Many people with epilepsy experience memory difficulties. The symptoms are typically caused by a combination of neurobiological factors, including the underlying cause of the epilepsy and side effects resulting from treatment. In some cases, the memory disturbance may become severe enough to disrupt the individual’s ability to function in the workplace or to perform common activities in the home. In these cases, a referral to a behavioral neurologist or a clinical neuropsychologist may be required for further delineation of the problem and to establish a treatment plan.
An examination by a behavioral neurologist involves more detailed evaluation of memory than what is typically received in a routine neurological visit. In some cases, the patient is referred for neuropsychological testing, which involves another appointment for completion of a 4-6 hour battery of standardized tests. This testing provides an objective means for measuring the severity of the disorder by determining how the individual’s scores on memory tests differ from what is expected, given their age and demographic background.
Many ask the question of whether any drugs have been found to be effective for improving memory. At this time, there is no evidence of any “wonder drug” that has been found to effectively reverse the effects of memory decline. The only FDA-approved medications for memory are limited to the treatment of elderly patients at risk for developing Alzheimer’s disease. Preliminary evidence suggests that these drugs are not likely to be effective for treating memory difficulties in younger patients with conditions such as epilepsy. However, there is a possibility that other drugs, such as the psychostimulants used to treat narcolepsy and/or ADHD, will prove to be more effective for treating memory disorders in younger age groups.
Cognitive remediation is the term that is used to describe a type of therapy emphasizing enhancement of cognitive skills and development of strategies for adapting to impairments in functions including memory. This therapy is conducted either individually or in a group format by a neuropsychologist or another qualified health professional. Most of the existing cognitive remediation techniques have been developed for use with victims of traumatic brain injury. Very little information exists on whether these techniques are helpful for patients with other neurologic conditions, including epilepsy.
Efforts are now underway to develop group remediation techniques aimed at treating the specific types of memory difficulties experienced by people with epilepsy. Participants in these groups are encouraged to share their experiences with memory and epilepsy. Group activities include a psychoeducational program on memory, brain functions, and the various ways that epilepsy may affect one’s memory. There is also specific instruction on the use of external memory devices, including notebook systems, calendars, electronic organizers, and alarms and on the use of internal strategies, including association techniques and the use of imagery for helping memory. Patients receive homework assignments based on techniques learned in the group. For more information about memory groups for patients with epilepsy, call NYU Comprehensive Epilepsy Center at 212-263-8317.