Memory
Living with memory difficulties
Throughout our lives memories are being made, stored and found by our brain. Links made between our brain cells help us to remember the thoughts, skills, experiences and knowledge that make each of us unique. Memory can be one of the key issues that affects people with epilepsy. This can be for many reasons, including the type of seizures they have, the effects of medication, the effect of concentration or mood, lack of sleep or age, or the effect of epilepsy surgery.
For people with memory problems, there are many tools and techniques that might be helpful in managing memory problem, including 'to do' lists, alarm reminder and using a diary, and ways to try and remember information such as alphabetical searching and using sayings or rhymes.
How does memory work?
Memory is the brain’s ability to store information and find it again later. Chemical and electrical changes happen in the brain when new memories are made. Making and using memories involves three stages: learning the information, storing it, then recalling it again. Memory can be affected if any of these stages are disrupted, for example by a break in concentration.
Learning
This is 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 address – '1 Albert Square' to the television show Eastenders.
Storing
This is when the information learnt is stored permanently in the brain.
Recalling (finding the information)
This is the brain’s way of finding and using the information that has been learnt. For example remembering a friend’s new address when sending a letter.
Types of memory
Long-term memory
This is information stored over a long time. There are many types of long-term memory:
- Semantic memory
This is memory of knowledge and facts about people, places and things. For example, recalling that a banana is a yellow fruit, or that Edinburgh is the capital of Scotland.
- Episodic memory
This is memory about events or episodes in our lives. For example, conversations, holidays or recalling your first day at school. Episodic memories are personal and different for everyone.
- Prospective memory
This is memory for doing things in the future. For example, recalling a doctor’s appointment next week or sending a card for a friend’s birthday.
Procedural memory
This is memory for skills and how to do things. For example, knowing how to ride a bike or to tie a shoelace. These tasks often require effort to learn but once learnt are rarely forgotten.
Short-term memory
Also called 'working memory' or 'attention span', short-term memory is information that is only kept for the length of time you need to use it. Most people can usually keep about seven to nine letters, words or numbers in their mind at once. 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 your brain doesn’t store it. This type of information is easily forgotten unless we try to store it in our memory.
How does epilepsy affect memory?
It is not unusual for people who have epilepsy to have memory problems. Problems may happen for any or all of the following reasons.
Seizures
Any type of epileptic seizure could potentially affect your memory, either during or after a seizure. If you have lots of seizures then memory problems might happen more often.
Some people have generalised seizures that affect all of the brain. Others have focal seizures (sometimes called partial seizures) that affect only part of the brain. Some people have generalised and focal seizures.
If you have focal seizures, the way your seizures can affect your memory will depend on where in the brain your seizures happen.
The brain has two halves called hemispheres. Each half has four parts called lobes: the occipital, parietal, temporal and frontal lobes. Abnormalities in the temporal or frontal lobes of the brain are the most common reason for memory problems in people with epilepsy.
The left temporal lobe is important for verbal memories such as learning names and remembering facts for exams. If you have seizures that start in this area you may have problems remembering words, and get stuck mid-sentence.
The right temporal lobe is important for visual memories like remembering a person’s face or finding your way around a place.
The frontal lobe is important for prospective memory. Seizures in this area can cause problems remembering to do things in the future.
After a seizure
You may have difficulty remembering information straight after a seizure. This is sometimes called post-ictal (after-seizure) confusion and it usually goes away once you have recovered. The length of time it takes for memory to return to normal can vary from person to person.
If you have temporal lobe epilepsy you may have memory difficulties even if your seizures are well controlled. This is because the temporal lobe is responsible for creating memories.
Do anti-epileptic drugs affect memory?
Memory problems can sometimes happen due to the side effects of anti-epileptic drugs (AEDs). Drowsiness or attention problems can affect your short-term memory, and may make it more difficult to learn and store new information.
You may be more likely to have memory problems if you take high doses or more than one type of AED. Memory problems rarely disappear completely following drug changes but taking AEDs may help to improve memory by making seizures less frequent or by stopping them completely. If you are concerned about the effect of AEDs on your memory, you could talk to your doctor.
Other things that can affect memory
Mood and concentration
Often the way you feel can affect how well you are able to remember information. Feeling confident or happy can affect the way the brain works by increasing your ability to concentrate and take in information. If you feel anxious or stressed it may be more likely that your brain will have difficulties at the ‘learning’ stage. Also, when you have trouble recalling information, worrying might make it harder to find the correct information.
Lack of sleep
Tiredness, lack of sleep or feeling unwell can affect concentration and memory. For some people lack of sleep can make them more likely to have seizure, for others it may be that seizures during the night causes them to be tired. Not getting enough sleep can also contribute to memory problems.
During sleep our brains process information and experiences. Research suggests that getting good quality sleep can help to make memories more stable and preserve our long-term memory.
If you have problems with sleep you could talk to your GP or consultant about referral to a specialist sleep clinic.
Age
As we get older, storing and recalling information can be more difficult. This might be because of the way the brain changes physically, and also because 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 chance of you forgetting things.
Surgery
Memory problems are frequently reported following surgery for epilepsy. This is most common with surgery to the temporal lobe.
Memory assessments are carried out before and after surgery, but even if the surgery stops your seizures from happening you may have memory problems afterwards.
Using memory aids and reminders
Anyone can have problems remembering information. Keeping your brain alert and active is a good thing but, on its own, may not necessarily improve memory.
Memory aids may help you to cope with memory problems. Different aids or reminders may suit different types of memory problems and they work best if they are used regularly as part of a routine. Here are some ideas:
- Sticky notes
Sticky notes, such as Post it Notes™ can help you to remember to do things. For example, sticking a note to the front door to remind you to pick up your keys before you go out.
- Calendars
Using a calendar can be helpful, particularly if it is placed somewhere you will see it easily and often, such as on the fridge door.
- Diaries, journals and ‘to do’ lists
Using a diary can help you to keep note of appointments, birthdays and phone numbers. Keeping more detailed notes in a diary may be helpful to keep track of people you have met, where you have been and what you did. A diary can also be a handy way of recording seizures.
- A 'to do’ list can be useful to record daily tasks, for example phone calls to make, bills to pay. Email, mobile phones and computer software often include diaries and 'to do' lists.
- Drug wallets
Drug wallets can help to remind you to take your 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, and can be removed if you are going out and want to take your medication with you. Some have an alarm to remind you when to take your medication. Drug wallets can also be used to check if you have taken your medication to avoid taking it twice by mistake.
Alarms and mobile phones
Alarm clocks or watch or mobile phone alarms may be a useful reminder in your daily routine. For example, reminding you to take your medication or feed a pet.
Many mobile phones also have a reminder function. With this you can write a message and set a date and a time for the phone to send the message to you or to set an alarm. This can be a useful way of remembering everyday tasks as well as something that is not part of your usual routine, for example a dentist’s appointment.
Smartphones can access the internet to download software applications (apps) which add functions to your phone. There are many different apps available, some include memory aids, others give useful information. Epilepsy Society has an app for iphones and android phones that gives first aid information, a step-by-step guide to the recovery position, and basic information about epilepsy.
Other memory techniques
Some memory techniques can help the brain to store and find information. They often need practice and may not be suitable for everyone. They may be helpful when you can’t use memory aids, such as in an exam.
These techniques often use rhymes, stories or images to help you to link ideas to make a stronger memory. Here are a few ideas for dealing with some common memory problems.
Remembering a word that’s ‘on the tip of your tongue’
If you have trouble remembering a word, alphabetical searching may help. In your head go through the alphabet asking yourself if the word you’re looking for begins with ‘a’ ‘b’ ‘c’…etc.
If this does not work, try using a different word. If you are talking to someone at the time, you may want to tell them that it’s not the word you were looking for. They may try to help by suggesting the right word.
Remembering someone’s name
Often the easiest way to avoid embarrassment is to ask someone to remind you of their name. The following techniques might also help.
- When you meet someone for the first time concentrate on their name, repeat it to yourself and use it while you talk to them.
- Imagine a picture of the person that has something to do with their name. For example, Mr Bridge sitting on a famous bridge.
- Use a rhyme, for example Joan always moans or Mr Shah drives a sports car.
- Physical features can help you to remember names, for example you could imagine Mr Pearman as a curvy pear.
It may be helpful to write the name down and try to think of a way to remember it later.
Remembering where you put something
Concentrating while you put things away can help you to avoid losing items. Take a few seconds to make a picture in your mind of the object in the place you’re putting it.
Going over in your mind what you were doing the last time you had the missing item is another technique. However physically going back to where you were is often helpful.
It can be helpful to have a filing system, a standard routine, or places to keep things. Putting your keys in the same place means you will 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 sayings or rhymes
Sayings or rhymes are often used to revise for exams and to recall information. Using the first letter of each word in a sentence can help you to remember a list. For example, Richard of York gave battle in vain, can remind you of the colours of the rainbow: red, orange, yellow, green, blue, indigo and violet.
Using pictures or mind mapping
Drawing a picture that represents what you are reading or revising may help you to recall the information. Mind maps, or ‘spidergrams’, where you draw a diagram or map of the information using keywords or phrases can also be helpful.
Preparing for exams
These ideas may help you revise for exams:
- Revising in a quiet place where you won’t be disturbed or distracted, can help you to focus on what you’re doing.
- When you revise try to link what you are reading to a personal experience or something you already know. This may help you to recall the correct information.
- 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 alert.
- When the exam begins you may find it helpful to quickly write or draw your revision aids on rough paper. This may help you to remember what you have been revising.
Brain training
This involves doing computer-based mental exercises. There are several 'brain training' packages available. Companies who promote brain training claim that doing these exercises regularly increases brain power and improves memory and other brain functions. Although some people find these exercises challenging and fun, independent research has shown that brain training does not improve memory performance in every day life.
memory assessments
The NHS provides memory assessments to people with memory problems. Assessments are usually done by neuropsychologists who can advise on ways to manage memory difficulties.
If you think a memory assessment would be helpful, you can ask your GP or specialist to refer you for one.
You can order a copy of our 'memory' leaflet from our online shop as part of our 'first five free' offer.
© Epilepsy Society
Information produced in August 2012.
