1 / 16

Memory Impairment in Epilepsy

Memory Impairment in Epilepsy. Lawrence Hudson MD MINCEP Epilepsy Care, P.A. Memory Dysfunction in Epilepsy. In the epilepsy clinic, >50% of patients complain of moderate-severe memory impairment Memory is a complex process Memory impairment in epilepsy can be the product of multiple causes.

brede
Download Presentation

Memory Impairment in Epilepsy

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Memory Impairment in Epilepsy Lawrence Hudson MD MINCEP Epilepsy Care, P.A.

  2. Memory Dysfunction in Epilepsy • In the epilepsy clinic, >50% of patients complain of moderate-severe memory impairment • Memory is a complex process • Memory impairment in epilepsy can be the product of multiple causes

  3. Possible Causes of Cognitive/Memory Impairment in Epilepsy • Known cause of epilepsy: meningitis, encephalitis, trauma, malformations/developmental abnormalities • Frequent interictal discharges • Repetitive seizures • Medications • Surgery

  4. Should We Treat Interictal Discharges? Binnie, 2003

  5. Should We Treat Interictal Discharges? Binnie, 2003

  6. Memory consolidation is mediated by the mesial temporal lobe structures The limbic system is a network of connected structures deep in the brain mediating emotional processes and memory.

  7. The Process of Memory Consolidation • Immediate Memory (digit, word span) • Short Term Memory (recall story, lists) • Long Term Memory (delayed recall) • Remote Memory (recall of biographic details or historical events)

  8. Speech dominant (left) hemisphere: Names Word lists Stories Speech dominant (right) hemisphere: Faces Abstract designs Location in space Melodies Material / Hemispheric Specific Memory

  9. Mesial temporal lobe tissue is essential for memory consolidation: H.M. Formation or consolidation of new memories requires functional mesial (deep) temporal lobe tissue in at least one hemisphere. Elimination of both mesial temporal lobes will produce a global amnestic syndrome.

  10. Metabolic inactivity in the epileptic temporal lobe: FDG-PET In epilepsy, the involved temporal lobe often shows Reduced glucose utilization between seizures

  11. Reversable changes in the deep temporal lobe associated with impaired word finding

  12. Decline in Speech Dominant Hemisphere Function With Uncontrolled Epilepsy Progressive decline in performance on tests of word recog- nition with increasing duration of epilepsy Dupont et al. 1999

  13. Decline in Nondominant Hemispheric Function with Uncontrolled Epilepsy Progressive decline in test of figural recall with longstanding uncontrolled epilepsy Dupont et al., 1999

  14. Stabilization of Memory Loss in Epilepsy with Successful Seizure Control Postsurgical increases in FSIQ offset by duration of seizures prior to surgery Dickson et al. 2006

  15. Other Sources of Memory Deficits in Patients With Epilepsy • Psychiatric comorbidity: depression and “pseudodementia” • Medications: anticonvulsants (especially zonisamide, topirimate); effects often overestimated, always reversible • Static deficits related to stroke, anoxia, encephalitis

  16. Memory Impairment in Epilepsy • Memory deficits related to epilepsy may not be reversible, but may not progress if seizures controlled • Early and successful treatment of seizures is critical • Interictal discharges between seizures may also produce memory impairment

More Related