Epilepsy :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 someone wants 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 more permanently in the brain.

  • Retrieval

This is the brain’s process of finding (recalling) what has been learnt. For example recalling your friend’s new address when sending a letter. 
A lapse in memory might happen if any of these stages are affected, such as by a break in concentration.

Types of memory

There are many types of memory.

Long-term memory

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

  • Memories of 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.
  • Memories about events or episodes in our life are called episodic memories. For example past conversations or recalling what film you saw on your first date. Episodic memories are different for everyone.
Remote memories

These are memories about events from the distant past such as 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. Recalling the name of your hotel on holiday after coming home is an example of a recent memory.

Short-term memory

This is sometimes called working memory or attention span. This is the amount of information a person can keep in their mind at one time. A person can usually keep about seven to nine letters, words or numbers in their mind at once. This will be forgotten in minutes unless the person tries to commit the information to memory.

In short-term memory information is only remembered for the length of time you need to use it. So remembering a telephone number while you dial is an example of short-term memory working. Because you only need this type of information for a short time the brain doesn’t store it.

Prospective memory

Memories that relate 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 are called prospective memories.

Procedural memory

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

Epilepsy and memory

It is not unusual for people who have epilepsy to have difficulties with their memory. Someone may experience memory problems for one, some or all of the following reasons.

Seizures

Any type of epileptic seizure has the potential to affect a person’s memory. If a person has lots of seizures then memory difficulties might happen more often.

The way seizures affect a person’s memory will depend on which part of the brain the seizure happens in. The brain has two halves (hemispheres). Each half has four parts called lobes. They are called the occipital, parietal, temporal and frontal lobes. The different lobes of the brain are important for different types of memory. For example:

  • People who have seizures in their frontal lobe may have problems remembering to do things in the future, because that part of the brain is responsible 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.
  • People who have seizures that start in the left side of the brain may have problems remembering words and get stuck in mid-conversation when they cannot think of the right word. This is because the left side of the brain is usually the side that controls language and words.

Depending on the type of seizures they have, some people have memory problems during a seizure. Other people find that straight after any type of seizure they have difficulty remembering or recalling 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. More information on seizures.

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 have an effect on short-term memory and may make it difficult to learn and store new information. There may be a higher chance of someone having memory difficulties if they are taking high doses of medication or more than one type of AED.

Controlling seizures with AEDs may help to improve memory, but this improvement is probably not due directly to the AEDs. Stopping seizures from happening might lower the effect that seizures have on a person’s memory.

Surgery

Some people can have surgery to stop their seizures from happening. Memory problems might happen after surgery, even if the person stops having seizures. This could happen if the part of the brain operated on is important for memory. 

Mood

The way someone is feeling has an effect on how well they are able to remember or recall information. Feeling confident or happy about things affects the way the brain works. It increases the brain’s ability to concentrate and take in information. The more anxious or stressed a person feels the more likely it is that their brain will have difficulties at the ‘learning’ stage. Also, when a person has trouble recalling information, panicking or worrying might make it harder to find the correct information.

Age

In general people have more difficulty storing and finding new information as they get older. This might be because of the physical change that becoming older has on the brain. But it can also be that as someone becomes older they may have more demands on their memory. Such as from work, family and their social life. This in itself may increase the chances of them forgetting things.

Dealing with memory difficulties

It is not unusual to have problems recalling information. Keeping the brain alert and active is a good thing but may not necessarily improve memory. Many improvements in memory can come from using techniques to avoid, or make up for, any memory difficulties. The type of memory difficulties someone has affects what sort of aids or techniques may be suitable for them.

Memory aids

These are reminders and tools that can help someone remember to do something. Using memory aids can be an easy way to help manage memory difficulties. They can ease the need for a person to remember things by themselves. 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 ‘must-do’ lists. Diaries can be a useful way to keep note of appointments, birthdays and phone numbers. Keeping a more detailed version of things may be a helpful way for someone to keep track of people they have met, where they went and what they did. A journal like this might also be a handy way of recording seizures if they happen. ‘Must-do’ lists can be a useful way to record daily tasks, for example, phone calls to make, bills to pay and remembering to set the video recorder.
  • Drug wallets.These work as reminders to take medication and how many tablets to take. The wallets 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 a person is going out for the day and wants to take their medication with them. Some drug wallets also have an alarm to remind people when it is time to take their medication. Drug wallets are available from pharmacies and from the NSE online shop.
  • Other people.Asking a friend or relative to remind you to do something may be helpful.
  • Alarms. Setting alarm clocks or using the alarm on a digital watch may be a useful reminder as part of a daily routine, for example reminding a person what time to take their medication.
  • Mobile phone.Many mobile phones have an alarm clock feature, but some also have a reminder service. This service lets a person write a message and then programme which date and at what time the phone should send the message to them. Because it sends a message as well as ringing, it can be a useful way of remembering to do something that is not part of a person’s usual routine, for example meeting a friend at the airport.
  • Hand held computers.These can now offer most of the above memory aids.

Techniques for improving memory

Memory techniques can help to improve the brain’s storing and finding of information. They often need practice and may be difficult to use at first. But they can be helpful when memory aids aren’t suitable or can’t be used, such as in exams. These techniques try to make information easier to recall by adding rhymes, stories or images.

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

Forgetting a word that’s ‘on the tip of your tongue’
If you have trouble finding a word there are a number of steps that may help the word come to you. 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, mouth, or vocalise 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.

Searching through the alphabet can take time and isn’t always suitable so it might be better to use a different word. If it happens while you are talking to someone it might help to tell them that it’s not the exact word you were looking for. Often the person you are talking to will suggest the right word.

Forgetting someone’s name

Sometimes you don’t need to use a person’s name when speaking to them face to face, so if you can’t remember their name it might not matter. If it is essential to use their name and you’ve forgotten it then asking them outright to remind you is often the quickest and easiest way to avoid embarrassment. The following steps might help you remember names:

When meeting someone for the first time concentrate on their name, repeating it to yourself and using 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 higher the chances are that you will 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.

Forgetting where you’ve put something

Concentrating when putting something away can reduce the chance of losing items. Take a few seconds to make a picture in your head that links the object to 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.

Sometimes memory aids such as having a good filing system, particular places and routines might be more helpful. Hanging your keys up in the same place when you come home means you will always know where they are. Writing down where you have hidden a birthday present in your diary a few days before the event may help you remember where you put it.

Using exam techniques

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.
  • Turning notes into pictures. 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 this could make it easier to recall the information during an exam.
  • Finding a connection. When revising try to link what you are reading to a personal experience or something you already know. Making a connection like that 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 to help you stay focused on what you’re doing.
  • Before the exam try to get a good night’s sleep, the brain’s ability to recall information works better when its been rested feels alert

When the exam begins some people find that quickly writing or drawing their revision aids on rough paper before looking at the questions can help their brain to recall what they 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. Referrals for a memory assessment are usually made from a person’s GP or from their specialist.

UK Epilepsy Helpline: 01494 601400
Monday – Friday 10am – 4pm
© The National Society for Epilepsy
April 2004