The Relationship Between Memory and Epilepsy
It is not uncommon for people with epilepsy to report problems with their memory. Sometimes these problems are the result of difficulties forming new memories and sometimes they are due to difficulties retrieving or remembering information. These can happen for many reasons, including seizure type, medication side-effects, mood, lack of sleep, age, or as a result of epilepsy surgery.
In October we held a lecture about this topic. The speaker was Dr. Jing Ee Tan. She is a Registered Psychologist with expertise in this subject. She also currently does the pre-surgical neuropsychological assessments for the Epilepsy Clinic at Vancouver General Hospital.
Below is a summary of her presentation along with slides from the presentation.
The presentation started off by identifying the different types of memory.
Procedural Memory refers to the type of activities that you learn to do but can’t necessarily explain it – such as riding a bicycle. Semantic Memory refers the ability to learn basic facts. These include things such as the name of the president of the United States or the meaning of the word “umbrella.” Episodic Memory refers to short-term memory. This type of memory helps you remember things such as what movie you saw a month ago or conversations that you may have recently had.
This diagram explains the formation of new memories. We start by attending to the information, and then the brain processes and encodes the information before it can be stored for retrieval at a different time.
Just like people experience seizures and epilepsy differently, people with epilepsy can experience specific types of effects on memory depending on the cause of the seizures and what part of the brain they originate from.
The severity of memory impairment in people with epilepsy also varies. However, people who only get auras are least likely to be impacted cognitively in the long run as compared to people with complex partial seizures and tonic-clonic seizures. Those who also have seizures frequently are also more likely to be negatively impacted. Individuals who have status epilepticus are most at risk of a sudden drop in memory following each episode. However, experts are still not in full agreement about the effect of seizures on thinking skills because it is difficult to study the long-term effect of seizures due to the multiple factors involved.
1. Medication side-effects
It has been found that negative cognitive side-effects from medications could cause slowing in thinking and attentional problems. This is particularly true for the seizure medications phenobarbital, valproic acid, and topiramate.
2. Sleep problems
People with epilepsy are more likely to have sleep problems due to night-time seizures or a disrupted sleep pattern. People who suffer from chronic poor sleep show problems in focus, concentration, and slowed thinking.
3. Mood problems
People with epilepsy more frequently suffer from mood issues, both because of their reaction to having a chronic medical condition, as well as the chemical changes in the brain as a result of seizures.
How can we protect and improve our memory?
1. Physical aerobic exercise has been shown to be the number one thing that anyone can do for brain health. Even walking an few extra blocks everyday has measurable impact on the memory. Aerobic exercise helps to manage stress, which is a trigger for many people with epilepsy. This may be why people who exercise on a regular basis see a reduction in their seizure frequency. Ideally it is recommended to have 30 sustained minutes of exercise at least three times a week for optimal brain, cardiovascular, and mood benefits.
Food rich in anti-oxidants and omega-3 fatty acids have been found to be great for the brain. Examples of foods that contain these types of nutrients include berries, nuts, and oily fish. Fresh produce, especially dark leafy and bright colour vegetables are also very rich in nutrients that could help brain functioning.
Chronic poor sleep is negative to brain health. Some ways to improve sleep quality and quantity include going to bed and waking up at the same time every day and to keep a specific routine that you do prior to going to bed. This could include having a cup of herbal tea or milk.
If you have difficulties with memory, there are a variety of strategies that can help.
1. Put information into "chunks." It is much harder to remember nine letters in a sequence, but once you put them in three chunks, it becomes much easier.
2. Smart phones and related devices have various functions that are helpful for memory. Alarms can be used for medication reminders. An automated text message could send reminders about meetings. A voice recording function may be useful to record shopping lists.
3. Active learning is also very useful to help with memory. This includes writing summary notes, drawing mind maps for remembering different concepts, and repetition.
4. Using mnemonics and visual cues to remember names and faces such as “tall tom is the accountant with brown spikey hair that looks like a troll” can also help.
5. Use one place for important belongings (such as keys or glasses), and return the item back to the same place.
6. Keep your work desk tidy to reduce visual distracters. Also, when you are working on important tasks, turn off the TV or music to prevent distraction.
7. Practice the method of loci.
For more information on this topic you can also read our information sheet called Epilepsy and Memory. The complete series of these PowerPoint slides are on our Presentations webpage. You can also watch a video recording of this lecture on our website.