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Epilepsy and Memory Impairment

August 12, 2020

For many people living with epilepsy, memory impairments are an all-too-common reality.

They’re obvious barriers to a person’s general quality of life. But in terms of managing seizures, memory impairments also make it hard to track and recall how many seizures one had in the past month, or whether they’ve taken their medication on time at the correct doses—all enormously important factors to guide better seizure management and medication adjustments.

Memory impairments from epilepsy can be due to numerous factors—including neurological, pharmacological, and psychological causes—and can manifest in various ways depending on the individual.

Epilepsy can sometimes affect a person’s ability to recall verbal, visual, procedural, or autobiographical information, and memory problems are especially prevalent during and after a seizure.

Common impairments include having difficulty forming sentences or remembering words, problems recalling visual or other sensory stimuli, temporarily forgetting how to do certain tasks, and struggling with short- or long-term memory loss.

Neurological Causes

Seizures themselves can cause electrical disruptions in the brain that directly interfere with memory. Certain types of seizures—particularly focal seizures—are more likely to cause impairments in memory, especially if the seizures affect regions of the brain that process memory, like the hippocampus and frontal lobes.

After a seizure, it’s common to experience impaired memory in an altered state of awareness called the postictal state. During this state, it can be difficult to remember what happened leading up to, during, and after a seizure.

Pharmacological Causes

Sometimes, medications used to control seizures can cause problems in attention and memory. Some anti-epileptic drugs, or AEDs, can also interfere with memory processing by causing side-effects like drowsiness and loss of concentration.

Psychological Causes

In addition to the neurological and pharmacological causes of memory impairment in epilepsy, it’s important to consider that psychological factors can play a role too. A coexisting mental health disorder, such as depression or ADHD, can cause changes in mood and deficits in attention that interfere with memory. Since mental health disorders are relatively common in people with epilepsy, it’s important to assess whether psychological causes are a contributing factor.

Treatment Options

For many people who experience memory impairments due to epilepsy, it can be a frightening and confusing experience. Fortunately, there are ways to help prevent memory loss and improve a person’s quality of life.

First and foremost, if a person with epilepsy is experiencing memory problems, it’s essential that they talk to their doctor and work together to identify the underlying cause of impairment.

Using a seizure diary is an excellent way of keeping track of information like seizure frequency, side-effects from medication, and fluctuations in mood—all of which are valuable data points that help a clinician create an effective treatment plan.

Other interventions may also be appropriate, such as undergoing a psychological evaluation or getting diagnostic imaging tests—like an EEG—to help narrow down the cause of memory impairments.

There are also behavioral techniques that show promise in helping people with epilepsy improve their memory. A skill-building program called HOBSCOTCH, developed by Dartmouth-Hitchcock Medical Center, may help people with epilepsy improve their attention, memory, and overall quality of life.

At the end of the day, memory impairments due to epilepsy are often manageable with proper medical support and behavioral interventions.

For more information, check out part two of our series on memory and epilepsy!

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