compassionate act of care.<\/pee>\n    <a href=\"https:\/\/www.dynseo.com\/en\/courses\/fatigue-and-cognitive-disorders-in-ms-what-families-can-do-en\/\" class=\"btn-cta\" target=\"_blank\">Access the MS training \u2192<\/a>\n  <\/div>\n<div class=\"cta-formation\">\n    <a href=\"https:\/\/www.dynseo.com\/en\/courses\/fatigue-and-cognitive-disorders-in-ms-what-families-can-do-en\/\" target=\"_blank\"><br \/>\n      <img decoding=\"async\" src=\"https:\/\/www.dynseo.com\/wp-content\/uploads\/2026\/03\/Fatigue-et-troubles-cognitifs-dans-la-sep.png\" alt=\"DYNSEO Training MS Fatigue Cognitive Disorders\" class=\"cta-img\"><br \/>\n    <\/a><\/p>\n<div class=\"cta-content\">\n<h4>\ud83c\udf93 Certified Training \u2014 Fatigue and Cognitive Disorders in MS<\/h4>\n<pee>100% accessible online training, Qualiopi certified, eligible for OPCO funding. Designed for families and healthcare professionals who support MS patients. Modules on neurological fatigue, mental fog, adapted communication, cognitive stimulation, and support for caregivers.<\/pee>\n      <a href=\"https:\/\/www.dynseo.com\/en\/courses\/fatigue-and-cognitive-disorders-in-ms-what-families-can-do-en\/\" class=\"btn-white\" target=\"_blank\">Access the training \u2192<\/a>\n    <\/div>\n<\/p><\/div>\n<p><\/main><\/p>\n<footer class=\"article-footer\">\n  <pee>This article was written by the DYNSEO team \u2014 specialists in cognitive stimulation and professional health training for 13 years.<\/pee>\n<div class=\"footer-links\">\n    <a href=\"https:\/\/www.dynseo.com\/en\/brain-games-apps\/clint-brain-games-for-adults\/\">JOE Application<\/a><br \/>\n    <a href=\"https:\/\/www.dynseo.com\/en\/our-tools\/\">All our tools<\/a><br \/>\n    <a href=\"https:\/\/www.dynseo.com\/en\/our-tests\/\">Cognitive Tests<\/a><br \/>\n    <a href=\"https:\/\/www.dynseo.com\/en\/courses\/fatigue-and-cognitive-disorders-in-ms-what-families-can-do-en\/\">The training<\/a>\n  <\/div>\n<\/footer>\n<\/div>\n<p>[\/et_pb_code][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":4,"featured_media":100456,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"[et_pb_section fb_built=\"1\" admin_label=\"Article HTML\" _builder_version=\"4.16\" custom_padding=\"0px||0px||false|false\" global_colors_info=\"{}\"][et_pb_row admin_label=\"Contenu\" _builder_version=\"4.16\" width=\"100%\" max_width=\"100%\" custom_padding=\"0px||0px||false|false\" global_colors_info=\"{}\"][et_pb_column type=\"4_4\" _builder_version=\"4.16\" global_colors_info=\"{}\"][et_pb_code admin_label=\"HTML import\u00e9\" _builder_version=\"4.16\" global_colors_info=\"{}\"]<style 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{display:inline-block;background:linear-gradient(135deg,var(--blue),var(--blue-dark));color:#fff;font-family:'Montserrat',sans-serif;font-weight:700;font-size:15px;padding:14px 32px;border-radius:50px;text-decoration:none;box-shadow:0 6px 20px rgba(94,94,215,.3);transition:transform .2s}\n.dbi-art-d635af .btn-cta:hover {transform:translateY(-3px)}\n.dbi-art-d635af .article-footer {background:linear-gradient(135deg,var(--blue),var(--blue-dark));color:#fff;padding:40px 24px;text-align:center}\n.dbi-art-d635af .article-footer p {color:rgba(255,255,255,.8);font-size:14px;margin-bottom:16px}\n.dbi-art-d635af .footer-links {display:flex;justify-content:center;gap:16px;flex-wrap:wrap}\n.dbi-art-d635af .footer-links a {color:#fff;text-decoration:none;font-size:13px;font-weight:600;padding:8px 18px;border:1px solid rgba(255,255,255,.3);border-radius:50px;transition:background .2s}\n.dbi-art-d635af .footer-links a:hover {background:rgba(255,255,255,.15)}\n@media(max-width:640px) {\n.dbi-art-d635af .cta-formation, .dbi-art-d635af .cta-outil {flex-direction:column}\n.dbi-art-d635af .cards-grid {grid-template-columns:1fr}\n}\n\n<\/style>\n<div class=\"dbi-art-d635af\">\n<header class=\"hero\">\n  <div class=\"hero-tag\">\ud83e\udde0 Multiple sclerosis \u00b7 Fatigue \u00b7 Support<\/div>\n  <h1>Fatigue and cognitive disorders in MS:<br>what families can do<\/h1>\n  <p class=\"hero-sub\">Understanding mental fog, identifying types of fatigue, adapting daily life, and supporting a loved one with multiple sclerosis \u2014 the complete practical guide for families and caregivers<\/p>\n  <div class=\"hero-meta\">\n    <span>\ud83d\udcd6 Reading: ~24 min<\/span><span>\u2705 Updated 2026<\/span><span>\ud83d\udc68\u200d\ud83d\udc69\u200d\ud83d\udc67 Families &amp; professionals<\/span>\n  <\/div>\n<\/header>\n\n<div class=\"stats-bar\">\n  <div class=\"stats-grid\">\n    <div class=\"stat-item\"><span class=\"stat-num\">110,000<\/span><span class=\"stat-label\">people with MS in France, of which 3 out of 4 are women<\/span><\/div>\n    <div class=\"stat-item\"><span class=\"stat-num\">80 %<\/span><span class=\"stat-label\">of MS patients suffer from fatigue \u2014 the most common and disabling symptom<\/span><\/div>\n    <div class=\"stat-item\"><span class=\"stat-num\">65 %<\/span><span class=\"stat-label\">of patients experience cognitive disorders at some point in their illness<\/span><\/div>\n    <div class=\"stat-item\"><span class=\"stat-num\">30 years<\/span><span class=\"stat-label\">average age at diagnosis of MS \u2014 a disease that primarily affects young adults<\/span><\/div>\n  <\/div>\n<\/div>\n\n<main class=\"container\">\n\n  <div class=\"intro-block\">\n    <p>Multiple sclerosis (MS) is a chronic neurological disease that is not limited to its visible motor symptoms. Fatigue and cognitive disorders \u2014 often invisible to others \u2014 are among the most challenging manifestations to live with daily, both for the person affected and their loved ones. \"She looks fine though,\" \"you just need to motivate yourself,\" \"you just have to rest\" \u2014 these phrases, heard too often, reflect a deep misunderstanding of what patients and their families actually experience. This guide provides you with the keys to understand, recognize, and act in the face of neurological fatigue and mental fog of MS.<\/p>\n  <\/div>\n\n  <h2>1. MS in a few words: a complex and variable disease<\/h2>\n\n  <p>Multiple sclerosis is an autoimmune disease of the central nervous system in which the immune system attacks the myelin, the protective sheath of nerve fibers. This demyelination disrupts the transmission of nerve signals, leading to a wide variety of symptoms depending on the areas of the brain and spinal cord affected.<\/p>\n\n  <h3>1.1 Forms of MS<\/h3>\n\n  <div class=\"cards-grid\">\n    <div class=\"card\">\n      <div class=\"card-icon blue\">\ud83d\udd04<\/div>\n      <h4>Relapsing-remitting MS (RRMS)<\/h4>\n      <p>The most common form (85 % of cases at diagnosis). Alternating between relapses \u2014 sudden onset or worsening of symptoms \u2014 and phases of remission. Recovery after each relapse is variable and often incomplete.<\/p>\n    <\/div>\n    <div class=\"card\">\n      <div class=\"card-icon teal\">\ud83d\udcc8<\/div>\n      <h4>Primary progressive MS (PPMS)<\/h4>\n      <p>Continuous progression of symptoms from the onset, without identifiable relapses. Represents 15 % of cases at diagnosis. Often diagnosed later (around 40\u201350 years) and with a predominance of motor impairment.<\/p>\n    <\/div>\n    <div class=\"card\">\n      <div class=\"card-icon yellow\">\ud83d\udcca<\/div>\n      <h4>Secondary progressive MS (SPMS)<\/h4>\n      <p>Natural evolution of uncontrolled RRMS: after a relapsing phase, the disease enters a continuous progressive phase. Modern disease-modifying treatments aim to delay or prevent this conversion.<\/p>\n    <\/div>\n    <div class=\"card\">\n      <div class=\"card-icon pink\">\u26a1<\/div>\n      <h4>Clinically isolated syndrome (CIS)<\/h4>\n      <p>First neurological episode that may evolve into MS. Monitoring and early treatment can prevent conversion to defined MS. Rapid diagnosis is essential to act at the first signs.<\/p>\n    <\/div>\n  <\/div>\n<div class=\"highlight-box\">\n    <h4>\ud83c\udf21\ufe0f The Uhthoff effect: when heat worsens everything<\/h4>\n    <p>In about 60% of patients with MS, an increase in body temperature \u2014 due to ambient heat, fever, physical exertion, or even a hot bath \u2014 temporarily worsens all symptoms, including fatigue and cognitive disorders. This phenomenon, called the Uhthoff effect, rarely lasts more than 24 hours but can be very debilitating. It does not correspond to a true relapse and does not leave additional sequelae \u2014 but it is often misunderstood by those around who do not comprehend these abrupt variations in condition.<\/p>\n<\/div>\n\n<h2>2. Fatigue in MS: a symptom in its own right<\/h2>\n\n<p>Fatigue related to MS is radically different from ordinary fatigue. It does not disappear with rest, it does not correspond to an effort made, and it can occur in the middle of an otherwise calm day. Understanding its neurological nature is essential to discuss it accurately with those around and to adapt support.<\/p>\n\n<h3>2.1 Primary fatigue vs secondary fatigue<\/h3>\n\n<div class=\"table-wrap\">\n    <table>\n      <thead><tr><th>Type of fatigue<\/th><th>Origin<\/th><th>Characteristics<\/th><th>Approach<\/th><\/tr><\/thead>\n      <tbody>\n        <tr>\n          <td><strong>Primary fatigue (neurological)<\/strong><\/td>\n          <td>Demyelination \u2014 nerve transmission requires more energy<\/td>\n          <td>Occurs without effort, worsens during the day, resists rest, worsened by heat<\/td>\n          <td>Energy management, planning, specific treatments<\/td>\n        <\/tr>\n        <tr>\n          <td><strong>Secondary fatigue (reactive)<\/strong><\/td>\n          <td>Depression, sleep disorders, chronic pain, medications, infections, sedentariness<\/td>\n          <td>Variable, linked to triggering factors, potentially improvable<\/td>\n          <td>Treat the underlying cause: depression, pain, sleep disorder<\/td>\n        <\/tr>\n        <tr>\n          <td><strong>Muscle fatigue (spasticity)<\/strong><\/td>\n          <td>Affecting motor pathways \u2014 muscles work harder to function<\/td>\n          <td>Worsened by activity, localized to affected limbs, relieved by rest<\/td>\n          <td>Physiotherapy, antispastic treatments, occupational therapy<\/td>\n        <\/tr>\n      <\/tbody>\n    <\/table>\n<\/div>\n\n<h3>2.2 The spoon theory: explaining fatigue to those around<\/h3>\n\n<p>Christine Miserandino, who has lupus, created the spoon metaphor in 2003, which has become universal for explaining fatigue in chronic illnesses. Each day starts with a limited number of \"spoons\" (units of energy). Each activity \u2014 getting up, showering, preparing breakfast, going out \u2014 costs one or more spoons. Unlike a healthy person who has an almost unlimited reserve, a person with MS starts with a reduced number of spoons and cannot \"borrow\" from the next day without paying the price.<\/p>\n\n<div class=\"quote-box\">\n    <p>This morning, I had ten spoons. Showering cost me two. Preparing lunch, two more. Responding to your messages, one. I have five left for the rest of the day. No, I can't go out tonight \u2014 I have nothing left.<\/p>\n    <cite>\u2014 Anonymous testimony from an MS patient, adapted from the spoon theory<\/cite>\n<\/div>\n\n<div class=\"tip-box\">\n<div class=\"icon\">\ud83d\udca1<\/div>\n    <p><strong>For families:<\/strong> Visualizing the day of a loved one with MS as a finite energy budget profoundly changes the way we interpret their refusals, silences, and renunciations. It is not bad will \u2014 it is a rigorous management of a rare resource. Your role may be to help prioritize energy expenditures, not to deny them.<\/p>\n  <\/div>\n\n  <h3>2.3 The envelope theory: planning for longevity<\/h3>\n\n  <p>Complementary to the spoon theory, the envelope theory recommends never using more than 70% of one's available energy in a day \u2014 even on good days. Using the \"bonus\" from easy days creates an energy debt that must be paid back on subsequent days. Learning to stop before becoming exhausted is a skill that patients and their families must cultivate together, sometimes against the natural instinct to \"make the most of good days.\"<\/p>\n\n  <h2>3. Mental fog in MS: understanding cognitive disorders<\/h2>\n\n  <p>The \"mental fog\" or \"brain fog\" of MS refers to a set of cognitive difficulties that affect 45 to 65% of patients at some point in their illness. It can be present from the onset of MS, even in patients whose motor symptoms are limited. Long underestimated, it is now recognized as one of the main causes of job loss and relational difficulties.<\/p>\n\n  <h3>3.1 Cognitive domains affected by MS<\/h3>\n\n  <div class=\"risque-card\">\n    <div class=\"risque-icon\">\u26a1<\/div>\n    <div class=\"risque-body\">\n      <h4>Information processing speed<\/h4>\n      <p>The most frequently affected domain in MS. The person needs more time to process information, respond to a question, make a decision, or react to a situation. This can create the false impression of being \"slow\" or \"less intelligent,\" which is incorrect \u2014 only the speed is affected, not the ability.<\/p>\n    <\/div>\n  <\/div>\n\n  <div class=\"risque-card blue\">\n    <div class=\"risque-icon\">\ud83d\uddc2\ufe0f<\/div>\n    <div class=\"risque-body\">\n      <h4>Working memory<\/h4>\n      <p>Working memory is what allows us to keep information in mind while using it \u2014 remembering a phone number long enough to dial it, following a conversation while preparing a response. Its impairment in MS leads to many relational misunderstandings (\"you're not listening,\" \"you forget everything I say\").<\/p>\n    <\/div>\n  <\/div>\n\n  <div class=\"risque-card yellow\">\n    <div class=\"risque-icon\">\ud83c\udfaf<\/div>\n    <div class=\"risque-body\">\n      <h4>Executive functions<\/h4>\n      <p>Planning, organization, mental flexibility, inhibition of distractions \u2014 executive functions allow us to manage complex, multi-step tasks. Their impairment makes it difficult to handle daily life (shopping, administrative tasks, elaborate meals) and explains why patients may feel \"overwhelmed\" by things that seemed simple before.<\/p>\n    <\/div>\n  <\/div>\n\n  <div class=\"risque-card\">\n    <div class=\"risque-icon\">\ud83d\udd24<\/div>\n    <div class=\"risque-body\">\n      <h4>Word-finding difficulties and verbal fluency<\/h4>\n      <p>Searching for words, making unusual pauses in conversation, losing the thread of a sentence \u2014 these difficulties with verbal fluency are often very socially embarrassing. They can lead the patient to avoid conversation situations, deepening isolation.<\/p>\n    <\/div>\n  <\/div>\n\n  <div class=\"risque-card pink\">\n    <div class=\"risque-icon\">\ud83d\uddd3\ufe0f<\/div>\n<div class=\"risque-body\">\n      <h4>Episodic and prospective memory<\/h4>\n      <p>Episodic memory (memories of lived events) and prospective memory (remembering to do something in the future \u2014 taking medication, calling someone) can be affected. Repeated forgetfulness of appointments or tasks does not reflect a lack of importance given, but a real neurological difficulty.<\/p>\n    <\/div>\n  <\/div>\n\n  <!-- CTA TRAINING ENVIRONMENT -->\n  <div class=\"cta-formation\">\n    <a href=\"https:\/\/www.dynseo.com\/courses\/fatigue-et-troubles-cognitifs-dans-la-sep-ce-que-les-familles-peuvent-faire\/\" target=\"_blank\">\n      <img src=\"https:\/\/www.dynseo.com\/wp-content\/uploads\/2026\/03\/Fatigue-et-troubles-cognitifs-dans-la-sep.png\" alt=\"DYNSEO Training SEP Fatigue and cognitive disorders\" class=\"cta-img\">\n    <\/a>\n    <div class=\"cta-content\">\n      <h4>\ud83c\udf93 DYNSEO Training \u2014 Fatigue and cognitive disorders in MS<\/h4>\n      <p>This certified online training (Qualiopi) has been specifically designed for families and professionals who support a person with multiple sclerosis. It teaches you to understand neurological fatigue, recognize cognitive disorders, adapt your communication, and implement concrete strategies in daily life. 100% online, at your own pace, fundable through your OPCO.<\/p>\n      <a href=\"https:\/\/www.dynseo.com\/courses\/fatigue-et-troubles-cognitifs-dans-la-sep-ce-que-les-familles-peuvent-faire\/\" class=\"btn-white\" target=\"_blank\">Access the training \u2192<\/a>\n    <\/div>\n  <\/div>\n\n  <h2>4. How to communicate with a loved one with MS<\/h2>\n\n  <p>The cognitive disorders of MS profoundly change communication within the family. Simple but consistent adjustments in the way you address the person can significantly reduce their cognitive load and improve the quality of exchanges.<\/p>\n\n  <h3>4.1 Adapting your speech: practical rules<\/h3>\n\n  <div class=\"numbered-card\">\n    <div class=\"num-badge\">1<\/div>\n    <div class=\"num-content\">\n      <h4>Speak slowly and allow time<\/h4>\n      <p>Slow down your own speech rate, pause between sentences, and wait for the response without completing it for the person. The slowness of processing does not mean that the response will not come \u2014 it will come if given time.<\/p>\n    <\/div>\n  <\/div>\n\n  <div class=\"numbered-card\">\n    <div class=\"num-badge\">2<\/div>\n    <div class=\"num-content\">\n      <h4>One piece of information at a time<\/h4>\n      <p>Avoid complex sentences with multiple instructions or simultaneous information. \"We're leaving at 2 PM, remember to take your coat and your medication, and don't forget to call the doctor this morning\": this guarantees cognitive overload. Break down the information and ensure that the first part is well understood before adding the next.<\/p>\n    <\/div>\n  <\/div>\n\n  <div class=\"numbered-card\">\n    <div class=\"num-badge\">3<\/div>\n    <div class=\"num-content\">\n      <h4>Rephrase without interpreting<\/h4>\n      <p>When the person seems to be searching for their words or loses the thread, gently suggest: \"Are you talking about the meeting on Tuesday?\" rather than guessing and finishing the sentence. Rephrasing validates what the person is trying to say without depriving them of their expression.<\/p>\n    <\/div>\n  <\/div>\n\n  <div class=\"numbered-card\">\n    <div class=\"num-badge\">4<\/div>\n    <div class=\"num-content\">\n      <h4>Choose favorable moments<\/h4>\n      <p>Cognitive functions in MS fluctuate throughout the day and according to the level of fatigue. Observe when during the day your loved one is most alert and reserve important conversations, decision-making, and complex tasks for those times. Never bring up a sensitive topic at the end of the day or after physical exertion.<\/p>\n    <\/div>\n  <\/div>\n\n  <div class=\"numbered-card\">\n    <div class=\"num-badge\">5<\/div>\n    <div class=\"num-content\">\n      <h4>Write down important information<\/h4>\n      <p>A visible wall calendar, strategically placed post-its, a shared notebook, reminders on the phone \u2014 written or visual supports compensate for prospective memory failures and reduce anxiety related to the fear of forgetting.<\/p>\n    <\/div>\n  <\/div>\n\n  <div class=\"two-cols\">\n<div class=\"col-block\">\n      <h4>\u274c What hurts (and why)<\/h4>\n      <ul>\n        <li>\"You're forgetting on purpose\" \u2192 denies neurological reality<\/li>\n        <li>\"Make an effort, you can do it!\" \u2192 disregards primary fatigue<\/li>\n        <li>\"Yesterday you were fine, why not today?\" \u2192 ignores fluctuations<\/li>\n        <li>Finishing sentences for them \u2192 deprives of expressive autonomy<\/li>\n        <li>\"You're exaggerating, it's all in your head\" \u2192 completely invalidates<\/li>\n        <li>Talking about her in her presence as if she weren't there<\/li>\n      <\/ul>\n    <\/div>\n    <div class=\"col-block\">\n      <h4>\u2705 What helps (and how to say it)<\/h4>\n      <ul>\n        <li>\"I'm writing this so we don't forget\" \u2192 compensate without judging<\/li>\n        <li>\"You look tired, can we postpone to tomorrow?\" \u2192 respect the limits<\/li>\n        <li>\"Take your time, I'm here\" \u2192 secure communication<\/li>\n        <li>\"How can I help you now?\" \u2192 let the person define their need<\/li>\n        <li>\"It's normal for it to fluctuate\" \u2192 validate the variations<\/li>\n        <li>Maintain simple and regular rituals \u2192 reduce cognitive load<\/li>\n      <\/ul>\n    <\/div>\n  <\/div>\n\n  <h2>5. Structuring the environment to compensate for cognitive disorders<\/h2>\n\n  <p>The environment in which a person with MS lives can significantly lighten or worsen the daily cognitive load. Simple and systematic adjustments reduce the number of decisions to be made, limit the risk of forgetfulness, and preserve autonomy.<\/p>\n\n  <h3>5.1 Routine: the first cognitive compensation<\/h3>\n\n  <p>A stable and predictable routine radically reduces cognitive load: if the same sequence of actions occurs every morning, the brain does not need to \"decide\" \u2014 it executes a known program. Building morning, evening, and recurring task routines (medications, medical appointments, shopping) together is one of the most effective interventions.<\/p>\n\n  <div class=\"cta-outil\">\n    <div class=\"cta-icon\">\ud83c\udf21\ufe0f<\/div>\n    <div>\n      <h4>DYNSEO Emotion Thermometer<\/h4>\n      <p>Emotional fluctuations are common in MS \u2014 related to the disease itself, fatigue, treatments, and the psychological burden of caregiving. The emotion thermometer is a simple visual tool that helps the person with MS and their loved ones identify and communicate their current emotional state \u2014 a starting point for adapting interaction and preventing misunderstandings.<\/p>\n      <a href=\"https:\/\/www.dynseo.com\/nos-outils\/thermometre-des-emotions\/\" class=\"btn-blue\">Access the tool<\/a>\n    <\/div>\n  <\/div>\n\n  <h3>5.2 Practical adjustments to the environment<\/h3>\n\n  <div class=\"energie-grid\">\n    <div class=\"energie-item\">\n      <span class=\"e-icon\">\ud83d\udccb<\/span>\n      <h4>Visual lists<\/h4>\n      <p>Check-lists for routines, shopping, weekly tasks \u2014 displayed visibly and consistently in the relevant areas.<\/p>\n    <\/div>\n    <div class=\"energie-item teal\">\n      <span class=\"e-icon\">\ud83d\uddd3\ufe0f<\/span>\n      <h4>Shared calendar<\/h4>\n      <p>Digital calendar (Google, Apple) or wall-mounted with automatic reminders for appointments, medications, and important commitments.<\/p>\n    <\/div>\n    <div class=\"energie-item yellow\">\n      <span class=\"e-icon\">\ud83d\udccd<\/span>\n      <h4>Fixed locations<\/h4>\n      <p>Each object (keys, medications, phone, glasses) has a defined and unchanging place \u2014 eliminates the burden of \"looking for\".<\/p>\n    <\/div>\n    <div class=\"energie-item pink\">\n      <span class=\"e-icon\">\ud83d\udd15<\/span>\n      <h4>Reducing distractions<\/h4>\n      <p>Turn off the television during an important conversation, choose quiet times for demanding cognitive tasks.<\/p>\n    <\/div>\n  <\/div>\n\n  <div class=\"cta-outil\">\n<div class=\"cta-icon\">\ud83c\udfaf<\/div>\n    <div>\n      <h4>DYNSEO Choice Wheel<\/h4>\n      <p>Faced with the multitude of possible adaptations, it can be difficult to know where to start. The DYNSEO Choice Wheel is a decision-making tool that allows the person with MS and their family to identify priority adjustments, set concrete goals, and distribute responsibilities in a balanced way.<\/p>\n      <a href=\"https:\/\/www.dynseo.com\/nos-outils\/roue-des-choix\/\" class=\"btn-blue\">Access the tool<\/a>\n    <\/div>\n  <\/div>\n\n  <h2>6. Cognitive Stimulation in MS: Why and How<\/h2>\n\n  <p>Cognitive stimulation in MS does not aim to \"cure\" cognitive disorders \u2014 there is currently no curative treatment for cognitive impairment in MS. Its goal is to maintain and strengthen preserved functions, develop compensation strategies, and preserve quality of life by maximizing cognitive autonomy.<\/p>\n\n  <h3>6.1 What Research Says About Cognitive Rehabilitation in MS<\/h3>\n\n  <p>Well-conducted clinical studies show benefits of cognitive rehabilitation on information processing speed and working memory in MS patients. Structured, regular, and sufficiently intense programs (several sessions per week) produce the most significant effects. The important thing is to adjust the intensity to the level of fatigue \u2014 a session that is too long or too difficult can temporarily worsen symptoms.<\/p>\n\n  <div class=\"sep-band\">\n    <h3>\ud83c\udfae CLINT, the DYNSEO app adapted for MS patients<\/h3>\n    <p>The <a href=\"https:\/\/www.dynseo.com\/en\/brain-games-apps\/clint-brain-games-for-adults\/\" style=\"color:var(--blue);font-weight:600;\">CLINT<\/a> app from DYNSEO offers cognitive stimulation exercises specifically designed for adults with cognitive disorders of neurological origin \u2014 including MS. It covers working memory, processing speed, selective and divided attention, executive functions, and language.<\/p>\n    <p>Its short and adaptable sessions (10 to 20 minutes) are particularly suited for individuals whose cognitive endurance is reduced by neurological fatigue. The difficulty level automatically adjusts based on performance, and progress is visualized to maintain motivation.<\/p>\n    <p>CLINT can be used independently by the patient or with the support of a caregiver or health professional (neuropsychologist, speech therapist, occupational therapist).<\/p>\n  <\/div>\n\n  <h3>6.2 Principles of a Cognitive Stimulation Session Adapted for MS<\/h3>\n\n  <div class=\"numbered-card\">\n    <div class=\"num-badge\">1<\/div>\n    <div class=\"num-content\">\n      <h4>Assess Energy Level Before Starting<\/h4>\n      <p>Never schedule a cognitive stimulation session after physical exertion, at the end of the day, or during an episode of intense fatigue. Prefer mornings or early afternoons, after a period of relative rest.<\/p>\n    <\/div>\n  <\/div>\n\n  <div class=\"numbered-card\">\n    <div class=\"num-badge\">2<\/div>\n    <div class=\"num-content\">\n      <h4>Start Slowly and Gradually Increase<\/h4>\n      <p>10 to 15 minutes to start, 3 to 4 times a week. Increase duration and frequency only if the level of fatigue remains acceptable after sessions. The goal is long-term regularity, not immediate performance.<\/p>\n    <\/div>\n  <\/div>\n\n  <div class=\"numbered-card\">\n    <div class=\"num-badge\">3<\/div>\n    <div class=\"num-content\">\n      <h4>Vary Exercises and Domains<\/h4>\n      <p>Memory, attention, language, executive functions \u2014 varying the types of exercises avoids monotony and stimulates different neural networks. Apps like CLINT offer varied catalogs that prevent identical repetition.<\/p>\n    <\/div>\n  <\/div>\n\n  <div class=\"numbered-card\">\n    <div class=\"num-badge\">4<\/div>\n<div class=\"num-content\">\n      <h4>Stop at the first signs of cognitive fatigue<\/h4>\n      <p>Difficulty concentrating, irritability, accumulating errors, feeling \"in a fog\" \u2014 these are the stop signals. Pushing beyond does not provide additional benefit and increases the risk of temporary worsening of fatigue.<\/p>\n    <\/div>\n  <\/div>\n\n  <div class=\"cta-outil\">\n    <div class=\"cta-icon\">\ud83c\udfad<\/div>\n    <div>\n      <h4>DYNSEO Facial Expression Decoder<\/h4>\n      <p>Social cognition disorders \u2014 difficulty recognizing emotions on faces \u2014 are present in a significant proportion of MS patients and contribute to relational misunderstandings. The DYNSEO facial expression decoder is an interactive exercise for training emotion recognition, usable in individual or group sessions with a professional.<\/p>\n      <a href=\"https:\/\/www.dynseo.com\/nos-outils\/decodeur-dexpressions-faciales\/\" class=\"btn-blue\">Discover the tool<\/a>\n    <\/div>\n  <\/div>\n\n  <h2>7. Taking care of the caregiver: family health matters too<\/h2>\n\n  <p>Supporting a loved one with MS is a deep commitment that exposes the caregiver to their own form of exhaustion. Caregivers of people with MS have significantly higher rates of depression and anxiety than the general population. Taking care of oneself is not a luxury \u2014 it is a condition for the sustainability of support.<\/p>\n\n  <h3>7.1 Recognizing caregiver exhaustion<\/h3>\n<div class=\"warning-box\">\n    <p>\u26a0\ufe0f <strong>Signs of caregiver burnout:<\/strong> increasing irritability towards the sick loved one, constant feelings of guilt, neglecting one's own health (postponed medical appointments, poor diet), loss of pleasure in usual activities, feeling \"trapped,\" sleep disturbances, gradual isolation. If you recognize yourself in this description, seeking support is a priority \u2014 not a weakness.<\/p>\n  <\/div>\n\n  <h3>7.2 Resources for caregivers<\/h3>\n\n  <p>The AFSEP (French Association of Multiple Sclerosis Patients) offers support groups for caregivers, information, and a helpline. The LFSEP (French League Against Multiple Sclerosis) provides similar resources. Many hospitals and health networks offer therapeutic education programs that include caregivers. The caregiver's primary care physician should be informed of their role to monitor and support them.<\/p>\n\n  <p>Taking time for oneself \u2014 even a few hours a week, through respite solutions (day care, home help, volunteer work) \u2014 is not abandoning one's loved one. It is preserving the quality of the relationship over time and one's own health.<\/p>\n\n  <h2>8. MS, professional life, and job retention<\/h2>\n\n  <p>Multiple sclerosis primarily affects young adults in full professional activity. Fatigue and cognitive disorders \u2014 slowed processing speed, organizational difficulties, working memory problems \u2014 have a direct impact on the ability to hold a job. However, many adjustments allow for a fulfilling professional life, often much longer than one fears at the time of diagnosis.<\/p>\n\n  <h3>8.1 Rights and professional adjustments<\/h3>\n\n  <p>MS is a chronic illness that grants the right to Recognition of the Quality of Disabled Worker (RQTH), issued by the MDPH. This recognition is confidential (the employer is informed only if the person wishes) and provides access to several provisions: workplace adjustments (adapted hours, telecommuting, ergonomic equipment), assistance from AGEFIPH for private companies or FIPHFP for the public sector, support from Cap Emploi for job retention or retraining, and enhanced protection against dismissal.<\/p>\n\n  <div class=\"tip-box\">\n    <div class=\"icon\">\ud83d\udcbc<\/div>\n    <p><strong>Telecommuting and MS:<\/strong> Telecommuting is one of the most beneficial adjustments for people with MS. It eliminates transportation fatigue, allows work at the best times of the day, permits recovery breaks without colleagues' scrutiny, and removes exposure to heat and temperature variations that worsen symptoms. Since the 2020 law, the occupational physician can recommend telecommuting for medical reasons.<\/p>\n  <\/div>\n\n  <h3>8.2 Managing fatigue and cognitive disorders at work<\/h3>\n\n  <div class=\"numbered-card\">\n    <div class=\"num-badge\">1<\/div>\n    <div class=\"num-content\">\n      <h4>Plan complex tasks at the best times<\/h4>\n      <p>Identify your \"cognitive peak\" of the day (often in the morning for people with MS) and reserve this time slot for tasks that require concentration and thought. Schedule meetings, decision-making, and important writing during these windows of maximum efficiency.<\/p>\n    <\/div>\n  <\/div>\n\n  <div class=\"numbered-card\">\n    <div class=\"num-badge\">2<\/div>\n<div class=\"num-content\">\n      <h4>Systematically use compensatory tools<\/h4>\n      <p>Digital agenda with automatic reminders, systematic note-taking in meetings (dedicated app or simple notebook), deferred proofreading of emails before sending, creation of templates for recurring tasks \u2014 these habits compensate for deficiencies in working memory and prospective memory without colleagues necessarily perceiving the reason.<\/p>\n    <\/div>\n  <\/div>\n\n  <div class=\"numbered-card\">\n    <div class=\"num-badge\">3<\/div>\n    <div class=\"num-content\">\n      <h4>Establish restorative micro-breaks<\/h4>\n      <p>5 to 10 minutes of recovery every 90 minutes of intense cognitive work \u2014 not on social media (which do not help recover), but in passive rest, a short walk, or conscious breathing. These breaks preserve the ability to concentrate throughout the day.<\/p>\n    <\/div>\n  <\/div>\n\n  <div class=\"numbered-card\">\n    <div class=\"num-badge\">4<\/div>\n    <div class=\"num-content\">\n      <h4>Communicate with your supervisor: how far?<\/h4>\n      <p>There is no obligation to disclose your diagnosis to your employer. However, communicating about functional needs (\"I need adjusted hours\", \"I prefer meetings in the morning\") without necessarily explaining why often allows for adaptations. The occupational physician is a key contact: confidential, they can prescribe adjustments without the diagnosis being communicated to the employer.<\/p>\n    <\/div>\n  <\/div>\n\n  <h2>9. Care pathway in MS: who to contact and when<\/h2>\n\n  <p>The management of MS is multidisciplinary. Each professional plays a specific role in supporting fatigue and cognitive disorders, and coordination among them is crucial for the patient's quality of life.<\/p>\n\n  <div class=\"cards-grid\">\n    <div class=\"card\">\n      <div class=\"card-icon blue\">\ud83e\udde0<\/div>\n      <h4>Referent neurologist for MS<\/h4>\n      <p>Global follow-up of the disease, adjustment of baseline treatments, prescription of MRI exams, referral to specialists. The frequency of consultations is generally quarterly to annually depending on the stability of the disease.<\/p>\n    <\/div>\n    <div class=\"card\">\n      <div class=\"card-icon teal\">\ud83e\udde9<\/div>\n      <h4>Neuropsychologist<\/h4>\n      <p>In-depth neuropsychological assessment every 1 to 2 years to map preserved and altered cognitive functions. Implementation of an individualized cognitive rehabilitation program. Psychological support in facing the impacts of the disease on identity and life project.<\/p>\n    <\/div>\n    <div class=\"card\">\n      <div class=\"card-icon yellow\">\ud83d\udcac<\/div>\n      <h4>Speech therapist<\/h4>\n      <p>Rehabilitation of language, verbal fluency, and swallowing. Working on verbal working memory and executive functions in a structured setting. Guidance for relatives on adapted communication strategies.<\/p>\n    <\/div>\n    <div class=\"card\">\n      <div class=\"card-icon pink\">\ud83d\udee0\ufe0f<\/div>\n      <h4>Occupational therapist<\/h4>\n      <p>Assessment of difficulties in daily living activities, prescription of technical aids, adaptation of home and work environment. Implementation of practical compensatory strategies for cognitive and motor disorders.<\/p>\n    <\/div>\n    <div class=\"card\">\n      <div class=\"card-icon blue\">\ud83c\udfcb\ufe0f<\/div>\n      <h4>Physiotherapist \/ APA<\/h4>\n      <p>Exercise program adapted to fatigue and motor symptoms. Prevention of sarcopenia and maintenance of balance. Adapted physical activity reduces neurological fatigue in the long term, contrary to intuition.<\/p>\n    <\/div>\n    <div class=\"card\">\n<div class=\"card-icon teal\">\u2764\ufe0f<\/div>\n      <h4>Psychologist \/ Psychiatrist<\/h4>\n      <p>Depression (present in 50% of MS patients), anxiety, mourning for the \"previous self\" \u2014 the psychological dimension of MS is significant and often insufficiently addressed. Cognitive-behavioral therapy (CBT) shows particular effectiveness in MS.<\/p>\n    <\/div>\n  <\/div>\n\n  <h3>9.1 Reference networks and associations<\/h3>\n\n  <p>In France, several dedicated organizations support MS patients and their families: the French Society of Neurology (SFN) coordinates the OFSEP reference centers (French Observatory of Multiple Sclerosis); the LFSEP (French League Against Multiple Sclerosis) offers information, support, and research funding; the AFSEP (French Association of People with Multiple Sclerosis) provides psychological support and support groups; and the MS Resource Centers (CR-SEP) present in major cities coordinate access to specialized multidisciplinary care.<\/p>\n<div class=\"highlight-box\">\n    <h4>\ud83d\udcf1 DYNSEO cognitive tests: a first home assessment<\/h4>\n    <p>If you or your loved one with MS want to explore your current cognitive profile before a neuropsychological consultation, or track changes between two formal assessments, DYNSEO offers online cognitive tests covering different areas \u2014 memory, attention, processing speed, executive functions. Find all the tests at <a href=\"https:\/\/www.dynseo.com\/nos-tests\/\" style=\"color:var(--blue);font-weight:600;\">dynseo.com\/nos-tests\/<\/a>. These tests do not replace a professional evaluation but serve as a useful complementary tracking tool.<\/p>\n  <\/div>\n\n  <h2>10. MS and family life: preserving relationships when illness invades daily life<\/h2>\n\n  <p>MS does not only affect the diagnosed person \u2014 it profoundly restructures family dynamics. Roles may reverse (a spouse becomes a caregiver), life projects adapt, and children develop an early awareness of fragility and illness. Addressing these relational realities with honesty and tools is essential to preserve the quality of bonds.<\/p>\n\n  <h3>10.1 Couple life when one partner has MS<\/h3>\n\n  <p>MS introduces an asymmetry into the couple that can destabilize a previously balanced relationship. The healthy partner may find themselves in a caregiver role \u2014 managing household tasks, finances, family logistics \u2014 while continuing to pursue their professional activity. This burden, if not named and shared, creates resentment. Conversely, the person with MS may feel guilty for \"not contributing anymore,\" which generates their own spiral of discouragement.<\/p>\n\n  <p>Couple consultations with a psychologist or a therapist trained in chronic illnesses can help renegotiate roles, verbalize needs and frustrations, and preserve the space of complicity and intimacy that the illness can gradually invade. Associations like LFSEP provide references for therapists sensitized to MS.<\/p>\n\n  <h3>10.2 Explaining MS to children according to their age<\/h3>\n\n  <div class=\"table-wrap\">\n    <table>\n      <thead><tr><th>Age group<\/th><th>How to explain MS<\/th><th>What children need<\/th><\/tr><\/thead>\n      <tbody>\n        <tr>\n          <td><strong>3\u20136 years<\/strong><\/td>\n          <td>\"Sometimes dad\/mom is very tired and can't play. It's not your fault and you can't catch it.\"<\/td>\n          <td>Reassurance about the continuity of love, maintaining daily rituals<\/td>\n        <\/tr>\n        <tr>\n          <td><strong>7\u201311 years<\/strong><\/td>\n          <td>Explain myelin, nerve messages, variable symptoms. Show illustrated books about MS for children.<\/td>\n          <td>Understanding why symptoms fluctuate, not feeling responsible for \"bad days\"<\/td>\n        <\/tr>\n        <tr>\n          <td><strong>12\u201315 years<\/strong><\/td>\n          <td>Direct conversation about the illness, its possible evolution, treatments. Invite questions.<\/td>\n          <td>To be included in family reality without being turned into a caregiver, maintaining their own social life<\/td>\n        <\/tr>\n        <tr>\n          <td><strong>16 years and older<\/strong><\/td>\n          <td>Open discussion about family impact, adaptations, long-term projects.<\/td>\n          <td>Not feeling alone as the bearer of information, access to psychological support if needed<\/td>\n        <\/tr>\n      <\/tbody>\n    <\/table>\n  <\/div>\n\n  <h3>10.3 Preventing social isolation of MS patients<\/h3>\n\n  <p>The fatigue and cognitive disorders of MS lead many patients to gradually give up their social activities \u2014 too tiring, too unpredictable, too anxiety-inducing around visible symptoms. This isolation worsens depression, accelerates cognitive decline, and impoverishes quality of life. Proactive strategies allow for maintaining social connections adapted to the new reality of the illness: choosing shorter and more predictable formats (a coffee rather than a dinner), using digital tools (video conferencing) for distant friends, joining an MS support group where the illness does not have to be explained or minimized.<\/p>\n\n<\/main>\n<div class=\"faq-section\">\n  <div class=\"container\">\n    <h2>Frequently Asked Questions \u2014 MS, Fatigue, and Cognitive Disorders<\/h2>\n\n    <div class=\"faq-item\">\n      <h4><span>Q1<\/span> Is fatigue in MS really that different from normal fatigue?<\/h4>\n      <p>Yes, radically. Neurological fatigue in MS is a primary fatigue related to demyelination \u2014 nerve transmission requires much more energy than in a healthy person. It can occur after minimal effort, or even without apparent effort. It does not go away with a good night's sleep. It can be debilitating in the middle of a seemingly calm day. It worsens with heat (Uhthoff's effect). It is not laziness, it is not psychological \u2014 it is a real neurological symptom, documented and recognized by the medical community.<\/p>\n    <\/div>\n\n    <div class=\"faq-item\">\n      <h4><span>Q2<\/span> Do all MS patients have cognitive disorders?<\/h4>\n      <p>No, not all \u2014 but the proportion is higher than one might think. About 45 to 65% of patients experience cognitive disorders at some point in their illness. They can be present from the beginning, even in patients with little physical disability. The most commonly affected area is the speed of information processing, followed by working memory and executive functions. A neuropsychological assessment by a professional trained in MS can accurately map cognitive strengths and weaknesses.<\/p>\n    <\/div>\n\n    <div class=\"faq-item\">\n      <h4><span>Q3<\/span> How to explain to children that their parent with MS \"forgets things\"?<\/h4>\n      <p>Adapting the explanation to the age is essential. For young children (3-8 years): \"Mommy's\/Daddy's brain sometimes sends messages a little slowly or that get lost \u2014 like when the internet is slow. That doesn't mean she\/he loves you less.\" For older children (9-14 years): explain myelin, its function as an insulating cable, and what happens when it is damaged. For teenagers: a more direct conversation about the disease, its fluctuations, and how they can help without becoming full-time caregivers. Age-appropriate transparency protects children better than silence.<\/p>\n    <\/div>\n\n    <div class=\"faq-item\">\n      <h4><span>Q4<\/span> Do MS disease-modifying treatments also affect cognitive disorders?<\/h4>\n      <p>Disease-modifying treatments (interferons, glatiramer acetate, natalizumab, ocrelizumab, etc.) primarily work by reducing inflammation and new brain lesions, which can indirectly slow the progression of cognitive disorders. Some studies suggest that high-efficacy treatments, started early, could better preserve cognition in the long term. But no treatment repairs already impaired cognitive functions \u2014 which is why cognitive rehabilitation and compensatory strategies remain essential as a complement.<\/p>\n    <\/div>\n\n    <div class=\"faq-item\">\n      <h4><span>Q5<\/span> Is the DYNSEO training on MS also aimed at healthcare professionals?<\/h4>\n      <p>Yes, fully. The training \"Fatigue and Cognitive Disorders in MS: What Families Can Do\" is designed to be accessible to families while providing added value to professionals \u2014 nurses, caregivers, occupational therapists, speech therapists, psychologists, social workers \u2014 who support MS patients. It is Qualiopi certified and eligible for OPCO funding for employees or independent professionals in the medico-social sector.<\/p>\n    <\/div>\n  <\/div>\n<\/div>\n\n<main class=\"container\">\n  <div class=\"conclusion\">\n    <h2>Understanding to Better Support<\/h2>\n    <p>Neurological fatigue and mental fog in MS are not excuses or exaggerations \u2014 they are real, documented, and debilitating symptoms. Families who understand these mechanisms can transform their perspective, adapt their communication, and implement strategies that preserve both their loved one's autonomy and their own balance. DYNSEO supports you with practical tools, a tailored cognitive stimulation app, and certified training to make this support an informed and compassionate act of care.<\/p>\n    <a href=\"https:\/\/www.dynseo.com\/courses\/fatigue-et-troubles-cognitifs-dans-la-sep-ce-que-les-familles-peuvent-faire\/\" class=\"btn-cta\" target=\"_blank\">Access the MS training \u2192<\/a>\n  <\/div>\n\n  <div class=\"cta-formation\">\n    <a href=\"https:\/\/www.dynseo.com\/courses\/fatigue-et-troubles-cognitifs-dans-la-sep-ce-que-les-familles-peuvent-faire\/\" target=\"_blank\">\n      <img src=\"https:\/\/www.dynseo.com\/wp-content\/uploads\/2026\/03\/Fatigue-et-troubles-cognitifs-dans-la-sep.png\" alt=\"DYNSEO Training MS Fatigue Cognitive Disorders\" class=\"cta-img\">\n    <\/a>\n    <div class=\"cta-content\">\n      <h4>\ud83c\udf93 Certified Training \u2014 Fatigue and Cognitive Disorders in MS<\/h4>\n      <p>100% accessible online training, Qualiopi certified, eligible for OPCO funding. Designed for families and healthcare professionals who support MS patients. Modules on neurological fatigue, mental fog, adapted communication, cognitive stimulation, and support for caregivers.<\/p>\n      <a href=\"https:\/\/www.dynseo.com\/courses\/fatigue-et-troubles-cognitifs-dans-la-sep-ce-que-les-familles-peuvent-faire\/\" class=\"btn-white\" target=\"_blank\">Access the training \u2192<\/a>\n    <\/div>\n  <\/div>\n<\/main>\n\n<footer class=\"article-footer\">\n  <p>This article was written by the DYNSEO team \u2014 specialists in cognitive stimulation and professional health training for 13 years.<\/p>\n  <div class=\"footer-links\">\n    <a href=\"https:\/\/www.dynseo.com\/en\/brain-games-apps\/clint-brain-games-for-adults\/\">JOE Application<\/a>\n    <a href=\"https:\/\/www.dynseo.com\/nos-outils\/\">All our tools<\/a>\n    <a href=\"https:\/\/www.dynseo.com\/nos-tests\/\">Cognitive Tests<\/a>\n    <a href=\"https:\/\/www.dynseo.com\/courses\/fatigue-et-troubles-cognitifs-dans-la-sep-ce-que-les-familles-peuvent-faire\/\">The training<\/a>\n  <\/div>\n<\/footer>\n<\/div>[\/et_pb_code][\/et_pb_column][\/et_pb_row][\/et_pb_section]","_et_gb_content_width":"","footnotes":""},"categories":[2915],"tags":[],"class_list":["post-683807","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-les-conseils-des-coachs"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.7 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Fatigue and Cognitive Disorders in MS: What Families Can Do - DYNSEO - Educational apps &amp; 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