Memory And Epilepsy
Memory and epilepsyA self help guide for improving memory functioningin people with epilepsyProduced by Epilepsy Action in association with the Universityof Liverpool. Professor Gus A Bakerepilepsy.org.ukEpilepsy Action Helpline: 0808 800 5050
Epilepsy Action – together we canchange livesTogether we can help more people gain the knowledge andconfidence to live better with epilepsy. We can raise awareness,so that more people understand epilepsy.Together we can: Provide expert information and advice, so everyone affected byepilepsy can get the support they need to live better with epilepsy Run local events and support groups, so that fewer peoplehave to face epilepsy alone Campaign to help make sure health services and national policiestake into account the needs of everyone living with epilepsyIt’s only donations like yours that make this life-changingwork possible.Please donate today.Text ACT NOW to 70700 to give 5 (message will cost 5 plusyour usual cost of sending a text, Epilepsy Action will receive 100%of your donation).You can also join Epilepsy Action and add your voice to the UK’sbiggest epilepsy movement. Together we can campaign for change,support each other and fight for a better future.Find out more by calling the Epilepsy Action membership team on0113 210 8800 or visit epilepsy.org.uk/joinThank you.2Memory and epilepsy
ContentsIntroduction 4What is memory? 4What causes memory problems? 6Memory difficulties in people with epilepsy 8How are people with memory problems affected? 10How are memory problems assessed? 11Tips for improving memory 12Specific memory problems 18Summary 25Hints for helpers 26How to contact us 31Epilepsy Action Helpline: 0808 800 5050epilepsy.org.uk3
IntroductionIt is widely recognised that people with epilepsy commonlycomplain about memory problems. This booklet, written byProfessor Gus Baker and colleagues at the University ofLiverpool, is a clear self-help guide to memory problems inpeople with epilepsy. This information is also useful for carers. Itexplains the difficulties that can be faced and provides simpletips that may help the individual to overcome them.What is memory?Memory is the ability to recall past experience and knowledge. Itis divided into short-term memory and long-term memory.Short-term memory deals with information that is to beremembered over a period of a few minutes, and long-termmemory deals with anything that is to be remembered forlonger than this.Recording the memory in the first place is called encoding. Theinformation is then passed from short-term to long-term memoryfor storage. Long-term memory is divided into three yActivities which arecarried out almostwithout thinking,for example, ridinga bike.Knowledge that has Personal memoriesof everyday life.been acquired butwe are not surewhen, for example,capital cities.Memory and epilepsy
Memory can also be divided into verbal and visual. Verbalmemory is the ability to remember information which isperceived aurally, for example, words and sound. Visual memoryis the ability to remember information that is provided visually,for example in terms of pictures and faces.When we want to remember something, the information weneed is brought back from long-term memory to short termmemory. This is called retrieval.If we have forgotten something it could be due to problems with: Recording the memory in the first place (encoding) The storing of the memory (storage) Recovering the memory from long term memory (retrieval)Epilepsy Action Helpline: 0808 800 5050epilepsy.org.uk5
What causes memory problems?Everybody will experience some minor lapses in memory. Thesecan occur when we are: Under stressTrying to concentrate on a number of things at onceFeeling unwellFeeling tiredAlso, as we get older, lapses in memory can become morecommon. This variation is perfectly normal and nothing to beconcerned about.However, memory problems can be much more pronouncedand long-term. They can be caused by a number of things, forexample: 6A dementia type illness such as Alzheimer’s diseaseAn infection of the brain, for example encephalitisA shortage of oxygen to the brain, as in cerebral palsyHead injuryCertain types of strokeA brain tumour or brain haemorrhageEpilepsy, on its own or with one of the aboveMemory and epilepsy
It is worthwhile noting that the cause of some of our memoryproblems may be due to another problem, which is resulting inimpairment in memory. Some examples are given below.An attention problemIf we do not pay attention to the information we are presentedwith then this information is not recorded by our memory.A language problemSometimes in conversation we find it hard to find the word thatwe are looking for. This can be misinterpreted as forgettingwords.Anxiety and depressionPeople with an altered emotional state often experience memorydifficulties. Those who experience anxiety can find their mind istoo occupied with worrying thoughts to concentrate on thingsaround them. Those who are low in mood can also feel lethargicand low in motivation, therefore lacking the attention needed torecord a memory.Sleep disturbancesIf we are not getting enough sleep then we can experiencedifficulty concentrating, which again disrupts our attention toinformation.Epilepsy Action Helpline: 0808 800 5050epilepsy.org.uk7
Memory difficulties in people withepilepsyThe presence of memory difficulties in people with epilepsy iswell recognised. In fact people with epilepsy seek help formemory problems more often than for any other impairment.There are a number of reasons why people with epilepsy mayhave memory difficulties.Epileptic seizures can affect memory functioning because, inorder for memory to work properly, the brain needs continuousself-monitoring. This self-monitoring system can be disruptedduring a seizure. Memories before a seizure can be lost, as theyhave not been fully incorporated into our memory system.During a seizure our memory may also be affected, because aloss of consciousness can interfere with normal brain processes,disrupting the encoding and storage of information. Theconfusion that can occur following a seizure can also preventour memory from working properly. Some people with epilepsycan experience unusual electrical activity within the brainbetween seizures and this can also affect attention and memoryfunctioning.Research has shown that a large portion of memory is locatedin a specific area of the brain known as the temporal lobe.8Memory and epilepsy
An underlying brain tumour or lesion can disrupt the memoryprocess. Therefore if a tumour or lesion is located in thetemporal lobe, this may also cause memory problems.Some epilepsy medicines may interfere with memory functioningas they can affect the speed at which the brain can processinformation. On the other hand they also reduce seizurefrequency and, as we have discussed, frequent seizures can alsocause memory impairment. If you are worried your medicinesmay be affecting your memory, it is important to speak to yourdoctor about your concerns. They can investigate this possibilityand will discuss possible solutions with you.Epilepsy Action Helpline: 0808 800 5050epilepsy.org.uk9
How are people with memory problemsaffected?Memory problems can affect people in different ways. It may bethat a person’s memory problems are very general, and willtherefore affect most areas of memory functioning. Howeverthey can also be very specific and might only affect one aspect ofmemory functioning, such as remembering what people tell you.Memory problems can cause a range of difficulties, making itdifficult to cope with everyday living and relationships. Thesedifficulties can cause a great deal of distress for the personaffected. However, while a memory problem cannot be cured, itis possible to adapt to having a memory impairment, making iteasier to cope and live a relatively normal life.10Memory and epilepsy
How are memory problems assessed?In order to get an accurate assessment of your memory function,the doctor may suggest carrying out a neuropsychologicalassessment. Neuropsychological simply means looking at theprocesses that the brain carries out, one of which is memory.This assessment aims to get an accurate idea of how well yourmemory is currently functioning and will be carried out by apsychologist. It will look at all areas of your memory ability.More specifically it will be looking at your ability to rememberpictures, stories and numbers. Through looking at these areas,the psychologist will be able to discover where your memorydifficulties lie and if there is any difference between your: Visual memory (your ability to remember pictures) and Verbal memory (your ability to remember informationpresented orally)This information then provides some focus on which tips forimproving memory are going to be the most helpful to you.Epilepsy Action Helpline: 0808 800 5050epilepsy.org.uk11
Tips for improving memoryIt is possible to find ways of adapting to living with memoryproblems. Various methods can be used to help people withmemory problems store and recall memories more effectively.Possible ways of doing this are: Following a set routineAdapting your surroundingsUsing external memory aidsUsing ‘mnemonics’ (see page 14)Improving general wellbeingDifferent methods can be combined to help you adapt to living withmemory problems.12Memory and epilepsy
The following section will outline these methods in more detail.It is likely to take some time to get used to using the variousmethods which can help to enhance your memory. There maybe some ‘trial and error’, and it will require effort on your part.However, experience has shown that, once incorporated intoyour lifestyle, these methods can be extremely effective andbeneficial. It is worth noting here that the key to making thesemethods work effectively is organisation and establishing aroutine, as this reduces the demands placed on your memory.Following a set routineIt cannot be stressed enough how important following a routineis to improving your memory. Having a routine means you canget used to what to expect, which helps reduce the demandsplaced on your memory. A lot of people find it useful to make anote of their regular activities in their diary or on the calendar.Also, always doing things at certain times of the day, for examplealways taking medicines with breakfast, can help some people.Adapting your surroundingsBy adapting your surroundings you will have less need to useyour memory, and therefore reduce the difficulties you canexperience. This can be achieved in a number of ways: Keeping a note pad by the phone to take messages Using a notice board for important information Having a particular place to keep things, such as keys andglasses, and always putting them in the same place Labelling cupboards to remind you what goes in themEpilepsy Action Helpline: 0808 800 5050epilepsy.org.uk13
Using external memory aidsThere is a wide range of external memory aids and the mostimportant thing is to choose something that you feelcomfortable with. What suits one person may not necessarilysuit another. For example, pictures or diagrams may be moreuseful for people who find reading difficult.Possible memory aids Diary/calendar Notebook Lists, for example shoppinglists Alarm clock or timer Mobile phone with alarm Wall chart or wipe cleanmemo board Tape recorder or digitalvoice recorder Pill reminder box formedicines Post-It notes Photo album or memorybook Smartphone appGetting used to a new memory aid can be quite demanding andit may take you a little while. However, the more you use amemory aid the easier it will become to incorporate into youreveryday life. Eventually it will seem like second nature.It can be easier to use memory aids that you are more familiarwith. For example, if you like using modern technology then youmay find personal organisers and computer diaries work for you.However, if you are not keen on computers, pen and papermethods such as diaries and calendars may be easier to use.14Memory and epilepsy
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MnemonicsA mnemonic is a verbal or visual aid which helps us to rememberinformation, usually in the form of sayings, rhymes or pictures. Forexample to remember the colours of the rainbow some peopleuse the rhyme:Richard Of York Gave Battle In VainRed Orange Yellow Green Blue Indigo Violet.Some people find visually pairing items can be useful; one suchmethod is known as the peg method. ‘Pegs’ are used to help youto remember a list of items. Each number is given a rhymingvisual cue – ‘one - bun, two - shoe, three - tree, four - door andso on. Using this method you would visualise the first thing youwant to remember and associate it with a bun. Other people tryto remember information in the form of a story they have madeup. These are only suggestions of methods you could use. Oftenthe best thing is to be imaginative and make up ones that arepersonally relevant and work for you.Combining a variety of methods to enhance memoryPeople with memory difficulties can often find it helpful to useseveral aids or methods, so that if one method fails there willbe another one as a back-up. Writing on the calendar and usingan alarm to remind you of an appointment is one example. Itcan take time to establish a memory system but, once it hasbeen set up and is used frequently, it can be very effective.16Memory and epilepsy
Improving wellbeingLiving with memory problems, you may often feel vulnerable andunsure of yourself. Given the practical difficulties of memoryproblems you may experience some anxiety. Anxietymanagement and the use of relaxation techniques can thereforebe beneficial. Your GP will be able to give you advice on whereyou can get information on this.Factors causing a reduction in wellbeing can include a loss ofstructure to your daily routine (for example losing your job) ora general loss of independence, status or role. This can beexaggerated if it is accompanied by other factors, such as aninability to drive and a dependence on others. Improvements inwellbeing can be achieved in a number of ways, for examplethrough developing new activities or hobbies. It can also behelpful to talk to others experiencing similar problems and tofind out if there are any organisations or support groups in thearea that may be useful.Epilepsy Action Helpline: 0808 800 5050epilepsy.org.uk17
Specific memory problemsSome of the most common difficulties people with memoryimpairments can experience are: Remembering to do somethingRemembering people’s namesRemembering where you put somethingRemembering what people tell youRemembering what you are readingRemembering how to get somewhereThe following section will outline how these problems can bemade easier to cope with and which methods will work well forparticular problems. These are only suggestions to give you anidea and you may think of others that you find more useful.Remembering to do something Leave things near your outside door before you go out, forexample, letters you need to post Programme watches or organisers to sound an alarm atcertain times to remind you to do something If possible, do things immediately rather than later on Keep a pen and paper handy at all times Use diaries, wall charts and calendarsPeople often forget if they have done a particular task (such aslocking the door). A way to improve this type of memory is tosay out loud what you are doing at the time you are doing it.18Memory and epilepsy
Remembering people’s namesRecording the information1.Listen carefully.2.If the name is unusual, ask them to spell it.3.Think about whether you like the name or not.4. If you’re introduced to several people, make an excuse torepeat back their names, for example “Let me make sureI’ve got your names right.”5. Try to use the name as often as possible in your initialconversation, for example “Glad to meet you John”. Whenyou say goodbye, repeat the name.Epilepsy Action Helpline: 0808 800 5050epilepsy.org.uk19
6. Repeat the name after a short interval. And remember,most people enjoy hearing their name being spoken.7. If it’s a foreign name, alter the way it sounds to make itmore meaningful to you.8. Split a long name into shorter words.9. Some names may be easy to pair with a visual image, forexample, Mr Butcher.10. Form a link between the person you meet and someoneyou know with the same name, or a famous personality. Tryto find some similarities.11. Keep rehearsing the names you learn every few hours ordays.12. Try associating the name with a prominent feature on theperson’s face.Recalling the name1.Try not to panic!2. Think through each letter of the alphabet in turn to see if ittriggers your memory for the person’s name.20Memory and epilepsy
3. Think of the situation where you first learned the name,and anything about the situation that you may have linkedwith the name.4. Say something like “I remember you very well but yourname has just slipped my mind for the moment”.5. Greet them and say your own name; they may instinctivelyrepeat theirs. If all else fails, you can often chat withoutsaying their name.Remembering where you put something1. Try to be well organised. Spend a little time each dayputting things back that you have put out of place. Setspecific places for things.2. Make a list of things that you lose quite often and make aspecial habit to put them back in the right place.3. Stop and think each time you put something away.Concentrate for a few seconds and look at the particularplace you put them.4. Find a connection between the object and the place thatyou are putting it. For example, if you put your keys in a cup,imagine yourself drinking with a large key in your handrather than a cup. This should help you when you try toremember where you put the key.Epilepsy Action Helpline: 0808 800 5050epilepsy.org.uk21
5. When you park the car, try to park it near the exit or neara ticket machine, and then look at it a few times as you walkaway and concentrate on where you left it.6. Once you have put something away try to think of it, andwhere you have put it, at intervals afterwards. Try to makethe intervals a little longer each time.Remembering what people tell you1. Write the message down. It is useful to do this in anorganised, meaningful way. You could make parts of themessage stand out by writing in a different colour orunderlining.2. Try to think about what you are hearing, for example doyou agree or disagree with it?3. When trying to remember numbers, group them together,for example 2-7-4 could be remembered as two hundredand seventy four. Telephone numbers can be rememberedin a similar way. Or try to find a meaning to the number. Forexample 2-7-4 could be somebody’s birthday (27th April) –the 27th of the fourth.22Memory and epilepsy
4. In the case of a list of things someone has asked you to door buy, it can be helpful to try and associate items in the listwith each other. This can be achieved by grouping certainitems together, depending on a category they belong to ormaybe using the first initial of each item to make up a word.So to remember to get bread, eggs, sugar and tea use theword ‘best’. It may also be useful to associate this word withthe place that you are going, so you could imagine GeorgeBest playing football in the aisles of your local supermarket.More unusual associations are usually more likely to stick inyour memory.5. If you have forgotten a message then try to remember detailsabout it, such as who gave it to you, where you were whenyou got the message and what you were doing at the time.This may jog your memory.Remembering what you are reading1. In general, it is useful to try and group the material that youare reading into subheadings and then go over thesubheadings each time
Memory and epilepsy. Epilepsy Action – together we can . change lives . Together we can help more people gain the knowledge and confidence to live better with epilepsy. We can raise awareness, so that more people understand epilepsy. Together we can: ovide expert information and advice, so everyone affected by Pr
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What is epilepsy? 3 Memory 4 Memory problems 5 Memory and epilepsy 6 Improving memory 8 Problem areas 10 Finally 11 This guide explains why people with epilepsy can have memory problems. This leaflet explains why. It also gives some ideas for improving memory.
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