Skip to Accessibility Tools Skip to Content Skip to Footer
Face Blindness: A Closer Look at Two Types of Cognitive Dysfunction

Face Blindness: A Closer Look at Two Types of Cognitive Dysfunction

How embarrassing.

While I was feeding pop cans into the return depository at the grocery store the other day, a woman suddenly planted herself in front of me and said “Hi, how are you?” in a very familiar manner. I didn’t know her from Adam.

“Fine thanks, and you?” I said, trying to act cordial while I racked my brain to remember where I’d seen her. But she wasn’t fooled.

“I’m Patty, Ann’s daughter,” she reminded me, looking a bit uncomfortable. I can’t say I blamed her. The same thing happened to me once, only the recipient wasn’t friendly and I turned three shades of purple before walking away. I felt bad that I’d rattled her, too. And really stupid that I hadn’t retained a memory of her face. Ann was my neighbor, and I’d seen Patty a few of times very briefly in passing whenever she walked through the grass behind my apartment complex on her way to her mother’s patio door.

“Oh, yes, of course, I’m sorry,” I said, smiling through my embarrassment. I vowed to emblazon her face on my brain promptly thereafter. Two weeks later, I was sitting in the waiting room of my doctor’s office. A door opened directly in front of me and a woman emerged, looking straight at me with a hesitant look, but said nothing. Then an older woman emerged behind her. It was my neighbor, Ann, whom I recognized immediately, and we said hello. At once I realized that yet again I’d failed to recognize the first woman as being Patty. What could I do? The next time I encountered her was at my apartment complex, walking past her near Ann’s patio in the backyard again. I knew she was Patty and said hello, noting that location had everything to do with the recognition. She was heading to her mother’s patio door to go inside and from her stride, hair and body shape I knew she was Patty and not some other relative or friend, but no other details. I’m not sure I’ll ever recognize her out in public, away from these identifying clues. This kind of lapse has happened before with neighbors when I lived in other venues, and only after I was diagnosed with MS in 2005.

If this kind of thing has happened to you, know that there can be MS-related reasons for it. Studies have shown that problems in structural integrity of the ILF and IFOF, which are white matter tracts, are present in those subjects having facial recognition dysfunction—but only if they exist in the right brain. For more details, see Ed Yong’s article in the reference section at the bottom of the page.

In an article written for MSFocus magazine, author and PwMS Jeffrey N. Gingold described failing to recognize his own wife, Terri, as a manifestation of this kind of cognitive dysfunction. He calls it “delayed recognition,” which can occur randomly. The episode with his wife happened while they were sitting on their couch and he suddenly felt what he called a “loss of presence.” He looked over at the woman seated next to him and struggled to figure out who she was. It took several minutes to re-orient himself and complete the connection between his wife’s face and its historical/emotional context that ultimately made her familiar and endearing.

Gingold went on to state unequivocally the importance of revealing delayed recognition to his loved ones. He substantiates his position by turning the tables on himself and realizing that if a loved one had a recognition problem, he would want to know about it so he could help out and they could work through it together. “I’ve learned to not challenge the lapses,” he writes. “Fortunately, they quickly vanish, unless I prolong the disorienting moment by dwelling on it. If I challenge the instinct to go on with life, then I become more of a bystander, not wanting to do or say anything wrong.”

Another form of cognitive dysfunction among people with multiple sclerosis is impaired ability to recognize emotional facial expressions. A 2014 study tested a cohort of 61 MS patients with unimpaired visual acuity and 53 healthy controls. Also investigated were possible relationships between impaired facial expression recognition and other clinical features such as depression. The result showed that MS patients were not impaired in facial identity discrimination, but showed a poor performance in all subtests that required emotion recognition. The study concluded that impaired recognition of facial emotions by patients with MS seems to be associated with both cognitive and affective (depression) aspects of the disease. (See complete study abstract below)

Whether we struggle with face recognition or emotional facial expression recognition, the biggest impact is felt in our confidence to remain social despite these difficulties. If we bravely choose to get back in the ring and participate, we must also remind ourselves to reveal our problems to those around us. Doing so can make it so much easier to enjoy being in the company of others. It also gives others the opportunity to help out on their end, and to learn something new about how MS affects us.1-3

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. Gingold JN. Missing Faces: Facial Recognition Loss Something to Talk About.*
  2. Yong E. Faulty connections responsible for inherited face-blindness. Not Exactly Rocket Science, Science Blogs. Published November 24, 2008.
  3. Berneiser J, Wendt J, Grothe M, Kessler C, Hamm AO, Dressel A. Impaired recognition of emotional facial expressions in patients with multiple sclerosis. Mult Scler Relat Disord. 2014 Jul;3(4):482-8. doi: 10.1016/j.msard.2014.02.001. Epub 2014 Feb 12.
*Jeffrey N. Gingold is the internationally acclaimed author of the award-winning book, Facing the Cognitive Challenges of Multiple Sclerosis, as well as Mental Sharpening Stones: Manage the Cognitive Challenges of Multiple Sclerosis.


  • Suzy Farmer
    3 years ago

    Thank you thank you thank you!

    I have struggled with facial recognition for years. Having MS for over 25 years now not sure when it first started happening but a while ago. So nice to hear that there is a reason for it!
    My neurologist has never mentioned it – and I have suffered in shame so many, many times! As a writer, I also suffer from word id. I know what I want to say but the word will not come. I can tell you what the word means etc., but cannot spit out the word. Again, my neurologist has no help for it.

  • Kim Dolce moderator author
    3 years ago

    Hi Suzy, thanks very much for your comments. I totally feel you about not being able to access a word directly even after defining it. It does come eventually, kind of like turning over a Magic 8-Ball and waiting a whole hour for the answer to float up through the blue dye and finally appear in the window.

    My neuro did mention Aricept as a possible medication for cognitive problems. It’s a standard med for dementia patients.

    I hope you can explore some of the options I mentioned in the article. Sometimes our docs don’t keep up with the literature and we have to self-educate. I wish us both well on keeping our wits about us 🙂


  • chalknpens
    3 years ago

    It was February, half-way through the school year, when a student came up to my desk to ask if he could schedule an after school help session. I had no idea who he was, nor if he was one of my 100 students. I knew I would need to retire then.
    My neurologist had told me I had “innumerable lesions” on my brain, and in my spine. I did not have mobility issues. I have what are called ‘benign’ invisible symptoms, and they don’t relapse or remit … they just are. Short term memory, name recall, face recall, inability to make decisions … all fatal for a school teacher. But I look fine.
    When I retired, I changed doctors, stopped taking DMD injections, and seem to have recovered some of what I had lost. I now run my own business (retail fabric/quilt shop) and have regained my self respect. But I cannot learn new names … I do not recognize many people I knew well. But quilters are kind people, and life is good again.

  • DonnaFA moderator
    3 years ago

    Hi chalknpens, thanks so much for sharing your story. To me, it seems a lovely tale of acceptance and grace, and finding the phoenix of reinvention in your path. We’re glad your here! -Warmly, Donna ( team)

  • Meagan Heidelberg moderator
    3 years ago

    Hi Chalknpens – thank you so much for reading and being a part of our community! We are so glad to hear that you have recovers some of what you lost since changing regimens and doctors. Our community members definitely recommend getting second opinions.
    We want you to know you’re certainly not alone not being able to recognize people! Thank you for commenting,
    Meagan, Team Member

  • Poll