How does epilepsy affect memory?

How and why does epilepsy affect memory?

Many people with epilepsy report having problems with their memory. In fact, it is one of the most common issues for which epilepsy patients seek help. 

Memory issues can be caused by any of the following:

Seizures

Any type of epileptic seizure can have an impact on memory, either before, during or after. Our brain is constantly monitoring itself to encode, store and retrieve information which we interpret as memories. During a seizure, sudden bursts of electrical activity interrupt this internal monitoring, which can keep memories from being formed, stored or retrieved.

Some epilepsy patients have generalised seizures that impact the entire brain, while others have focal (partial) seizures that impact only a part of the brain. Some patients may even have both. Seizures can affect memory during any of these phases:

• Before a seizure - memories created before a seizure can be lost as the encoding and storing processes are disturbed.
• During a seizure - loss of consciousness during a seizure prevents memories from being recorded and stored.
• After a seizure - confusion after a seizure (called post-ictal confusion) is common and can cause difficulty in remembering information. It usually subsides as the patient recovers.

Anti-epileptic medicines

Certain medicines used to treat epilepsy (sometimes called anti-epileptic drugs or AEDs) can cause side effects that affect memory as they slow down the excessive electrical activity in the brain. They can cause concentration issues or drowsiness that can affect short-term memory and make it hard to learn and remember new information.

Inversely, AEDs help to reduce the number of seizures, so for some patients they can actually help improve memory.

Temporal lobe damage

The brain has two hemispheres, or halves, made up of four lobes: the occipital, parietal, temporal and frontal. Research into brain activity has determined that much of our memory processes occur in the temporal lobe, so seizures in this part of the brain can cause memory issues:

• Damage to the right temporal lobe: This part of the brain is essential for visual memory, such as remembering faces or navigating around a particular physical setting. 
• Damage to the left temporal lobe: This lobe is important to verbal memory, such as learning names and facts, so patients who have seizures in this part of the brain may have trouble remembering words and may have problems speaking.

Surgery

If AEDs are not helping to control epilepsy seizures or if scans show that the seizures are isolated to one small area of the brain, surgery is a possible treatment option. Some patients report experiencing memory problems post-surgery, particularly after surgery on the temporal lobe. Though surgery may help to ease or stop seizures from occurring, it may also cause temporary or permanent memory problems.

Emotional health and well-being

Epilepsy can take a toll on patients’ everyday lives, adding stress or anxiety or causing sleep problems. Stress and lack of sleep are known to have a significant impact on concentration and memory, as our brain processes information while we sleep and has a harder time creating and storing memories while under stress

How to cope with memory issues caused by epilepsy?

While memory problems caused by epilepsy can be frustrating, there are a few techniques that can help you cope with it:

• Focus on what is most important - No one, whether they have epilepsy or not, can remember everything. When you have something you need to remember, try to focus on the most important aspects and ignore the rest.
• Repetition - Repeating what you need to remember out loud forces you to process the information in two different ways (through listening and speaking). By thinking about, speaking, and hearing the information you create more connections in your brain and are more likely to remember.
• Make lists - This one may seem obvious, but by writing down minor things or tasks you need to complete, you clear out space in your brain to focus on remembering more important information instead of tomorrow’s grocery list or. 
• Be kind to yourself - We all have memory slips at some point or another, so try to not dwell on them when they happen. Remember that no one is perfect and try to learn from your lapse. 
• Work your brain - We’ve all heard the adage “your mind is like a muscle”, right? Well there’s some truth to it; an active brain helps to keep memory strong! Try to find a subject or hobby that interests you and exercises your brain. Learn a new language, take up a musical instrument, read a challenging book, take up jigsaw or crossword puzzles, the choice is limitless!

Though memory issues caused by epilepsy can be frustrating or difficult to accept, understanding how and why it occurs and adding some memory-strengthening techniques to your tool belt can hopefully help you to manage it better!

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