People with epilepsy often report memory concerns and/or memory problems. The most common form of epilepsy-related memory problems are with immediate, recent (short-term), and prospective memory. It is less common for epilepsy to affect long-term memory.
We have different types of memory. Some of the main types are:
Memory of the past/recent few seconds. This memory fades very quickly without effort to hold on to it or if you are distracted.
Recent Memory (Short-term Memory)
Memory of the last few minutes, maybe hours. Like immediate memory, recent memory fades away after that.
“Permanent” memories of things you have learned or memorized. There may be no real time limit or maximum amount of information you can store.
Long-term memory for how to do things that may be hard to put into words such as tying shoelaces or riding a bicycle. Similar to “muscle memory”.
Long-term memory you can put into words. There are two main types:
- Semantic Memory – Long-term memory for facts and information.
- Episodic (autobiographical) – Memories tied to a person’s life at a specific time and place.
Memories from the distant past.
Remembering to do something in the future. (For example, remembering to pick up milk on the way home.)
Why do people with epilepsy have memory problems?
- If someone loses consciousness during a seizure, they won’t be able to form new memories based on what is going on around them.
- Some people will be conscious during a seizure, but can’t really pay attention to their surroundings and they will probably be unable to form memories during that seizure.
- If the seizure is in the hippocampus (the part of the brain that helps form new memories), the person may be unable to create new memories during that seizure.
- Unusual brain activity between seizures can disrupt thinking and memory making.
- Damage to the brain (particularly the hippocampus) is often connected to problems with memory. In some cases it is unclear if the damage is due to epilepsy or if the epilepsy was triggered by the damage.
Surgery can result in memory changes in some people, but not everyone. In fact, many people can have surgery and experience no noticeable change in their memory. There are many factors that help determine if surgery will lead to memory challenges, including:
- how memory was functioning before surgery
- where in the brain the surgery will take place
- how much surgery the neurosurgeons will do
Even if it is likely that there will be memory change due to surgery, there is no guarantee that a person’s memory will be affected when they have surgery.
Memory problems can be more frequent with older anti-seizure medications like Phenobarbital or Tegretol. Many of the newer medications tend to have fewer side effects. One exception is that some people taking Topamax have trouble with concentration and attention, which can affect memory.
When anti-seizure medications affect memory, it is often related to the dosage. In those cases, the memory problems are likely reversible if a doctor reduces the prescribed dosage or prescribes another medication. Of course, controlling seizures with the right medication is important too.
How to Improve Memory
Diet and Exercise
People who eat a balanced diet full of vitamins and minerals and lower in fat and cholesterol tend to have better thinking and memory abilities.
After light to moderate exercise, people have a brief period of improved memory. People who maintain a semi-regular exercise routine where they get up and move around may have better memory function than those who don’t have some regular activity.
High levels of stress cause an increase in the hormone cortisol. Small amounts of cortisol for a brief period of time can be helpful. High levels of cortisol over a long time can worsen memory. Luckily, the effects of increased cortisol tend to be reversible once stress is reduced. Stress reduction can sometimes help improve memory.
Try activities that relax you and make you feel better. You could try meditation, yoga, and other relaxing activities. Talk with a doctor about physical activities like yoga before trying them to make sure that you take any necessary safety precautions.
Do things you enjoy to stimulate thinking, including reading, socializing, doing puzzles and games.
If you’re having difficulty with memory, there are a number of strategies that you can use to work around these challenges.
1. FOCUS ATTENTION
- Focus on the information you want to remember.
- Be choosy about what you want to pay attention to.
- Reduce distractions. Work in a quiet place. Clear your desk except for the material you need.
- Reduce multi-tasking. Do one thing at a time.
2. EMPHASIZE KEY INFORMATION
- Picture yourself doing the activity you want to remember, such as turning off the stove or locking the door.
- Say what you’re trying to remember out loud. (e.g. “I’ve turned off the stove”). It’s a form of repeating it and this makes the brain think about it in a different way.
3. ADD MEANING
- Put the information in a context that helps explain why it’s important.
- Add unusual meaning like a visual image. The more unusual or odd the meaning, the better. This is very good for names.
- Use rhymes or sayings to remember things. (e.g. In the year 1492, Columbus sailed the ocean blue.)
- Look for patterns. Break a long series of numbers into chunks. (e.g. phone numbers)
4. REPEAT INFORMATION IN DIFFERENT WAYS
- Instead of going over and over the information, review the information in smaller chunks spread out over time.
- Start with a very short space between repetitions.Then repeat the information at gradually increasing intervals. (e.g. immediately, 5 sec, 10 sec…5 min, 15 min)
- Do something else during that time.
- If you forget the information, go back to shorter intervals.
- Always put important things in the same place. (e.g. keys, phone, etc.)
- Use logical locations. (e.g. place your keys on a hook and your phone on the counter)
- Don’t use this for everything, just for a few important things.
- Organize lists by categories.
- On your shopping list put meat items together and dairy items together in separate sections.
- Organize your To-Do list by the order of tasks, their importance, or some other logical order.
- You may have to recopy your list to do this, but it will help.
6. WRITTEN REMINDERS
- Post-It notes are great if you carry them with you.
- A notebook is good, but a planner or organizer is better. They have organization built in with a calendar, a contact or phone numbers list, and task lists.
- If you use a paper organizer, you can carry post-it notes with you to add little items to remember for short periods of time (e.g. where you parked).
- The organizer should be small enough that it’s easy to carry it with you.
- Determine a set place for it when you have it at home.
- Check the organizer regularly at set times (e.g. morning and night or at meal times).
- You can use an electronic or paper organizer. Each of them have pros and cons.
Strategies for Parents and Teachers
- Get the child’s attention early. Children can’t remember what they don’t pay attention to in the first place.
- Establish routines to help children know the when and where of activities.
- Keeping things in the same places will help children know where to find them.
- Help the child learn memory strategies. For example, when you teach left and right, have them hold both hands up in the shape of an L. The hand with the forward-facing L is the left one. To help them remember how to read a word with two consecutive vowels, tell them, “When two vowels go walking, the first does the talking.”
- Ask the child questions about events that encourage them to remember details. When you talk about a recent movie, for instance, ask “What was your favourite part?” or “What did the hero do?” Fill in the details if they cannot provide them.
- If the child has to memorize material, have them break the material down into manageable parts and work on the most difficult sections first.
- Find ways to relate the content you’re discussing to things the child already knows. Connect new information to the child’s own life and interests.
- Bring in concrete examples for the child to explore so the content becomes a meaningful part of their experience.
- Use hands-on activities. Children remember content better when they experience it forthemselves.
- Use tools that best suit the child. If a child has verbal memory problems, use pictures, photographs, illustrations, videos, or diagrams. Encourage them to create images or “pictures in their head. If a child has visual memory problems, use verbal or descriptive strategies
- Repeat information. Children remember information better if they have practice using it more frequently. Integrate lots of review in your teaching. Provide the child with activities that will allow them to practice previous information often.
- Writing things down in order to remember them is a practice called “external memory.” Teaching the child to keep an assignment notebook and a student calendar can help them remember to do things.
- Teach older children to use aids such as timers on watches that signal them to do specific events or to use a calendar app on tablets and smart phones.
- Children retain information better if they actively think through new information, rather than simply repeating it.
Strategies for Teachers
- Evaluate your student’s understanding of concepts in ways that do not rely solely on memory. For example, use projects and open-book tests that emphasize memorization.
The information on this page was adapted from the Spark sheets “Epilepsy and Memory (Children) and “Epilepsy and Memory (Adults)” (Epilepsy Ontario, 2015). Download a pdf of the parent and teacher strategies here and the rest of this information here.