NSE : Information on epilepsy: Memory and epilepsy, memory problems related to seizures and epilepsy

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Information on epilepsy: Epilepsy and memory

Living with epilepsy and memory difficulties

Throughout our lives memories are being made, sorted, stored and found by our brain. Links made between our brain cells helps us to remember the thoughts, skills, experiences and knowledge that make each of us unique.

How does memory work?

Memory is the brain's ability to store information and then find it again later. Chemical and electrical changes happen in the brain when new memories are made. When a person remembers something for the first time, there are usually three stages:

Learning
This happens when you want to learn something new, such as a friend's new address. It may involve repeating the address several times or linking it to an existing memory. For example linking the new address, 1 Albert Square, to the memory of a favourite television show.
Storage
This is when the information learnt is stored permanently in the brain.
Retrieval
This is the brain's way of finding (recalling) what has been learnt. For example recalling your friend's new address when sending a letter.

Your memory might be affected if any of these stages are disrupted, for example, by a break in concentration.

Types of memory

There are many types of memory.

Long-term memory

This is information stored over a long time. It can be divided into two main types:

semantic memories: knowledge and facts about people, places and things are called semantic memories. An example of a semantic memory would be recalling that a banana is a yellow fruit, or that Edinburgh is the capital of Scotland.
episodic memories: remembering events or episodes in our lives, such as past conversations or recalling your first day at school, are called episodic memories. Episodic memories are personal, and so are different for everyone.

Remote memories

These are memories about events from the distant past, for example, from childhood. Most people find it easy to recall details and events from the distant past. This is usually because they have often thought or talked about them in the years since the event first happened.

Recent memories

These are memories about things that have happened a few weeks or months ago. For example, remembering the name of your hotel after a recent holiday.

Prospective memory

This relates to doing things in the future, such as remembering to cancel the papers before going on holiday, or sending a card in time for a friend's birthday.

Procedural memory

This is recalling the way to do a certain job or task. For example knowing how to ride a bike or tie a shoelace.

Short-term memory

This is sometimes called working memory or attention span. This is the amount of information you can keep in your mind at any one time. Most people can usually keep about seven to nine letters, words or numbers in their mind at once. This will be forgotten in minutes unless they try to commit the information to memory.

In short-term memory, information is only kept for the length of time you need to use it. An example of your short-term memory working is remembering a telephone number while you dial. Because you only need this type of information for a short time the brain doesnt store it.

How epilepsy can affect memory

It is not unusual for people who have epilepsy to have difficulties with their memory. If you have epilepsy, you may experience problems with your memory for any or all of the following reasons.

Seizures

Any type of epileptic seizure could potentially affect your memory. If you have lots of seizures then memory difficulties might happen more often.

Some people have seizures that affect all of the brain at once: these are called generalised seizures. Others have partial seizures, affecting only part of the brain, and some people have both generalised and partial seizures. Memory problems can happen in both cases.
More information about seizures

If you have partial seizures, the way your seizures can affect your memory will depend on where in the brain your seizures happen. The brain has two halves (hemispheres). Each half has four parts called lobes. They are the occipital, parietal, temporal and frontal lobes. The different lobes of the brain are important for different types of memory.

If you have seizures in your frontal lobe you may have problems remembering events coming up, or tasks to do in the future, because this part of the brain is important for prospective memory.
Some people who have seizures in their temporal lobe may have difficulty remembering new things because the temporal lobe is responsible for new learning.
If you have seizures that start in the left side of the brain, you may have problems remembering words, and get stuck in mid-conversation when you cannot think of the right word. This is because the left side of the brain is usually the side that controls language and words.

After a seizure

Some people find that straight after a seizure they have difficulty remembering information. This is sometimes called post-ictal confusion and it usually goes away once the person has had time to recover. The length of time it takes for memory to return to normal can vary from person to person. Even after fully recovering from a seizure some people find that their memory is permanently affected.

Anti-epileptic drugs (AEDs)

Memory difficulties can sometimes happen because of the side effects of taking AEDs, such as drowsiness or attention problems. These side effects can affect short-term memory and may make it more difficult to learn and store new information. There may be a higher chance of you having memory difficulties if you take high doses of medication or more than one type of AED.

Controlling seizures with AEDs may help to improve memory. This improvement is probably not due directly to the AEDs, but because the seizures are less frequent or have stopped completely, and so seizures have less effect on your memory.
Information on medication for adults
Information on medication for children

Surgery

Some people can have surgery to stop their seizures from happening. Even if you stop having seizures because of surgery, you might have memory difficulties afterwards. This could happen if the part of the brain operated on is used for memory.
Information on surgery

Other factors that can affect memory

Mood

The way you feel has an effect on how well you are able to remember or recall information. Feeling confident or happy affects the way the brain works, increasing your ability to concentrate and take in information. The more anxious or stressed you feel, the more likely it is that your brain will have difficulties at the 'learning' stage. Also, when you have trouble recalling information, panicking or worrying might make it harder to find the correct information. Tiredness, lack of sleep or feeling unwell can also affect concentration and memory.

Age

In general we have more difficulty storing and finding new information as we get older. This might be because of the way the brain changes physically. But also as we go through life the demands on our memory can change.

Managing different areas of your life such as work, family, study and social life, can be complicated, and may increase the chances of you forgetting things.

Managing memory difficulties - using memory aids and reminders

Anybody can have problems recalling information, and so memory difficulties are common. Keeping the brain alert and active is a good thing but may not necessarily improve memory.

Below are various aids that can help you cope with memory difficulties. Different aids or reminders may suit different types of memory problems.

Memory aids work best if they are used regularly as part of a routine. Here are some ideas for memory aids and how to use them.

Post-it Notes
Using sticky notes in obvious places may help you remember to do certain things. For example, sticking a note to the front door to remind you to pick up your house keys before going out.
Diaries, journals and 'to do' lists
Diaries can be a useful way to keep note of appointments, birthdays and phone numbers. Keeping more detailed notes in a diary or journal may be a helpful way to keep track of people you have met, where you went and what you did. A diary can also be a handy way of recording seizures.
'To do' lists can be a useful way to record daily tasks, for example, phone calls to make, bills to pay and remembering to put the recycling out.
Seizure diaries are available from the online shop
Drug wallets
These remind you to take medication and how many tablets to take. They usually hold seven small containers to keep medication in, one for each day of the week. Each container is divided into sections usually marked morning, afternoon and evening.
The containers can be removed if you are going out for the day and want to take your medication with you. Some drug wallets also have an alarm to remind you when it is time to take your medication.
Drug wallets are available from pharmacies and from the NSE online shop.
Alarms and mobile phones
Setting alarm clocks or using the alarm on a watch or mobile phone may be a useful reminder as part of a daily routine, for example reminding you that its time to take your medication, or feed the goldfish.
Many mobile phones also have a reminder service. With this you can write a message and then set a date and a time for the phone to send the message to you. As well as for everyday tasks, it can be a useful way of remembering to do something that is not part of your usual routine, for example meeting a friend at the airport.
Hand held computers
Personal digital assistants (PDAs) or other hand-held devices often have memory aids such as diaries, to do lists, alarms and reminder messages.
Other people
Asking a friend or relative to remind you to do something may be helpful.

Managing common memory problems

Memory techniques can help the brain to store and find information. They often need practice and may be difficult to use at first. But they can be helpful when memory aids arent suitable or cant be used, such as in exams. These techniques often use rhymes, stories or images to help you link ideas together.

There are lots of different memory techniques, and often more than one technique for each problem. Here are a few common memory challenges and ways to deal with them.

Remembering a word that's 'on the tip of your tongue'

If you have trouble finding a word there are ways that may help you to think of it. One strategy is alphabetical searching:

in your head go through the alphabet asking yourself if the word you're looking for begins with 'a' 'b' 'c'etc. If this doesn't work try the next step
concentrate on the letters that seem to be most likely and think about, or say out loud, the letter or combination of letters
if the first two steps haven't helped within about five minutes, stop trying to think of the word and it may eventually come to you.

If alphabetical searching does not work, you could try using a different word. If you are talking to someone at the time, you may want to tell them that its not the word you were looking for. Often the person you are talking to will try to be helpful and suggest the right word.

Remembering someone's name

Sometimes you don't need to use a person's name when speaking to them face to face. If you need to use their name and youve forgotten it then simply asking them to remind you is often the quickest and easiest way to avoid embarrassment. The following strategy could help you to remember their name the next time you meet:

When you meet someone for the first time, concentrate on their name, repeat it to yourself and use it while you talk to them.
Imagining pictures can be helpful to try to make the name more memorable. To do this make an image of the person that has something to do with their name or appearance. The sillier and more detailed the image is, the more likely you are to remember it. If your new neighbour is called Mr Farrington you could picture him far off in the distance trying to carry a very large and heavy diamond ring that weighs a ton.

Remembering where you've put something

Concentrating while you put things away can reduce the chance of losing items. Take a few seconds to make a mental picture of the object in the place you're putting it. This may make it easier to recall where you put it the next time you need it.

Another technique is going over in your mind what you were doing the last time you had the missing item. This is sometimes called mental retracing.

It can also be helpful to have a filing system, a standard routine or particular places to keep things. Hanging your keys up in the same place when you come home means you will always know where they are. Making a note in your diary of where you have hidden a birthday present may help you to find it later.

Using exam techniques as memory aids

There are many different revision aids and techniques people use to prepare for an exam, which can also be used to help manage memory difficulties.

Using mnemonics
Mnemonics are sayings or rhymes that help you remember and recall information. A mnemonic for remembering the colours of the rainbow is: Richard of York gave battle in vain, to help remember the colours red, orange, yellow, green, blue, indigo and violet.
Using pictures or mind mapping
Some people find it easier to remember pictures than words. If you can draw a picture that explains what it is you are reading or revising, then remembering the picture may help you to recall the information.
Mind mapping is drawing a diagram of the information, often with a key word or phrase at the centre of the diagram.
Finding a connection
When revising try to link what you are reading to a personal experience or something you already know. Making such a connection makes it more likely that you will recall the correct information again.

Preparing for exams

If you are taking exams these ideas might help alongside other techniques or memory tools:

Revise somewhere quiet where you won't be disturbed or distracted, to help you stay focused on what you're doing.
Test yourself before the exam. Past papers or revision guides can help.
Try to get a good night's sleep before the exam. The brain's ability to recall information works better when it's been rested and feels alert.
When the exam begins you may find that quickly writing or drawing their revision aids on rough paper before looking at the questions can help you recall what you have been revising.

Assessing memory

The National Health Service (NHS) is able to provide memory assessments for people who are having memory difficulties. Memory assessments are usually done by a psychologist who can also advise on ways to manage memory difficulties.

If you think a memory assessment would be helpful for you, you can ask your GP or specialist to refer you for one.

UK Epilepsy Helpline: 01494 601400
Monday - Friday 10am - 4pm