Memory and epilepsy
The more intelligible a thing is, the more easily it is retained in the memory.
The true art of memory is the art of attention
Memory disturbances are the most common cognitive complaint of people with epilepsy.
Advances in Epileptology, volume 17, Raven Press, 1989.
In psychology, the word memory is used to refer to the ability of our brains to retain the things we have learned.
We all have times when we cannot think of things which we know we have learned. We may be tired. We may be working outside our usual environment. We may have too much on our minds. There can be many reasons.
Memory is actually quite a slippery term. It is not quite the same thing as our ability to recall material. We sometimes talk about our memory failing us, when really it is our ability to recall that is giving us trouble.
There are many things we can do to improve our ability to commit material to memory, and there are many strategies we can use to help us recall what is there. Perhaps one of the most important things we need to be aware of is the quality of the input into memory. If we are careful about our input we are more likely to have less difficulty with remembering.
How well we remember depends on many things including our general health and well-being, our level of concentration, our attention span, and how motivated we are by the material we are trying to learn.
Many writers have recognised the important links between memory and our feelings, emotions and general well-being.
What is the situation for people who have epileptic seizures? Is there reason for more concern? What are the facts?
It is generally agreed that memory function improves as the control of seizures improves.
"There are many different factors affecting memory. These include the underlying cause of the epilepsy, seizure type, frequency and severity of seizures, undetected seizures [sub-clinical attacks], psychosocial factors such as mood and expectations and antiepileptic drugs."
Thompson, antiepileptic Drugs and Memory, Epilepsia 33 [Supplement6]:S37-S40, 1992
"Short and uncomplicated seizures cause no permanent or progressive neurological dysfunction in humans."
Duncan, Shorvon, Fish, Clinical Epilepsy, Churchill Livingstone 1995, page 313
"Isolated and brief seizures do not generally cause people to forget material that has recently been learned, even when the seizures cause impairment of consciousness."
Bergin, Thompson, Fish and Shorvon, The effect of seizures on memory for recently learned material, Neurology 1995:45:236-240
Some interesting considerations
Memory is a "notoriously faulty and unreliable faculty" [Ref 1] for everyone. So if you do believe that you have memory problems, it does not necessarily follow that it is because of your epilepsy.
Many people with epilepsy do not have any particular difficulties with their memory and a wide variety of different tests show that many people with epilepsy have very good memories, while others fall well within the standard range on standardised memory tests.
Memory problems often seem to arise when we are anxious, depressed, overworked, sleep deprived or heavily medicated.
While many people may feel they experience a decline in their memory as they grow older, many others do not. Assumptions that older people are automatically less able to learn and to commit things to memory are outmoded. Many older people are extremely capable learners and have excellent recall.
There are many parts of the brain important to memory and the mature brain does not really need all of the neurones provided at birth.
With the application of strategies aimed at reducing stress, anxiety, depression, and poor levels of fitness - both physical and mental, and by learning and practising strategies and techniques designed to support our memory, we can do much to help ourselves.
Finding out about various strategies and techniques for improving our memories is not enough. We need to actually practise those techniques for them to become effective tools for us.
"The most common problems for people with epilepsy are "tip of the tongue" difficulties, losing things and having to go back to check whether something was done."
Corcoran and Thompson, Everyday Memory Complaints associated with Epilepsy, Seizure 1, Supplement A,14/09, 1992
"People who complained of memory problems were significantly more depressed and anxious than non-complainers."
Corcoran and Thompson, Epilepsy and poor memory: Who complains and what do they mean? British Journal of Clinical Psychology , 32, 199-208
What are some of the strategies or techniques known to help memory?
There are many different strategies and techniques and there is a wide range of books, videotapes and audiotapes available which will help you find out about them.
Some people find some strategies more helpful than others, and often enough, it is not until you practise these techniques that you really get the hang of them and see their value in your life.
Sometimes we need to pay attention to the way we learn things. Other times we need only worry about being able to recall material.
Writing an entry in a dairy, for instance, is not done so that we learn it or commit it to memory. It is simply an aid to being able to recall something that needs to be attended to on a particular day.
On the other hand, learning how to use a diary or a personal organiser in the first place is about committing things to memory.
Some of the many things which can be used to help us commit things to memory and to then be able to recall them, include word associations, mnemonics, word substitutions, numbers, images, linking items, using prompts such as events, sensations, thoughts, pictures, smells, tastes and so on.
Some people actually find the use of repeated absurd phrases, crazy rhymes and songs very helpful.
Writing reminders, using diaries and reminder notes can help a great deal. As can organising ourselves better. Routine can also be a great help.
If we crowd too much into the time we have at our disposal, of course we will get disorganised and overloaded. Courses and materials on time management and personal organisation can also be very useful.
In fact, anything that makes us more motivated, more alert, more selective in what we need to remember or more responsive to the material we need to remember is worth considering.
With the assistance of many people including doctors and neuropsychologists, we can do a lot to lessen any memory problems we are experiencing.
The neuropsychologist, in particular, is trained to undertake memory assessments which involve a careful consideration of our background, our present life circumstances, and our medical history, as well as observations and tests that identify not only deficits, but more importantly, provide valuable recommendations for improving memory by maximising on our strengths.
If we can work towards overcoming poor attention, negative expectations, inactivity, fatigue, lack of organisation, having our vision and hearing checked, and if we can enjoy a balanced diet without too many excesses, we will be doing much to enhance our memory.
Improving memory is a matter of developing good learning habits
Ultimately, though, the big challenge lies with ourselves so that we use the memory aids which work for us.
For more information on epilepsy and memory . . .
Why not consider attending one of the popular memory workshops held at the Epilepsy Foundation where the emphasis is on sharing of tips and strategies. Enjoy the many varied resources on this topic available in our members' library.
Reference committee: Dr Lindsay Vowels, Dr David Andrewes, Margot Boyle, Marie Vita, Russell Pollard